Should I Have Elective Surgery in the Pandemic?
Patients must balance the chance of a life-threatening Covid-19 exposure against the opportunity for relief from a condition that may be painful but is not considered urgent.
With the Covid-19 pandemic raging across the country, many people hoping to undergo elective surgery can expect their operations to be on hold indefinitely. Hospitals in many places are at or near bed capacity and facing staff shortages. Even facilities still able to handle operations not considered urgent are likely to experience cancellations when patients themselves, fearing contagion, postpone the procedures.
My brother, for example, was scheduled for a total knee replacement mid-December in upstate New York. But when three stores he frequented closed early in the month because employees got Covid and the community’s infection rate climbed through the roof, he opted to reschedule the procedure.
Should I Have Elective Surgery in the Pandemic?
Better to risk missing another season of tennis than to miss his daughter’s wedding in the spring and old age altogether. As a 75-year-old who had open-heart surgery two years ago, he knows he’s high-risk for a life-threatening Covid infection. Even if an overnight hospital stay were not a risk, he feared possible exposure to the virus during the weeks of rehab afterward.
Two of my friends scheduled for elective surgery managed to sneak under the wire this fall; one had a knee replacement in early October and the other a hip replacement in early November. But if you or a loved one is on a surgeon’s schedule for a similar optional procedure in the weeks ahead, you may want to rethink your plans, depending on where you live.
In a list of “guiding principles,” the American Academy of Orthopaedic Surgeons cautioned its members that during the pandemic, decisions to proceed with elective surgery “should be locally based” and take into account “incidence, prevalence, patient beds, hospital beds, ventilators and personal protective equipment,” in addition to local shutdown orders and whether there’s been “a sustained reduction in new cases of Covid-19” in the area.
Likewise, there are many issues for prospective patients to consider before proceeding with an elective operation. First and foremost is an understanding of what “elective” means and whether there are less risky alternatives to consider, at least until the pandemic surge abates or most Americans are protected by a vaccine.