Kicking on while it’s still kicking off - getting surgery and anaesthesia restarted after COVID-19

Summary

The UK NHS has risen to the challenge posed by COVID-19 through Herculean efforts to expand capacity. This has included doubling or trebling intensive care (ICU) capacity within hospitals, augmenting this with Nightingale Hospitals, cancelling all non-emergency surgery and redeploying staff and equipment to focus on a single disease. At the same time, government and population efforts have – through social distancing then lockdown – successfully flattened the epidemic curve and so reduced demand. Together, these actions have enabled treatment of all those needing hospital care for COVID-19 and avoided the unfettered increase in mortality that would have accompanied an overwhelmed healthcare service. However, this has been achieved ‘by the skin of our teeth’ and until very recently, the threat of insufficient ICU beds ventilators, and the need for triage were all anticipated: a few hospitals were overcome by the surge of critically ill patents.

Now, political and social thoughts and actions are turning to loosening lockdown and determining what ‘post-pandemic normality’ will look like. In this Editorial, William Harrop‑Griffiths and Tim Cook discuss the prospects and challenges of ‘planned surgery’ – both time-critical and wholly elective procedures.