Abstract
Objective/Purpose: To evaluate risks and impacts of COVID-19, SARS-CoV-2, on a private retina practice in Ohio and share initial strategies and guidelines to maintain a sustainable and safe practice. Design: A retrospective analysis was performed using outpatient clinic logs for patients seen during the first 10 weeks of 2020 and for 10 weeks during the COVID-19 pandemic. Methods: The number of visits, intravitreal injections and surgeries were analyzed for before and during the COVID-19 pandemic. Measures conducted initially to reduce the spread of COVID-19 and maintain pre-pandemic clinical care levels were discussed. Results: During the first month, there was a 57% decrease in the average number of visits (1147 SD±168, P= 0.001). Visit numbers steadily increased, especially after initiating COVID-19 testing to staff, to reach 2010 visits per week by the end of the study. Surgical cases saw a 40% drop in the first month post-pandemic. Mostly the decrease of surgeries was with epiretinal membrane peel surgeries (60% decrease). Surgical case numbers in the following weeks improved reaching similar averages by the end of the study, 43 vs. 39.8 (SD±11 cases, respectively) per week. Similarly, intravitreal injections during the first month of the pandemic averaged 852 (SD±122) per week and by the last 4 weeks of the study, the number of injections averaged 972 (SD±142) per week. During the pandemic, 69% (149) of employees received the antibody test. Five employees tested positive and were required to take 2019-nCoV RT-PCR test. Only one tested positive and was immediately quarantined for two weeks. Conclusion: The decrease in visits and surgeries during the early stages of the pandemic was reversed by the completion of the study. Initiation of frequent, rapid and early COVID-19 testing to staff, in addition to implementing preventive measurements in clinics, were essential to establish a safe clinical environment.
Highlights
The COVID-19 pandemic, which is caused by the novel coronavirus SARS-CoV-2, was first reported in China on December 31, 2019 [1]
We propose the measures that can be taken in order to reduce the spread of the virus and maintain a similar clinical care level to the period before the pandemic
Despite the marked reduction during the in-person visits over the first month of the pandemic, the average number of weekly intravitreal injections dropped by 17% (852 SD±122 injections, P= 0.03 Matt-Whitney U test)
Summary
The COVID-19 pandemic, which is caused by the novel coronavirus SARS-CoV-2, was first reported in China on December 31, 2019 [1]. It is the newest and one of the most contagious pathogens in the last 10 years which is mainly transmitted through direct or indirect contact of infected people or contaminated surfaces [2]. A recent report demonstrated that the ocular surface tissue from non-SARS-CoV-2 does express specific cell surface-associated receptors that facilitate viral entry [4]. These new findings add more evidence that the eye can be a source of both transmission and infection in asymptomatic/ symptomatic carriers [4].
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