Dr. Jose Leon – CSTAR International
Since the beginning of 2020, the world has witnessed, just as it did back in 2003 with SARS-CoV-1 and in 2012 with MERS, another coronavirus causing havoc among humans. Unfortunately, this coronavirus, SARS-CoV-2, is different from the previous two, as it is a much more virulent organism (its ability to spread from host to host and cause disease is significant). This fact, as well as the world’s inability to quickly react, the reach of social media, and a number of different political decisions that reach beyond the scope of the article, gave SARS-CoV-2 something the other two viruses didn’t have: POWER.
It remains unclear, the whole spectrum of difficulties that will be created as a result of this pandemic but what is totally clear is that COVID-19 will leave its mark in every aspect of human life. However, the world has never stopped for any of its previous pandemics, and it won’t stop now either. People are now beginning to accept the idea that we will need to coexist with the virus and adapt our lives to minimize its spread. For now, medical tourism has ground to a halt, as countries attempt to purge themselves of the virus and flatten their curves. Once some control is established, and airports begin to open up, I believe, patients will start to have confidence in travel again and medical tourism will return.
As physicians, we need to develop a protocol to ensure, as much as possible, the safety of our patients. Even though COVID-19 has an average of five days of incubation time, there have been cases with as many as 12 days before the onset of symptoms. Accurate diagnostic testing is essential and we must also figure out when the test is most reliable during the incubation period in order to establish proper time between arrival of patients, testing, and surgery. We need to protect against possible false negative results that could lead to very catastrophic outcomes.
The bottom line is that all patients should be tested for COVID-19 before undergoing elective surgery. As such, the main goal after identifying the proper window to perform testing after arrival, is to guarantee the availability of proper tests. Another action being considered is adding a pulmonologist evaluation prior to surgery as a precaution. It is hoped that the pulmonologist will be able to see any signs that we might miss during our evaluations. It may seem ominous now, but this is definitely not mankind’s first tango with pandemics, and we have better scientists, better medications, and a more comprehensive understanding of the pathophysiology of diseases these days, so in the end, we will undoubtedly prevail.