Impact of the COVID-19 pandemic on the planning of operating theatres: Case of the Department of Orthopedic Surgery B4 Of Hassan II University Hospital In Fez, Morocco

Background: The COVID-19 pandemic has forced the cessation of all non-urgent surgical activity in Morocco. In order to reschedule the delayed interventions, a quantification of the decline in activity is necessary. The aim of this work was to evaluate compared to 2019 the reduction in trauma and orthopedic surgical activity during 2020. Methods: This is a retrospective analytical study performed in the orthopedic surgery department B4 of the Hassan II University Hospital of Fez, comparing the surgical activity of the department in 2020 with the reference year 2019. Including all patients operated in the department during these two years. The data collected were: dates of interventions, surgical indications, type of intervention, type of hospitalization and time of occupation of the operating room. The comparison was made by calculating the variation between the two years according to months, type of surgery and surgical categories. The data received were entered and processed in Excel 2013. Different proportions were compared using a Chi2 test. Results: We observed a decrease in the overall activity of the service of 46% between 2019 and 2020 (1022 and 551 interventions respectively). The oncology activity recognized the largest drop of 72%. Ambulatory and orthopedic activities decreased by 64% and 62%. Approximately 1109 hours of surgery will need to be rescheduled to make up for the canceled operating program. Conclusion: Surgical activity has clearly decreased after the decision to confine and postpone any non-urgent activity, in favor of the care of patients with Covid-19. To cope with this critical situation, a massive and balanced reprogramming is necessary, taking into consideration the new patients.