The Unpreparedness of a Health District in the Face of an Epidemic, the Case of COVID-19 and Its Impact on Neurosurgery Activities

Abstract

In December 2019, the occurrence of several cases of pneumonia of unknown origin in Hubei province in China led to the identification in January 2020 of a new coronavirus, named SARS-CoV-2 by the Coronavirus Working Group of the International Committee on Taxonomy of Viruses. In 2019 the national strategy to combat COVI 19 planned for national and regional centres. Thus, as of 20 March 2019, the first suspected cases were registered and taken care of by the District Hospital of Dschang in an unpredictable manner and without any fund.
 The objective of this study was to describe the management of the COVID 19 epidemic by a district hospital without preparation and to describe its impact on hospital activities, in particular neurosurgery. 
 Methodology: it was a retrospective descriptive study, focused on the documents and the management of human resources, material, suspect patients and financial means of the hospital during the first phase of the epidemic from March - August 2019 the crisis. It wasonly in September 2019 that the plan provided for the monitoring of patients at home and the patient at the case infected in KOUEKONG in Bafoussam in the region.
 The result A service was created with new staff as a matter of urgency and the hospitalisation of the first suspect led to a drop in the early attendance of the structure, hospitalisation of the hospital and especially of the surgery service. The barrier measures introduced at the hospital were financed entirely by the hospital's own funds and donations, without any special funding, the hospital's revenue fell from 46,909,106 CFA francs in January 2019 to 27,103,235 CFA francs in June 2019, with a 43% drop in June 2019. expenses, masked by donations, fell from 46,909,106 CFA francs in January 2020 to 24,765,492 CFA francs in May 2020, but increased slightly to reach 38,724,361 CFA francs in August 2020. All activities were affected particularly surgery and neurosurgery.
 Conclusion: The unpredictable management of the Covi19 epidemic led to a disruption of the hospital's organisation and human resources, a drop in the hospital's income and an increase in the burden of self-management, without subsidies from the hierarchy.