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. 2020 Aug 25;122(7):1276–1287. doi: 10.1002/jso.26174
Number (%) Tier‐1 vs Tier‐2 vs Tier‐3 (n [%], P value) Government vs private vs mixed sector vs NGO (n [%], P value) Academic vs nonacademic centres (n [%], P value) Red zone vs orange zones vs green zones (n [%], P value) Dedicated cancer vs multispecialty centre (n [%], P value)
Out‐patient services
Suspended cancer screening 118 (48.4) 66 (56.9) vs 38 (42.7) vs 14 (35.9), P = .031 21 (50) vs 88 (49.4) vs 2 (28.6) vs 7 (41.2), P = .665 69 (46.6) vs 49 (51), P = .5 80 (57.7) vs 29 (38.2) vs 9 (32.1), P = 0.005 44 (51.2) vs 74 (46.8), P = .518
Follow‐up cases 203 (80.6) 96 (78) vs 71 (79.8) vs 36 (90), P = .24 36 (83.7) vs 148 (80.4) vs 4 (57.1) vs 15 (83.3), P = .421 119 (77.8) vs 84 (84.8), P = .166 113 (77.9) vs 62 (80.5) vs 28 (93.3), P = 0.152 70 (82.4) vs 133 (79.6), P = .60
New cases 244 (96.1) 177 (93.6) vs 88 (98.9) vs 39 (97.5), P = .21 39 (90.7) vs 181 (97.3) vs7 (100) vs 17 (94.4), P = .21 148 (96.1) vs 96 (96), P = .96 140 (95.2) vs 74 (96.1) vs 30 (100), P = 0.47 84 (97.7) vs 160 (95.2), P = .345
Telemedicine 182 (72.2) 99 (79.8) vs 57 (64) vs 26 (66.7), P = .028 27 (61.4) vs 143 (77.3) vs 4 (66.7) vs 8 (47.1), P = .015 118 (76.6) vs 64 (65.3), P = .051 111 (76) vs 49 (64.5) vs 22 (73.3), P = .188 47 (56) vs 135 (80.4), P < .001
Oncology practices
Nonavailability of staging investigations 177 (70) 88 (70.4) vs 63 (71.6) vs 26 (65), P = .7 27 (61.4) vs 130 (70.7) vs 7 (100) vs 13 (72.2), P = .20 100 (64.1) vs 77 (79.4) P = .01 105 (71.9) vs 52 (67.2) vs 20 (66.7), P = .72 62 (72.9) vs 115 (68.5), P = .46
Some difficulty in getting endoscopy 171 (68.7) 89 (73) vs 53 (60.9) vs 29 (72.5) P = .15 31 (73.8) vs 123 (67.6) vs 6 (85.7) vs 11 (61.1), P = .5 99 (64.7) vs 72 (75), P = .08 101 (70.6) vs 50 (65.8) vs 20 (66.7), P = .73 57 (67.1) vs 114 (69.5), P = .6
Difficulty in finding microvascular surgeon 93 (40.8) 41 (35.7) vs 31 (40.3) vs 21 (58.3), P = .05 18 (48.6) vs 65 (38) vs 3 (75) vs 4 (43.8), P = .32 46 (32.9) vs 47 (53.4), P = .002 54 (40.6) vs 30 (44.8) vs 9 (32.1), P = .52 30 (39.5) vs 63 (41.4), P = .77
Operate inadequately staged patient 39 (16) 15 (12.5) vs 18 (20.9) vs 6 (15.4) P = .27 9 (22) vs 28 (15.6) vs 1 (16.7) vs 1 (5.6) P = .46 21 (14.3) vs 18 (18.6) P = .37 25 (17.5) vs 11 (15.1) vs 3 (10.7), P = .64 12 (14.3) vs 27 (16.9), P = .60
Avoiding tracheostomy due to risk of aerosolization 42 (20.5) 19 (20.2) vs 15 (20) vs 8 (20), P = .96 9 (28.1) vs 28 (18.1) vs 1 (25) vs 4 (28.6), P = .50 23 (19.3) vs 19 (22.1), P = .62 23 (19.3) vs 13 (21.7) vs 6 (23.1), P = .88 14 (18.2) vs 28 (21.9), P = .52
Continue microvascular reconstruction 121 (60.2) 58 (61.7) vs 46 (60.5) vs 17 (54.8), P = .73 11 (40.7) vs 99 (63.9) vs 5 (100) vs 6 (42.9), P = .017 74 (63.2) vs 47 (56), P = .29 72 (60.5) vs 34 (59.6) vs 15 (60), P = .99 48 (66.7) vs 73 (56.6), P = .16
