Impact of the COVID-19 pandemic on orthopedic Surgeon in Pakistan (Preprint)

BACKGROUND In the light working under the constant threat of getting infected while treating orthopedic related patients, and trying to minimize their exposure as much as possible to avoid the contagion, has stressed out even the more seasoned orthopedicians. So we decided to initiate an anonymous online survey, and our target was to solely involve the orthopedic surgeons of our country to figure out how much this ongoing pandemic has affected their mental well-being, how prepared they feel they are to face this threat and what, according to them in the end-game solution to this pandemic. OBJECTIVE The objective of our study is to assess the impact of COVID-19 pandemic on clinical practice as well as psychological impact on orthopedic surgeons of Pakistan. METHODS An online survey involving orthopedic surgeons working in different regions of Pakistan through social media platforms like whatsapp and facebook and also through email, to assess the impact of COVID-19 pandemic. The questionnaire comprises of multiple options all carefully chosen with a definitive aim to understand the impact of COVID-19 on their day to day practice and how well equipped they feel they are , in terms of knowledge as well as personal protective equipment . Our survey also aims to evaluate their state of mind and physical as well as emotional wellbeing in the wake of COVID-19 pandemic. RESULTS Among 77 respondents, mean age of participants was 47 ± 12 years, mostly 31 (40.3%) were consultant and mostly 28(36.4%) having experience in field of orthopedics was between 5-10 years.This data revealed 48(62.3%) respondent did not received any specific training or recommendations about COVID pandemic from their institute and principle source of knowledge among them was social media 46 (59.7%) and only 37(48.1%) reported they are well informed on latest COVID guidelines. During pandemic 73(94.8%) did not operate any covid patient and among them 31(40.3%) not declared willingness to do elective orthopedic surgery on covid positive patient. Interestingly, this data revealed the willingness of orthopedic surgeons 30(39%) to take care of COVID-19 positive patients and support their colleagues in intensive care units, if needed. Concerning their orthopedic practice, mostly 35(45.5%) stopped planned surgeries and 20(26%) reported decrease in emergency surgeries during pandemic, this might be due to decrease in road traffic accident notified by study participant 24(31.2%). For consultation 56(72.7%) respondent used telemedicine and video conference during pandemic. During pandemic respondent revealed that in suspicious of covid infection mostly 34(44.2%) agreed on go through covid test and isolation while 28(36.4%) agreed to stay at home and observe and 65(84.4%) agreed on complete isolation on positive testing. 67(87%) feel anxious, stressed, furious, angry or depressed due to pandemic and most common fear among them was to infect their family members followed by getting infected and loss of their life and health. As the age decreased, the percentage of orthopaedic surgeons feeling stressed out increased and only 4(5.8%) estimate their protection as well protected. 40(51.9%) did not think their institute is well equipped to deal COVID pandemic and 31(40.3%) did not agreed to strategy of their institute to face COVID pandemic. Mostly agreed on specific vaccine 25(32.5%) quarantine 26(33.8%) would be best solution to preventive method to handle pandemic. CONCLUSIONS COVID-19 pandemic has pitted our orthopedic community against challenges rarely encountered in the field of health care professionals. They nevertheless have to play an important role in the face of an increasing psycological and emotional stress which comes from working in a post COVID era . The dread of getting infected while treating and operating on patients and the sinking feeling of spreading the contagion to their loved ones has put a massive toll on the emotional well being of our orthopedic community and needs to be addressed through open and fair discussion . So during these trying times, we need to rise to the occasion and work as a close knitted team to overcome every obstacle encountered in the face of COVID-19 pandemic.