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28m operations cancelled worldwide because of Covid-19

Friday May 15th, 2020

More than 28 million elective operations across the globe could be cancelled or postponed because of Covid-19, according to a new study by the CovidSurg Collaborative.

The modelling study, led by researchers at the University of Birmingham, UK, and published in the British Journal of Surgery, suggests that every additional week of disruption to hospital services will result in a further 2.4 million cancellations.

The researchers collected detailed information from surgeons from 359 hospitals and 71 countries on their plans for cancelling elective surgery and this data was statistically modelled to estimate totals for cancelled surgery across 190 countries.

They said that 72.3% of planned surgeries worldwide would be cancelled through the peak period of Covid-19 related disruption, most of which would be for non-cancer conditions.

Most cancellations – 6.3 million – will be cancelled the most often, but they also projected that 2.3 million cancer surgeries will be cancelled or postponed globally.

Mr Aneel Bhangu, consultant surgeon and senior lecturer at the NIHR Global Health Research Unit on Global Surgery at the University of Birmingham, said: “Although essential, cancellations place a heavy burden on patients and society. Patients' conditions may deteriorate, worsening their quality of life as they wait for rescheduled surgery. In some cases, for example cancer, delayed surgeries may lead to a number of unnecessary deaths.”

The news comes as a predictive modelling study by the World Health Organisation warns that nearly quarter of a billion people in Africa will catch coronavirus in the first year of the Covid-19 pandemic and up to 190,000 could die, unless urgent action is taken.

Nevertheless, say the researchers, writing in BMJ Global Health last night, that the figures indicate a lower rate of exposure and viral spread than in other parts of the world.

However, the associated rise in hospital admissions, care needs, and impact on other health conditions in the region would severely strain limited health resources and worsen the impact of the virus, they warn.

By April 29, 45 African countries had reported cases of SARS-CoV-2, the coronavirus responsible for Covid-19 infection.

Because many mathematical models used to predict transmission and death rates in Africa have not adequately incorporated characteristics unique to the region and its individual countries, the researchers adjusted for these factors in their modelling to predict the most likely consequences of widespread and sustained spread of SARS-CoV-2.

They estimate that the pandemic may spread more slowly in Africa, with fewer severe cases and deaths than in other parts of the world, but it is likely to linger for a number of years.

They predict that per head of the population, Mauritius, Seychelles and Equatorial Guinea would likely have the highest proportions of people infected, while among large countries in the region, Cameroon, South Africa, and Algeria would be most at risk. Nigeria is likely to have the largest number of infections, overall, followed by Algeria and South Africa.

The modelling suggests that about one in four of the one billion people in the WHO Africa Region would be infected in the first 12 months. Of these, between 37 million and 44 million could have symptoms.

An estimated 4.6-5.5 million people would need to be admitted to hospital, of whom 140,000 would have severe Covid-19 infection and 89,000 would be critically ill. There could be between 150,000 and 190,000 deaths.

* The World Medical Association yesterday appealed for continued backing for the World Health Organisation.

It issued a joint statement from doctor organisations around the world, warning that threats to withdraw funding were "neither helpful nor safe."

Cabore JW, Karamagi H, Kirpruto H et al. The potential effects of widespread community transmission of SARS-CoV-2 infection in the WHO African Region: a predictive model. BMJ Global Health 15 May 2020; doi: 10.1136//bmjgh-2020-002604

Tags: Africa | Flu & Viruses | UK News | World Health

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