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Study Design: Survey Objective: In March of 2020, an original study by Louie et al investigated the impact of COVID-19 on 902 spine surgeons internationally. Since then, due to varying government responses and public health initiatives to the pandemic, individual countries and regions of the world have been affected differently. Therefore, this follow-up study aimed to assess how the COVID-19 impact on spine surgeons has changed 1 year later. Methods: A repeat, multi-dimensional, 90-item survey written in English was distributed to spine surgeons worldwide via email to the AO Spine membership who agreed to receive surveys. Questions were categorized into the following domains: demographics, COVID-19 observations, preparedness, personal impact, patient care, and future perceptions. Results: Basic respondent demographics, such as gender, age, home demographics, medical comorbidities, practice type, and years since training completion, were similar to those of the original 2020 survey. Significant differences between groups included reasons for COVID testing, opinions of media coverage, hospital unemployment, likelihood to be performing elective surgery, percentage of cases cancelled, percentage of personal income, sick leave, personal time allocation, stress coping mechanisms, and the belief that future guidelines were needed (P<.05). Conclusion: Compared to baseline results collected at the beginning of the COVID-19 pandemic in 2020, significant differences in various domains related to COVID-19 perceptions, hospital preparedness, practice impact, personal impact, and future perceptions have developed. Follow-up assessment of spine surgeons has further indicated that telemedicine and virtual education are mainstays. Such findings may help to inform and manage expectations and responses to any future outbreaks. [ABSTRACT FROM AUTHOR]

This study examines the effects of a COVID-19 outbreak on levels of social capital on a college campus, drawing on survey data collected from students at two colleges—one that experienced an outbreak and one that did not. Social capital is examined as an individual level resource and as a campus level normative tool used to fight collective action problems. We test the hypothesis that the outbreak, as a "shock" to the campus, diminished social capital. We also test hypotheses on gender, race, and ethnicity and social capital, informed by prior research. Our findings suggest that the outbreak did reduce social capital at both the individual and campus levels, though individual social capital had a mitigating effect that increased campus social capital. We find also that gender was significantly linked to campus social capital, while race was predictive of individual level social capital. [ABSTRACT FROM AUTHOR]

This investigation examines the interplay between individual‐level social capital, psychological distress, and the effects of a coronavirus disease 2019 (COVID‐19) outbreak on a college campus. Data were collected from students at two colleges in early 2021. Hypotheses were formed based on prior research on social capital and the COVID pandemic. A structural equation model was constructed to allow the modeling of both latent and observed variables. The Kessler‐6 measures were used to create a latent psychological distress variable, which was the dependent variable. Predictor variables include whether the student experienced the outbreak, the student's race and gender, and the level of reported individual social capital (having supportive and rewarding relationships). Our findings suggest that the most robust predictor of reduced psychological distress was individual social capital, which also served as an intermediary between the outbreak and distress. Social capital mediates psychological distress in an outbreak. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic forced many surgeons to adopt "virtual medicine" practices, defined as telehealth services for patient care and online platforms for continuing medical education. The purpose of this study was to assess spine surgeon reliance on virtual medicine during the pandemic and to discuss the future of virtual medicine in spine surgery.Methods: A comprehensive survey addressing demographic data and virtual medicine practices was distributed to spine surgeons worldwide between March 27, 2020, and April 4, 2020.Results: 902 spine surgeons representing seven global regions responded. 35.6% of surgeons were identified as "high telehealth users," conducting more than half of clinic visits virtually. Predictors of high telehealth utilization included working in an academic practice (OR = 1.68, p = 0.0015) and practicing in Europe/North America (OR 3.42, p < 0.0001). 80.1% of all surgeons were interested in online education. Dedicating more than 25% of one's practice to teaching (OR = 1.89, p = 0.037) predicted increased interest in online education. 26.2% of respondents were identified as "virtual medicine surgeons," defined as surgeons with both high telehealth usage and increased interest in online education. Living in Europe/North America and practicing in an academic practice increased odds of being a virtual medicine surgeon by 2.28 (p = 0.002) and 1.15 (p = 0.0082), respectively. 93.8% of surgeons reported interest in a centralized platform facilitating surgeon-to-surgeon communication.Conclusion: COVID-19 has changed spine surgery by triggering rapid adoption of virtual medicine practices. The demonstrated global interest in virtual medicine suggests that it may become part of the "new normal" for surgeons in the post-pandemic era. [ABSTRACT FROM AUTHOR]

Introduction: While telemedicine usage has increased due to the COVID-19 pandemic, there remains little consensus about how spine surgeons perceive virtual care. The purpose of this study was to explore international perspectives of spine providers on the challenges and benefits of telemedicine.Methods: Responses from 485 members of AO Spine were analyzed, covering provider perceptions of the challenges and benefits of telemedicine. All questions were optional, and blank responses were excluded from analysis.Results: The leading challenges reported by surgeons were decreased ability to perform physical examinations (38.6%), possible increased medicolegal exposure (19.3%), and lack of reimbursement parity compared to traditional visits (15.5%). Fewer than 9.0% of respondents experienced technological issues. On average, respondents agreed that telemedicine increases access to care for rural/long-distance patients, provides societal cost savings, and increases patient convenience. Responses were mixed about whether telemedicine leads to greater patient satisfaction. North Americans experienced the most challenges, but also thought telemedicine carried the most benefits, whereas Africans reported the fewest challenges and benefits. Age did not affect responses.Conclusion: Spine surgeons are supportive of the benefits of telemedicine, and only a small minority experienced technical issues. The decreased ability to perform the physical examination was the top challenge and remains a major obstacle to virtual care for spine surgeons around the world, although interestingly, 61.4% of providers did not acknowledge this to be a major challenge. Significant groundwork in optimizing remote physical examination maneuvers and achieving legal and reimbursement clarity is necessary for widespread implementation. [ABSTRACT FROM AUTHOR]

Telehealth use in spine surgery has become widespread due to the COVID-19 pandemic. The degree of global adoption remains unknown. To our knowledge, this is the first global survey to directly evaluate provider perspectives surrounding telemedicine use-cases. To elicit the extent of adoption of international spine telehealth. We aimed to explore telemedicine platform used, ease of use, and acceptable use-cases. Cross-sectional email survey, international. Spine Surgeons. Perspectives and practices of spine telemedicine. An anonymous, cross-sectional email survey was sent to the members of AO Spine. Survey questions covered provider experiences with and perceptions of telemedicine. Descriptive statistics were used to depict responses and responses were compared amongst regions. A total of 485 spine providers responded to the survey. As of May 2020, telemedicine usage comprised >39.0% of all visits — up from <10.0% of visits pre-pandemic. A majority of providers (60.5%) performed at least 1 telemedicine visit. The format of "telemedicine" varied widely by region: African (45.2%) and European (50.0%) providers were more likely to use phone calls (no video), whereas North (66.7%) and South American (77.0%) surgeons more commonly used audio-visual telemedicine (p<0.001). North American providers used telemedicine the most during COVID-19 (>60.0% of all visits). There were 81.9% of all providers who "agreed/strongly agreed" telemedicine was easy to use. Respondents tended to "agree" that imaging review, the initial appointment, and postoperative care could be performed using telemedicine. Almost all (95.4%) surgeons preferred at least one in-person visit prior to the day of surgery. Our study noted significant geographical differences in the rate of telemedicine usage and the platform of telemedicine utilized. Spine surgeons found telemedicine feasible for imaging review, initial visits, and follow-up visits although the vast majority still preferred at least one in-person preoperative visit. This abstract does not discuss or include any applicable devices or drugs. [ABSTRACT FROM AUTHOR]