Experience of a surgeon at the emergency department during COVID-19 pandemic

Introduction: The COVID pandemic, which started on 11th March as per the World Health Organization, has resulted in a drastic change in health care delivery, including emergency services. Most health workers have deviated towards COVID care delivery; only a few were available for non-COVID conditions. All elective and nonessential services were postponed resulting in the increased burden of the emergency department. The emergency department had to provide essential emergency care with available staff without exposing them to the virus. Triaging of the patients was modified according to the needs. Methods: The statistics of the emergency department of this period (April and May 2020) are compared with the same period of previous years (2018-2019) with the number of patients, indications, and complications. The methods of triaging and preparation were discussed. Discussion: The number of patients admitted to the emergency department (ED) was low during the COVID pandemic. Nevertheless, they got admitted with complications due to delay in accessing the health care facility. Patients with diabetic foot ulcers were also presenting late, leading to an increased number of the forefoot and below knee amputations. In trauma, the emergency department has maintained the same death rate as previous years by giving great care. The indications for tracheostomy were worrisome because it would have been prevented if the patients presented early. Pediatric patients were also presented late, resulting in increased mortality. Some cancer patients also presented with a complication in the emergency department because of the postponement of elective surgeries. Conclusion: There is a delay in accessing the health care delivery for non-COVID conditions resulting in more amputations of limbs and resections of the bowel. So the type of care in the emergency department was changed due to atypical presentation and complicated cases. It is necessary to ensure the provision of high quality health care delivery to non-COVID patients also.