2020
BRITISH JOURNAL OF SURGERY
Surgeons' fear of getting infected by COVID19: A global survey
01 Pubblicazione su rivista
An, Y., Bellato, V., Konishi, T., Pellino, G., Sensi, B., Siragusa, L., Franceschilli, M., Sica, G. S., Kefleyesus, A., Hoofwijk, A. G. M., Eldaly, A. S., Gonzalez, A., Jawad, A., Jooma, A., Hafez, A. M., Rubio, A. V., Landaluce-Olavarria, A., Wu, A., Nagatsu, A., Inoue, A., Kanamoto, A., Ouchi, A., El-Hussuna, A., Vazquez-Melero, A., Wolthuis, A. M., Peral, A. M., Lozano, A. C., Efremov, A., Ryasantsev, A. V., Di Giorgio, A., Parente, A., Tamburrini, A., Alo, A., Forero-Torres, A., Vahrmeijer, A. L., Varabei, A., Hinojosa, S., Balkan, A. Z. A., Frontali, A., Oleg, A., Soler-Silva, A., Makni, A., Andre, A., Cabrera, A. M. G., Fernandez, A. M. G., Minaya-Bravo, A. M., Rodriguez-Sanchez, A., Musina, A. -M., Pangeni, A., Zolotko, A., Tonoyan, A., Balla, A., Belli, A., Cavallaro, A., Chierici, A., Divizia, A., Bucci, A. F., Salido, A. J., Morini, A., Muratore, A., Vignali, A., Chitul, A., Sebastian, D. A., Pcolkins, A., Shchegolev, A., Hollenbeck, A., Wisneski, A., Iossa, A., D', Amore, A., Hunter, A., Hesketh, A. J., La Brocca, A., Spinelli, A., Caires, A., D', Alessandro, A., Correo, A. F. S. L., Macri, A., Navarro-Sanchez, A., Pronk, A., Akunc, A., Mehri, A., Pelta, A., Papadopoulos, A., Kechagias, A., Rashid, A., Ramazanov, A., Chandio, A., Kohyama, A., Nishimura, A., Ohkawa, A., Dulskas, A., Jamal, A., Mariani, A., Unal, A. G., Karagoz, A., Ozkan, B. B., Salih, B., Gulcu, B., Pessia, B., Martin-Perez, B., Ielpo, B., Tulelli, B., Yang, B., Mhamed, B., Murphy, B., Pirozzi, B. M., Sensi, B., Langenhoff, B., Belevi, B., Guney, B., Ng, C., Rueda, C., Roxburgh, C. S., Feo, C. V., Ferrari, C., Gazia, C., Pratesi, C., Ratto, C., Santacruz, C. C., Arroyave, C. R. M., Macias, C., Fernandez, C. G., Fernandez, C. C., Curtis-Martinez, C., Fortmann, C., Kim, C., Galeano, C. U., Barroso, C., Baldi, C., Foppa, C., Formisano, C., Li, C., Ding, C., Wang, C., Iacusso, C., Yang, C., Pizzera, C., Skias, C., Chouliras, C., Liakos, C., Matsuda, C., Wu, C. -Y., Ozaslan, C., Tanda, C., Tommaso, C. M., Dagorno, C., Ramos, C. P. A., Arcudi, C., Coco, C., Morales, C. M., Ali, M. Z., Lozano, C. C., Sala, C., Leo, C. A., Scarpa, C. R., Ferro, C. V., Fernandez, C. M., Morales-Garcia, D., Nakano, D., Cristian, D., Hechtl, D., Canovas, D. T., Calabrese, D., Rega, D., Ferraro, D., Morezzi, D., Sommacale, D., Brogden, D., Miskovic, D., Merlini, D., Pertile, D., Coniglio, D., Zhu, D., Wu, D., Coletta, D., Rubio, D. R., Sasia, D., Fillipov, D., Russiello, D., Dardanov, D., Consten, E. C. J., Smolskas, E., Muttillo, E. M., Jones, E., Sunami, E., Etienne, E. -H., Chalkiadaki, E., Giacomelli, E., Karbovnichaya, E., Ruiz-Ucar, E., Guaitoli, E., Samadov, E., Jovine, E., Treppiedi, E., Vaterlini, E. M., Zambaiti, E., Moggia, E., Coetzee, E., Chisari, E., D', Errico, E., Ciofic, E., Pena, E., Kurt, E., Balik, E., Gunay, E., Sivrikoz, E., Andolfi, E., Araimo, E., Lucci, E., Opocher, E., Pinotti, E., Rubino, E., Reyhan, E., Mazzotta, E., Navarro, E. B., El-Helou, E., Licardie-Bolanos, E., Porto, E. I., Contreras, E., Boerma, E. -J., Cianchi, F., Marino, F., Uggeri, F., Han, F., Calculli, F., Falaschi, F., Ghignone, F., Perrone, F., Borghi, F., Garcia, F., Agresta, F., Cananzi, F. C. M., Mendoza-Moreno, F., Cengiz, F., Almeida, F. M., Baracchi, F., Carannante, F., La Torre, F., Fernandes, F., Friedmacher, F., Grama, F., Carissimi, F., Pecchini, F., Bianco, F., Colombo, F., Ferrara, F., Litta, F., Carrano, F. M., Martignoni, F., Tasselli, F. M., Milone, F., Pata, F., Sammartino, F., Zambianchi, F., Barragan, F., Herrero, F., Schlottmann, F., Den Boer, F. C., Pfeffer, F., Fujita, F., Navarra, G., Herrera-Almario, G., Pozzo, G., Capolupo, G. T., Van Ramshorst, G. H., Liscia, G., Gallo, G., Asawa, G., Wang, G., Raiyani, G., Beets, G., Naval, G. S., Jin, G., Chang, G. J., Saakian, G., Kahane, G., Borroni, G., Secco, G. L., Baiocchi, G. L., Baronio, G., Pagano, G., Pattacini, G. C., Lisi, G., Milito, G., Sinibaldi, G., Serrao, G., Bagaglini, G., Sarro, G., Brisinda, G., Candilio, G.
