Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation


Background: Surgeons urgently need guidance on how to deliver surgical services safely and effectively during the COVID-19 pandemic. The aim was to identify the key domains that should be considered when developing pandemic preparedness plans for surgical services.

Methods: A scoping search was conducted to identify published articles relating to management of surgical patients during pandemics. Key informant interviews were conducted with surgeons and anaesthetists with direct experience of working during infectious disease outbreaks, in order to identify key challenges and solutions to delivering effective surgical services during the COVID-19 pandemic.

Results: Thirteen articles were identified from the scoping search, and surgeons and anaesthetists representing 11 territories were interviewed. To mount an effective response to COVID-19, a pandemic response plan for surgical services should be developed in advance. Key domains that should be included are: provision of staff training (such as patient transfers, donning and doffing personal protection equipment, recognizing and managing COVID-19 infection); support for the overall hospital response to COVID-19 (reduction in non-urgent activities such as clinics, endoscopy, non-urgent elective surgery); establishment of a team-based approach for running emergency services; and recognition and management of COVID-19 infection in patients treated as an emergency and those who have had surgery. A backlog of procedures after the end of the COVID-19 pandemic is inevitable, and hospitals should plan how to address this effectively to ensure that patients having elective treatment have the best possible outcomes.

Conclusion: Hospitals should prepare detailed context-specific pandemic preparedness plans addressing the identified domains. Specific guidance should be updated continuously to reflect emerging evidence during the COVID-19 pandemic.

Similar articles

See all similar articles

Cited by 2 articles


    1. Brindle M, Gawande A. Managing COVID-19 in surgical systems. Ann Surg 2020; [Epub ahead of print].
    1. Pellino G, Spinelli A. How COVID-19 outbreak is impacting colorectal cancer patients in Italy: a long shadow beyond infection. Dis Colon Rectum 2020; [Epub ahead of print].
    1. Spinelli A, Pellino G. COVID-19 pandemic: perspectives on an unfolding crisis. Br J Surg 2020; [Epub ahead of print].
    1. Chen YH, Peng JS. [Treatment strategy for gastrointestinal tumor under the outbreak of novel coronavirus pneumonia in China.] Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23: I-IV.
    1. Hu XH, Niu WB, Zhang JF, Li BK, Yu B, Zhang ZY et al. [Thinking of treatment strategies for colorectal cancer patients in tumor hospitals under the background of coronavirus pneumonia.] Zhonghua Wei Chang Wai Ke Za Zhi 2020; 23: E002.

LinkOut - more resources