The setup
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.