Practice pedicle flaps over free flap 116 (59.2) 52 (56.6) vs 44 (61.1) vs 20 (62.5), P = .769 16 (66.7) vs 88 (57.5) vs 3 (75) vs 9 (60), P = .765 62 (54.9) vs 54 (65.1), P = .15 72 (61.5) vs 32 (57.1) vs 12 (52.2), P = .6 40 (56.3) vs 76 (60.8), P = .54
Defer surgery (if NACT has good response) 93 (38.4) 51 (42.9) vs 30 (34.5) vs 12 (33.3), P = .37 22 (52.4) vs 65 (36.3) vs 1 (16.7) vs 5 (33.3), P = .16 59 (39.1) vs 34 (37.4), P = .79 62 (43.7) vs 23 (32.4) vs 8 (27.6), P = .124 22 (26.8) vs 71 (44.4), P = .008
Defer adjuvant RT/Chemotherapy (only if there is marginal benefit) 76 (32.3) 41 (36) vs 25 (28.4) vs 10 (30.3), P = .5 20 (51.3) vs 49 (27.8) vs 1 (20) vs 6 (40), P = .03 53 (36.6) vs 23 (25.6), P = .08 42 (30.7) vs 27 (38) vs 7 (25.9), P = .42 28 (34.1) vs 48 (31.4), P = .6
Defer treatment of preinvasive disease 139 (60.7) 72 (64.9) vs 47 (55.3) vs 20 (60.6), P = .37 30 (76.9) vs 98 (57.3) vs 1 (25) vs 10 (66.7), P = .58 86 (61.5) vs 53 (58.9), P = .652 83 (61.5) vs 46 (67.6) vs 10 (38.5), P = .033 47 (58.8) vs 92 (61.7), P = .65
PPE for high‐risk surgery
N95 respirator 229 (94.2) 113 (95.8) vs 78 (90.7) vs 38 (97.4), P = .199 39 (95.1) vs 170 (94.4) vs 5 (100) vs 15 (88.2), P = .681 140 (95.9) vs 89 (91.9), P = .175 133 (93.7) vs 70 (95.9) vs 26 (92.9), P = .759 81 (96.4) vs 148 (93.1), P = .20
Surgical mask 185 (78.1) 93 (83) vs 61 (70.1) vs 31 (81.6), P = .078 27 (73) vs 142 (79.8) vs 5 (100) vs 11 (64), P = .2 112 (80.6) vs 73 (74.5), P = .265 109 (80.1) vs 56 (78.9) vs 20 (66.7), P = .266 68 (84) vs 117 (75), P = .114
PAPR 66 (28.9) 39 (36.4) vs 17 (20) vs 10 (27.8), P = .044 10 (27) vs 53 (31.4) vs 0 vs 3 (17.6), P = .3 39 (30) vs 27 (27.6), P = .68 39 (29.1) vs 15 (22.7) vs 12 (42.9), P = .44 20 (25.6) vs 46 (30.7), P = .427
Regular surgical gown 131 (56.5) 56 (50) vs 55 (64.7) vs 20 (57.1), P = .119 20 (54.) vs 96 (55.8) vs 4 (66.7) vs 11 (64.7) P = .8 74 (55.2) vs 57 (58.2), P = .65 69 (50.4) vs 42 (63.6) vs 20 (69), P = .67 49 (62) vs 82 (53.6), P = .22
HIV protection kit 169 (73.2) 81 (73) vs 61 (73.5) vs 27 (73) P = .996 28 (71.8) vs 123 (72.4) vs 4 (80) vs 14 (82.4), P = .81 98 (72.6) vs 71 (74), P = .81 99 (73.9) vs 51 (73.9) vs 19 (67.9) P = .79 55 (69.6) vs 114 (75), P = .38
Suit for COVID‐19 122 (51.7) 67 (58.3) vs 33 (39.3) vs 22 (59.5), P = .018 19 (48.7) vs 89 (50.6) vs 4 (80) vs 10 (62.5) P = .46 74 (52.5) vs 48 (50.5) P = .76 74 (53.6) vs 36 (50.7) vs 12 (44.4), P = .67 32 (39) vs 90 (58.4), P = .004
Face shield 220 (90.2) 113 (96.6) vs 72 (82.8) vs 35 (87.5), P = .004 38 (92.7) vs 160 (88.9) vs 6 (100) vs 16 (94), P = .665 135 (93.1) vs 85 (85.9), P = .06 133 (93.7) vs 63 (87.5) vs 24 (80), P = .049 78 (90.5) vs 144 (90), P = .906
Adequacy of PPE for the surgical team
