Table 1.

Challenges and Considerations Related to Neurosurgical Practice During the COVID-19 Pandemic

Challenges	Considerations
Redeployment	•Appropriate training for work outside neurosurgery •Consideration of transferable skills for redeployment •Risk of deskilling if redeployment lasts long periods •Maintenance of minimum staff for safe neurosurgical practice
Priority setting	•Priority for time-critical neurosurgical conditions •Adoption of substandard treatment to cope with demand •Prognosis for many neurosurgical conditions is better than severe COVID-19 •Risk assessment of coronavirus transmission to neurosurgery staff and patients
Ethical challenges	•Risk of health care injustices against neurosurgery patients •Equitable access to health care based on clinical needs •Exposure to moral injuries/ violation of ethical code •Development of guidance to inform ethical dilemmas
Medicolegal and financial implications	•Potential increase in clinical negligence claims •Exposure to legal risk while working outside neurosurgery •Shared and timely decision-making to mitigate individual risk •Extension of indemnity cover for the additional liabilities •Reduced revenue in countries where remuneration is based on neurosurgical activity/ volume and from impact on private practice
Supporting professional activities
Training	•Impact on neurosurgical training pathway and professional development •Distance-learning tools to be used for training
Research	•Clinical and laboratory research is reduced/ceased •New opportunities for neurosurgical research in relation to the pandemic
Global health	•Halt on global health missions during the pandemic •Increased demand in all affected countries due to backlog after the pandemic

COVID-19, coronavirus disease 2019.