Coronavirus pandemic will result in the cancellation of 28 MILLION global surgeries

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Millions of elective surgeries could be cancelled around the world as a direct result of disruption from the coronavirus pandemic, a new study revealed


Millions of elective surgeries could be cancelled around the world as a direct result of disruption from the coronavirus pandemic, a new study revealed.

Researchers from the University of Birmingham say cancelled elective surgeries will lead to patients facing a lengthy wait for the health issues to be resolved. 

Based on a 12-week period of peak disruption to hospital services due to COVID-19, 28.4 million elective surgeries worldwide will cancelled or postponed in 2020.

The modelling study, published in the British Journal of Surgery, indicates that each additional week of disruption will add another 2.4 million cancellations. 

Study authors predict 72.3 per cent of all planned surgeries will be cancelled and the bulk of these will be either orthopaedic or cancer related operations. 

Millions of elective surgeries could be cancelled around the world as a direct result of disruption from the coronavirus pandemic, a new study revealed

This map shows the percentage of benign surgeries cancelled by country around the world - with the majority of cancellations happening in wealthier countries

This map shows the percentage of benign surgeries cancelled by country around the world – with the majority of cancellations happening in wealthier countries

The Birmingham team collected detailed information from surgeons across 359 hospitals in 71 countries on plans for cancellation of elective surgery. 

They then put this information through a new data model to estimate the total number of surgery cancellations expected across 190 countries.  

The majority of cancelled surgeries are for benign diseases 

Most of the cancelled surgeries would be operations for benign diseases.  

The study looked at the overall rate of cancellations over 12-weeks of disruption from COVID-19. 

The following percentage of surgery types will be postponed: 

  • 81.7 per cent: benign surgery
  • 37.7 per cent: cancer surgery
  • 25.4 per cent: elective Caesarean sections

They have based the estimates on 12-weeks of disruption as that is the estimate for how long it has taken Wuhan in China to come out of lockdown. 

In the UK alone there will be 516,000 cancelled surgeries and it will cost the NHS at least £2 billion to catch up on the missed operations, the authors say.

The researchers project that worldwide 72.3 per cent of planned surgeries would be cancelled through the peak period of COVID-19 related disruption. 

Most cancelled surgeries will be for non-cancer conditions with orthopaedic procedures cancelled most frequently.

They predict that 6.3 million orthopaedic surgeries could be cancelled worldwide over a 12-week period due to COVID-19. 

They also think 2.3 million global cancer surgeries will be cancelled or postponed.

In the United Kingdom, the NHS advised hospitals to cancel most elective surgeries for 12 weeks – during the peak of the virus outbreak. 

It is estimated that this will result in 516,000 cancelled surgeries, including 36,000 cancer procedures – creating an ongoing backlog for after the disruption. 

If, after the disruption ends, the NHS increases the number of surgeries performed each week by 20 per cent compared to pre-pandemic activity, it will take 11 months to clear the backlog. 

However, each additional week of disruption will lead to the cancellation of an extra 43,300 surgeries, significantly extending the period it will take to clear the backlog.

Aneel Bhangu, Consultant Surgeon and Senior Lecturer at the NIHR Global Health Research Unit on Global Surgery at the University of Birmingham said elective surgeries were cancelled to reduce the risk of patients being exposed to COVID-19.

It was also done ‘to support the wider hospital response, for example by converting operating theatres in to intensive care units’. 

Researchers say more than 72 per cent of all elective operations are being cancelled as a result of coronavirus disruption, as can be seen by the yellow bars in this graph

Researchers say more than 72 per cent of all elective operations are being cancelled as a result of coronavirus disruption, as can be seen by the yellow bars in this graph

The Birmingham team collected detailed information from surgeons across 359 hospitals in 71 countries on plans for cancellation of elective surgery

The Birmingham team collected detailed information from surgeons across 359 hospitals in 71 countries on plans for cancellation of elective surgery

“Although essential, cancellations place a heavy burden on patients and society.

Over 72 per cent of elective surgeries will be cancelled with San Marino cancelling the most at 86.6 per cent

Researchers found that San Marino cancelled the most elective operations of the 190 countries at 86.6 per cent.