ISSN: 0007-1323
Editor
During the last three months, COVID-
19 pandemic had led to a serious backlog
of operations globally, and plans for
restarting operation are imperative1-3.
Recommendations for surgical activities
were studied, aiming to protect the
surgical staff from being infected4,5. In
the meantime, it is also important to
give attention to the surgeon’s personal
feeling during work. We conducted
a survey to investigate global surgical
practices during the COVID-19
pandemic6, and the surgeon’s personal
feeling was also investigated in the survey.
In this special letter, we performed
multivariate analysis to explore factors
that associated with surgeon’s fear of
getting infected by COVID-19.
In total, 1124 surgeons from 936
centers in 71 countries replied to the
questions. Regarding surgeon’s satisfaction
towards hospital’s preventive measures,
612 of the respondents (54?4%)
agreed that their centers were taking
enough preventive measures to avoid inhospital
transmission. With respect to
the results by nations, respondents from
the UK reported lowest satisfaction
(6/27, 22?2%), while those from China
(70/73, 95?9%) and the Netherland
(26/33, 78?8%) reported higher satisfaction.
When asked about the personal
fear of getting sick or infecting others
(1 point = never, 5 points = always),
the respondents in overall reported a
relatively high score (the mean±SD of
all respondents: 3?7±1?3). The respondents
from Mexico (4?7±0?6, n = 31),
the US (4?2±1?2, n = 51) and Turkey
(4?2±1?0, n = 38) had higher scores,
while those from the Netherlands
(2?5±1?2, n = 33) and China (2?6±1?4,
n = 73) had lower scores.
In order to explore factors that were
associated with surgeon’s fear of getting
infected, univariate and multivariate
analysis were performed using the data
from the entire survey (including content
about COVID-19 testing policies,
protective measures and COVID-19
caseload) (Table 1). Surgeons with personal
fear were defined as those with
4 or 5 points in the question “Have
you ever been afraid of getting sick
or infecting others because of your
work?”. The factors with P values
<0?1 in the univariate analysis were
high risk country (P = 0?067), shortage
of gloves (P = 0?077), shortage of
gowns (P = 0?096), shortage of surgical
masks (P <0?001), satisfaction to
hospital’s measures (P <0?001), available
guideline (P = 0?019), episodes
with asymptomatic patients in surgical
settings (P = 0?001), experiencing inhospital
infections (P = 0?002), and staff
infections (P = 0?006). The multivariate
analysis of these parameters revealed
that shortage of surgical masks (OR:
1?605, 95%CI: 1?120-2?299, P = 0?01),
unsatisfaction towards hospital’s preventive
measures (OR: 2?155, 95%CI:
1?650-2?813, P <0?001) and experiencing
in-hospital infections (OR: 1?457,
95%CI: 1?052-2?018, P = 0?024) were
independently associated with surgeon’s
fear of getting infected. It is noteworthy
that high caseload (>10 cases) of
COVID-19 in the centers (P = 0?544
in univariate analysis) and countries’
pandemic status of high risk (P = 0?729
in multivariate analysis) were not related
to surgeon’s fear. (High risk countries
are defined as the ones with death case
number of COVID-19 being more than
5000 on 8th April.)
This survey clarified the current surgeons’
fear of getting infected due to
their work, and the fear was particularly
associated with surgical mask
shortage and experiencing in-hospital
infections. Since the propagation of the
virus is subsiding, many hospitals are
currently restarting elective surgeries.
With increasing surgeons’ workload,
the social support for the surgeons’ fear
and securing working environment with
enough PPE supply are warranted.