TABLE 2.

General Organizational Measures of Particular Importance to Neurosurgery During the COVID-19 Pandemic

Operate on as few patients as possible: Only perform surgeries that cannot be delayed When an alternative to surgery exists and is equally valid, favor the alternative If the healthcare system becomes overwhelmed, only offer surgery to patients who have a reasonable prognosis

Involve as few people as possible in the surgical procedures: Keep the number of individuals in the OR to the minimum required for safe completion of the surgery Do not involve observers, students, and even residents who do not have an indispensable role Minimize personnel turnover by extending shifts and minimizing breaks Segregate surgeons in specific hospitals to minimize nosocomial transmission from one hospital to another If possible, assign all COVID-19 patients to a single team that will minimize contacts with other surgeons Once immune status testing becomes available and reliable, consider assigning contamination-prone tasks and COVID-19 patients to staff with proven immunity.

Depending on local epidemiology and resources, consider testing all surgical patients for SARS-CoV-2 or treating all patients (even asymptomatic) as potentially infected