The UK cancelled 71.8 per cent of operations and the US will cancel 72.4 per cent of elective surgeries.

Researchers say 72.3 per cent of all planned global surgeries will be cancelled as a result of COVID-19.

The ten countries expected to cancel the most elective surgeries:

  1. San Marino – 86.60 per cent
  2. Austria – 85.90 per cent 
  3. Denmark – 85.00% per cent 
  4. Thailand – 82.10 per cent
  5. Uzbekistan – 81.60 per cent 
  6. St. Lucia – 81.00 per cent 
  7. Botswana – 80.70 per cent
  8. Jamaica – 80.20 per cent 
  9. Indonesia – 80.10 per cent
  10. Nauru – 75.70 per cent 

‘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,’ said Bhangu.

Dr. Dmitri Nepogodiev from the study team said: “Each additional week of disruption to hospital services results in an additional 43,300 surgeries being cancelled.

‘It is important that hospitals regularly assess the situation so that elective surgery can be resumed at the earliest opportunity.’ 

‘The Government must ensure that the NHS is provided with additional funding and resources to ramp up elective surgery to clear the backlog,’ said Nepogodiev.

The research was completed as a collaboration with CovidSurg – a research network focused on the impact of COVID-19 on surgical care. 

Authors say the study demonstrates the major burden of cancelled elective surgery due to the COVID-19 pandemic. 

‘Although a similar proportion of surgery will be cancelled across different country- income settings and geographic regions, the greatest number of cancellations will be in upper middle-income countries,’ they wrote in the paper. 

‘Cancer surgery will be prioritised in most settings, with most cancellations relating to surgery for benign conditions, most frequently orthopaedics.’

