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?:abstract
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INTRODUCTION: The recent outbreak of a novel coronavirus illness (COVID-19) has grown into a global pandemic. As a response, there have been several treatment recommendations published by international, federal, state, and local governing bodies. METHODS: We performed a comprehensive review of COVID-19 policies and aggregated multi-disciplinary expertise at our quaternary care academic facility to formulate objective criteria for scheduling surgery, providing neurosurgical coverage, and engaging in neurosurgical research during the COVID-19 outbreak. Recommendations from the CDC, WHO, California State Department of Public Health (CDPH), San Francisco Department of Public Health (SFDPH), and the UCSF School of Medicine were collected and reviewed by the expert panel. Treatment algorithms regarding the following issues were drafted: (1) neurosurgical case scheduling, (2) neurosurgical clinic scheduling, (3) contingency plans for neurosurgical staffing and ICU utilization, and (4) staffing neurosurgical research directives. RESULTS: Here, we present a neurosurgical treatment algorithm for varying levels of COVID-19 community infection. This algorithm (with an accompanying checklist) is centered around a three-tiered system of viral ‘surge’ quantification, which we use to triage case scheduling, and a paired coverage model for inpatient services. CONCLUSION: COVID-19 represents a challenge to ongoing practice, however with clear algorithms, checklists, and contingency planning, it is possible to provide focused neurosurgical care during this pandemic.
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