PPE for anesthetist 211 (88.3) 110 (94.8) vs 71 (83.5) vs 30 (78.9), P = .007 36 (90) vs 153 (86.4) vs 5 (100) vs 17 (100), P = .30 130 (91.5) vs 81 (83.5), P = .058 127 (92) vs 60 (83.3) vs 24 (82.9), P = .10 70 (85.4) vs 141 (89.8), P = .31
PPE for scrub nurse 208 (86.7) 107 (92.2) vs 71 (82.6) vs 30 (78.9), P = .042 35 (87.5) vs 152 (85.4) vs 5 (100) vs 16 (94.1), P = .60 129 (90.2) vs 79 (81.4), P = .05 128 (92.1) vs 56 (77.8) vs 24 (82.8), P = .012 69 (84.1) vs 139 (88), P = .40
PPE for the surgical assistant 213 (89.1) 110 (94.8) vs 72 (84.7) vs 31 (81.6), P = .02 36 (90) vs 155 (87.6) vs 5 (100) vs 17 (100) P = .368 132 (92.4) vs 81 (84.4), P = .05 128 (92.8) vs 60 (83.3) vs 25 (86.2), P = .09 72 (88.9) vs 141 (89.2), P = .934
Functioning of radiotherapy units
RT centre shut down 9 (5.1) 4 (4.7) vs 2 (3.2) vs 3 (10.3), P = .015 4 (11.4) vs 4 (3.1) vs 1 (25) vs 0, P = .03 6 (5.6) vs 39 (4.2), P = .8 6 (5.7) vs 2 (3.7) vs 1 (5.3), P = 0.4 1 (1.8) vs 8 (6.5), P = .15
Increased waitlist at RT centre 52 (26.9) 19 (19.4) vs 19 (29.2) vs 14 (46.7), P < .001 22 (57.9) vs 29 (20.7) vs 1 (25) vs 0, P < .001 35 (30.4) vs 17 (21.8), P = .24 30 (26.1) vs 18 (32.1) vs 4 (18.2), P = 0.49 18 (28.6) vs 34 (26.2), P = .46
Hypo fractionated regimen followed 66 (35.1) 38 (40.4) vs 20 (30.8) vs 8 (27.6), P = .048 11 (30.6) vs 51 (37) vs 1 (25) vs 3 (30) P = .069 45 (38.1) vs 21 (30), P = .28 45 (40.2) vs 16 (29.1) vs 5 (23.8), P = 0.2 24 (40) vs 42 (32.8), P = .05
Palliative RT 163 (78.7) 72 (72) vs 62 (86.1) vs 29 (82.9), P = .025 28 (68.3) vs 123 (82) vs 2 (50) vs 10 (83.3) P = .038 98 (76.6) vs 65 (82.3), P = .5 91 (76.5) vs 53 (81.5) vs19 (82.6), P = .83 61 (88.4) vs 102 (73.9), P = .016
Employee well‐being
Work in rotation 108 (47) 64 (58.7) vs 30 (35.7) vs 14 (37.8), P = .003 30 (71.4) vs 65 (39.2) vs 5 (83.3) vs 8 (50), P = .001 82 (57.7) vs 26 (29.5) P < .001 68 (51.9) vs 26 (36.6) vs 14 (50), P = .10 42 (50.6) vs 66 (44.9), P = .4
Provision of paid leave for surgeons 68 (30.1) 32 (29.6) vs 23 (28) vs 13 (36.1), P = .7 20 (46.5) vs 41 (25.3) vs 2 (33) vs 5 (33.3), P = .20 48 (33.6) vs 20 (24.1), P = .32 31 (24.2) vs 28 (40.6) vs 9 (31), P = .074 31 (38.3) vs 37 (25.5), P = .13
Provision for daily transportation 168 (68) 88 (71.5) vs 59 (67) vs 21 (58.3), P = .28 25 (59.5) vs 127 (70.2) vs 5 (83.3) vs 11 (61.1), P = .36 109 (72.7) vs 59 (60.8), P = .004 99 (67.8) vs 46 (63) vs 23 (82.1), P = .38 52 (61.9) vs 116 (71.2), P = .11
Deduction in salary 122 (47.7) 57 (44.9) vs 47 (52.8) vs 18 (45), P = .48 15 (34.1) vs 101 (54) vs 1 (14.3) vs 5 (27.8), P = .007 67 (42.9) vs 55 (55), P = .06 17 (56.7) vs 35 (45.5) vs 70 (47), P = .5 42 (48.8) vs 80 (47.1), P = .78

Abbreviations: COVID, coronavirus disease; NACT, neoadjuvant chemotherapy; PAPR, powered air‐purifying respirator; RT, radiotherapy.