BREAK DOWN OF CANCELLED SURGERIES BY TYPE IN EACH OF 190 COUNTRIES 
 Benign surgeryCancer surgeryObstetricsOverall
Afghanistan74.90%70.70%35.40%67.60%
Albania83.80%44.20%23.70%73.10%
Algeria80.80%49.70%26.70%74.00%
Andorra83.80%32.50%19.40%73.40%
Angola75.90%63.80%29.70%69.10%
Antigua and Barbuda81.00%43.70%26.60%71.10%
Argentina82.00%36.70%22.00%70.20%
Armenia81.00%48.20%26.40%74.00%
Australia85.40%25.90%22.50%73.50%
Austria85.90%31.00%21.20%74.80%
Azerbaijan80.80%48.20%28.80%74.00%
Bahamas, The82.40%39.70%24.90%71.30%
Bahrain82.40%37.50%22.00%70.70%
Bangladesh76.00%61.00%31.00%69.10%
Barbados82.40%38.80%23.30%71.00%
Belarus82.90%37.50%23.50%71.20%
Belgium82.70%27.80%22.10%71.70%
Belize78.00%50.80%26.90%71.90%
Benin75.20%69.60%30.00%66.80%
Bhutan77.00%62.80%31.80%70.10%
Bolivia77.00%55.40%26.60%68.70%
Bosnia and Herzegovina80.30%45.90%24.50%70.80%
Botswana80.70%50.40%28.10%74.10%
Brazil81.20%43.60%26.10%73.50%
Brunei Darussalam84.50%35.70%22.50%72.00%
Bulgaria81.10%39.90%24.10%70.30%
Burkina Faso72.80%74.00%37.00%66.70%
Burundi73.10%72.50%34.40%66.30%
Cabo Verde77.10%59.00%28.40%69.40%
Cambodia74.10%66.00%31.50%68.20%
Cameroon74.70%63.40%34.40%68.70%
Canada84.30%29.10%17.90%73.10%
Central African Republic71.20%77.10%36.30%65.70%
Chad74.60%74.10%37.30%68.10%
Chile82.30%37.30%23.10%70.60%
China79.40%48.40%28.00%72.80%
Colombia79.20%44.80%29.90%72.30%
Comoros74.70%67.00%33.50%66.70%
Congo, Dem. Rep.71.50%72.30%37.70%65.70%
Congo, Rep.77.20%66.40%34.80%71.00%
Costa Rica80.40%42.50%24.40%70.30%
Cote d’Ivoire74.00%69.70%32.90%66.40%
Croatia82.80%34.60%24.30%70.60%
Cuba84.30%41.20%23.60%72.90%
Cyprus83.80%32.20%24.50%73.40%
Czech Republic83.90%32.10%22.70%73.40%
Denmark85.00%31.30%20.50%74.10%
Djibouti76.20%71.50%34.80%68.50%
Dominica79.90%53.50%26.60%73.80%
Dominican Republic80.90%46.90%29.00%73.80%
Ecuador78.20%49.90%26.50%71.90%
Egypt, Arab Rep.76.60%57.90%30.50%69.20%
El Salvador78.60%58.80%30.00%70.70%
Equatorial Guinea78.20%65.10%31.70%71.30%
Eritrea74.20%73.70%35.10%67.30%
Estonia83.50%32.10%21.20%73.10%
Eswatini76.30%64.20%31.50%69.70%
Ethiopia73.60%73.60%34.70%66.80%
Fiji80.40%52.30%27.10%74.00%
Finland83.50%28.20%19.00%72.30%
France83.00%32.40%20.50%72.70%
Gabon78.90%55.00%28.80%70.50%
Gambia, The75.80%73.50%36.00%68.60%
Georgia80.40%44.80%23.20%70.70%
Germany85.00%24.00%19.70%72.80%
Ghana75.80%64.10%31.00%69.30%
Greece80.80%32.00%19.90%70.90%
Grenada79.50%47.10%25.70%72.60%
Guatemala78.90%60.70%28.00%71.00%
Guinea75.70%71.80%34.00%68.00%
Guinea-Bissau75.00%74.30%36.00%68.10%
Guyana77.90%59.00%25.60%69.70%
Haiti72.10%69.10%36.50%65.60%
Honduras74.00%61.00%28.30%67.20%
Hungary83.50%33.10%21.30%70.70%
Iceland84.80%27.80%20.00%73.30%
India79.30%59.70%28.40%71.20%
Indonesia80.10%54.40%28.60%74.10%
Iran, Islamic Rep.80.60%41.30%23.20%70.20%
Iraq79.30%58.50%28.10%71.10%
Ireland87.40%26.70%17.40%75.20%
Israel85.30%29.00%21.20%73.90%
Italy84.20%33.50%25.20%74.00%
Jamaica80.20%52.40%29.70%74.10%
Japan84.10%30.10%21.60%73.20%
Jordan79.00%53.00%27.70%73.00%
Kazakhstan81.90%37.10%23.30%70.30%
Kenya75.70%66.00%33.20%69.60%
Kiribati76.90%60.70%34.50%70.10%
Korea, Rep.85.00%30.50%20.40%74.00%
Kuwait81.20%38.50%27.70%70.30%
Kyrgyz Republic77.90%58.30%28.90%70.00%
Lao PDR76.40%62.60%30.90%69.60%
Latvia80.70%35.30%22.40%69.00%
Lebanon79.80%50.00%25.00%73.10%
