Coronavirus and the Responsibility of Plastic Surgeons

The ongoing COVID-19 pandemic has massive implications both for our collective health and for the state of our healthcare system. At the present time, the Johns Hopkins Coronavirus Resource Center has confirmed 181,587 total cases of COVID-19 infection and 7,139 total deaths (death rate 3.9%).¹ By the time this letter reaches publication, both of these numbers are bound to have increased significantly. Of particular concern in regard to the current crisis are the high rates of critical illness and death related to contraction of the virus and the rate at which the outbreak has been spreading. Mizumoto and Chowell² hypothesize that a possible explanation for the severity of the epidemic may be associated with a faulty healthcare system. In response, the Centers for Disease Control and Prevention and the National Institutes of Health have published information about COVID-19 and recommendations on how to protect oneself and curb spread of the disease.^3,4 In such treacherous times, physicians and other healthcare professionals bear an important responsibility to treat affected patients and prevent further spread.

Healthcare professionals most likely to encounter infected individuals include first responders, primary care physicians, emergency room physicians, and infectious disease specialists. Nevertheless, physicians and allied health staff from all disciplines may see exposed patients in the course of their clinical duties. As plastic surgeons, we too have a responsibility to understand the threat we are facing and act appropriately. Indeed, there are many strategies plastic surgeons can implement to help fight this fight.

First and foremost, we must arm ourselves with knowledge and data. This involves an understanding of the disease process and how patients might present. While we may not be qualified to formally counsel patients on COVID-19, we must be able, at a bare minimum, to identify patients at risk or showing signs and symptoms of infection. Further, a mitigation measure with demonstrated efficacy in reducing spread and containing the virus is social distancing.⁵ What is meant by social distancing depends on the context. At the national and city levels, this may involve reduced social gatherings, closing of restaurants and meeting spots, and at its most severe, mandatory quarantine. In the context of plastic surgery, this may involve postponing elective surgeries and nonurgent consults and limiting nonessential personnel in clinic and the operating room. This becomes particularly important for plastic surgeons who routinely care for immunocompromised patients (eg, patients on chemotherapy) or other high-risk populations.

Finally, we must take care of ourselves, our loved ones, and our staff. Appropriate hand hygiene, as always, is crucial. Importantly, should we develop signs or symptoms of infection, we should refrain from going to work and potentially exposing patients and colleagues. Just as we do with many other decisions made on a routine basis, we must rely on common sense, pragmatism, and our judgment to do our part as plastic surgeons in this global battle.

DISCLOSURE

The authors have no financial relationships to disclose with respect to this research.