Most of the large health centers are now overwhelmed by patients of
COVID-19. The non-COVID-19 health care set up is also at risk of
cross-contamination due to rampant community infection. Patients with
history relating to FTOCC (fever, travel, occupation, contact, and
clustering) mandates Screening13. Many hospitals use
pre-operative COVID screening, though the hospital policies may differ
from place to place. All asymptomatic patients should be considered as
potential infective cases and all precautions should be taken while
managing them. If a patient planned for surgery is positive, the surgery
should be postponed till he/she becomes negative. The emergency
surgeries like carotid blowouts, acute bleeds, etc. however may need
intervention even inactive COVID infection, such cases would need
surgeries with full PPEs and in designated COVID operation theatres. In
the future, the pre-operative viral test may become mandatory.
Isolation facility for high-risk patients may be done to prevent the
spread of infection. The areas can be marked as contaminated,
non-contaminated, and potentially contaminated areas to stratify the
risk. Route and lifts of these areas should be separate to prevent
cross-contamination. Biomedical waste handing consideration as per
standard protocol should be done13,14. The significant
point to contemplate is whether the hospital is treating both COVID and
non-COVID patients or is it a specialized center for cancer treatment.
The role of tertiary centers and specialized cancer hospitals, which
does not deal with COVID-19 patients directly have a vital role for
onco-reconstruction. It is understandable that, due to some patients and
the health care staff developing COVID infections and thereby resulting
in compromise of the resources, the overall number of cancer surgeries
and reconstructive procedures may decrease. Even minor reconstruction
for oncological defects can be carried out in smaller hospitals to
decrease the burden on major hospitals. It is wise to think of both the
COVID case burden in community patients and hospital capacity before
planning the protocol for management.