Introduction
The COVID-19 pandemic caused by the SARS-CoV-2 coronavirus infection has
challenged the world’s healthcare systems in an unprecedented way1,2. In the UK and wider world there has been a lot of
discussion about how to change the shape of the SARS-CoV-2 incidence and
associated mortality curve. The aim of this study is to look at the
shape and timing of the information curve, in particular with reference
to Otolaryngology in the UK. Although the broad principles may apply to
other specialities and in other countries.
The result of the pandemic has led to a significant reduction in GP
cancer referrals, elective Otolaryngology and cancer surgery3-5. This reduction is due to a number of factors,
including access to health care, re-purposing theatre suites,
ventilators and staff in addition to evidence that suggesting an
unacceptably high morbidity and mortality if patients contract COVID 19
in the perioperative period 6-9.
In addition, there has been significant concern as to the risks to the
surgical team 10. Early evidence emerged that
surgeons, in particular otolaryngologists, as well as other
professionals operating on the aerodigestive tract were at particularly
high risk. This is due to the high level of aerosol generated procedures
involved in the speciality. A number of fatalities among
Otolaryngologists and other similar practitioners has been reported4,11.
During the pandemic there has been a significant number of guidelines
produced by international sources, UK governmental organisations as well
as specialist bodies such as the Royal Colleges and specialist
organisations 4-6,12-17.
These guidelines have dealt with a number of aspects including personal
protective equipment, prioritisation of treatment and recovery. As well
as specific aspects of Otolaryngology practice, including cancer,
clinics, tracheostomy, rhinology, otology and
paediatrics4-6,12-17.
The volume and quantity of guidelines has resulted in significant
challenges for the Otolaryngologist to stay up to date and to be able to
incorporate the advice into safe practice both for the patient and the
clinician. In addition to the published advice the Otolaryngologist has
been required to assimilate guidance produced by local hospitals, as
well as considering governmental briefings, web-based discussion, the
press and social media.
Not all of this advice has been consistent and high-level advice from
international and national sources has been difficult to apply to
specific procedures and settings.
This study aims to document the volume and timing of advice pertinent to
the Otolaryngologist. This may help to inform new systems in the future
if there are ‘second’ waves or future pandemics.