Screening of COVID-19 disruption for elective surgery

If the number of COVID-19 hospital patients in England were to remain at the level observed in the first 2 weeks of October 2021, when, on average, 5,003 patients were receiving treatment for COVID-19, we would expect 51,204 (95% IC 44 219–58 343) elective surgical procedures would take place per week (figure). If the average number of COVID-19 hospital patients were to increase to 10,000, 47,348 (39,206-56,641) elective surgeries would take place per week. If the number of COVID-19 hospital patients were to increase to reach the levels seen in the first COVID-19 wave (as of April 2020, there were an average of 16,090 COVID-19 hospital patients in England at any given time), elective surgeries would decrease to 43,225 (33,859–54,633) per week.

These data suggest that if the number of COVID-19 hospital patients reached the levels seen in April 2020, rather than continuing to the levels seen in October 2021, 100,273 fewer elective surgeries would take place over the next 3 months, or 15 · 3% reduction.

There are limits to our analysis. First, we assume that the relationship between the number of COVID-19 hospital patients and elective surgery activity this winter will be consistent with previous trends. However, the NHS could develop strategies to maintain elective surgery activity despite increasing admissions of COVID-19; conversely, resilience could be weakened by worsening staff shortages. Second, we did not explore regional variations, which could result from differences in the availability of resources, accessibility of surgical pathways without COVID-19, or the mix of baseline surgical cases. Finally, we did not discuss the differences between the surgical specialties. Hospitals are likely to prioritize life-saving surgeries, meaning less urgent surgeries are more vulnerable to disruption from COVID-19.