Lesotho73.90%70.80%36.80%67.10%
Liberia75.00%72.90%35.70%68.00%
Libya78.50%53.40%27.80%72.70%
Lithuania83.60%34.00%21.10%73.50%
Luxembourg84.10%29.40%20.90%73.10%
Madagascar73.50%70.60%34.10%66.30%
Malawi74.00%69.20%34.20%66.50%
Malaysia81.50%41.00%26.10%70.90%
Maldives78.90%54.80%27.70%73.20%
Mali73.40%72.70%35.50%66.70%
Malta84.40%31.20%19.50%73.60%
Marshall Islands78.00%55.60%32.30%70.30%
Mauritania74.70%70.10%34.00%67.10%
Mauritius82.20%40.30%23.50%71.20%
Mexico80.70%41.80%25.00%70.40%
Micronesia, Fed. Sts.77.00%62.20%30.80%69.90%
Moldova79.20%52.80%29.10%73.20%
Monaco84.70%24.50%17.70%72.60%
Mongolia79.40%51.40%29.10%73.20%
Montenegro81.40%42.90%24.50%71.10%
Morocco78.00%58.10%31.50%70.40%
Mozambique75.20%74.00%34.50%68.00%
Myanmar76.00%64.60%30.00%69.30%
Namibia74.80%58.40%30.20%67.70%
Nauru82.20%53.80%26.90%75.70%
Nepal76.50%66.30%28.50%69.70%
Netherlands85.40%26.90%19.50%73.70%
New Zealand84.30%29.00%24.50%73.20%
Nicaragua77.00%56.40%30.00%69.20%
Niger74.00%76.20%35.40%67.50%
Nigeria74.80%68.00%33.70%66.90%
North Macedonia79.90%45.90%25.80%72.70%
Norway86.20%23.40%19.80%73.70%
Oman83.10%35.00%22.90%70.80%
Pakistan77.50%64.00%31.60%68.10%
Palau84.40%39.10%25.80%72.70%
Panama81.00%42.90%23.90%70.80%
Papua New Guinea74.50%66.40%31.30%66.10%
Paraguay79.50%48.70%28.20%72.90%
Peru78.40%46.70%25.10%71.60%
Philippines78.90%55.10%27.90%73.20%
Poland83.70%35.10%20.20%73.70%
Portugal81.70%34.90%19.00%69.50%
Qatar82.80%34.20%22.70%70.40%
Romania82.50%35.30%24.20%70.50%
Russian Federation81.60%36.90%23.40%70.10%
Rwanda76.00%67.20%35.90%68.10%
Samoa76.50%55.80%28.80%71.40%
San Marino86.60%26.10%18.80%74.50%
Sao Tome and Principe75.70%60.60%32.40%69.00%
Saudi Arabia82.50%34.70%23.50%72.70%
Senegal77.10%69.60%33.90%68.80%
Serbia82.50%41.30%22.40%71.50%
Seychelles81.00%39.50%22.70%70.00%
Sierra Leone74.00%75.80%35.00%67.40%
Singapore85.20%27.40%18.70%73.50%
Slovak Republic82.40%32.80%22.70%72.40%
Slovenia82.80%32.10%22.80%72.50%
Solomon Islands78.30%68.20%32.80%69.30%
South Africa77.50%56.30%28.30%69.40%
South Sudan72.90%74.60%36.00%66.60%
Spain82.20%31.80%22.20%72.00%
Sri Lanka82.40%44.70%24.40%72.20%
St. Kitts and Nevis78.60%46.80%24.70%69.70%
St. Lucia81.00%50.80%26.80%74.40%
St. Vincent and the Grenadines79.20%50.70%26.10%72.80%
Sudan74.60%72.30%35.90%67.60%
Suriname79.30%50.50%28.20%73.00%
Sweden85.40%28.20%17.40%73.80%
Switzerland85.10%24.30%20.20%73.00%
Syrian Arab Republic77.70%70.20%33.70%69.30%
Tajikistan78.60%57.20%30.40%70.70%
Tanzania75.20%68.30%35.60%67.60%
Thailand82.10%44.00%26.80%74.30%
Timor-Leste74.80%61.20%32.40%68.30%
Togo76.50%71.40%37.80%69.20%
Tonga80.00%54.60%26.70%74.00%
Trinidad and Tobago80.10%41.30%26.70%69.90%
Tunisia80.30%50.90%23.90%73.60%
Turkey81.10%38.20%22.50%69.90%
Turkmenistan79.10%54.40%29.60%73.40%
Tuvalu77.80%55.10%28.80%72.40%
Uganda75.20%69.30%33.00%67.20%
Ukraine80.80%46.30%22.70%73.40%
United Arab Emirates83.20%33.00%21.30%72.90%
United Kingdom82.80%28.80%18.80%71.80%
United States83.00%31.10%17.50%72.40%
Uruguay80.10%39.70%23.20%69.40%
Uzbekistan81.60%52.80%27.30%75.10%
Vanuatu78.70%65.20%29.60%71.50%
Venezuela, RB80.20%50.40%28.60%73.70%
Vietnam80.00%57.00%28.30%71.40%
Yemen, Rep.73.60%70.90%36.10%66.80%
Zambia77.40%61.80%31.80%70.40%
Zimbabwe75.20%66.20%33.20%69.20%



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