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Patients to undergo COVID-19 test prior to surgery  

Public and private patients from metropolitan Melbourne and the Mitchell Shire will be tested for COVID-19 in the lead up to their elective surgery to prevent virus transmission within operating theatres.

It comes as the state government confirmed it would delay reinstating elective surgery capacity to pre-pandemic levels to ensure it can cope with a rise in life-threatening COVID-19 cases. With cataract surgery being one of the most common procedures, the move is set to have an impact on ophthalmology services and extend waiting times even further.

On Tuesday 14 July, Victorian Health Minister Ms Jenny Mikakos said all patients within the new Victorian lockdown zone will be tested for COVID-19 about a week before their scheduled elective surgery.

Jenny Mikakos.

She said that while elective surgery was continuing throughout the pandemic it was important to manage the higher risks associated with the increased number of cases throughout Victoria.

“Screening patients for coronavirus before they get to hospital will provide them with the best chance at recovery, while also providing an added layer of protection for the doctors and nurses caring for them,” she said.

“Public and private patients will be tested around a week before their scheduled surgery and will be asked to self-isolate until their surgery to reduce the risk of contracting coronavirus. If a patient tests positive their surgery will be postponed until they have recovered, unless the surgery is urgent.”

She added: “Anyone needing emergency surgery will not be impacted by these changes – the current coronavirus screening protocols will remain in place for those patients. No emergency patients will be compromised by having to wait for a test or result.”

Capacity freeze

Meanwhile, after originally planning to allow all state-run hospitals to return to 100% of typical elective surgery capacity this month, along with other states and territories, the Victorian Government confirmed to Insight this week that would no longer be the case.

“Victoria’s public hospitals have been advised to remain at 75% levels of elective surgery to ensure our hospitals have the capacity they need to provide lifesaving care should we continue to see a rise in coronavirus cases,” a Department of Health and Human Services (DHHS) spokesperson said.

The Royal Victorian Eye and Ear Hospital will need to maintain its elective surgery capacity at 75% for the foreseeable future.

“We understand the anxiety a patient can feel waiting for their surgery and thank all Victorians for their patience in these challenging times.”

Importantly, the capacity freeze does not apply to elective surgery in private hospitals, which can remain at 100%, the spokesperson confirmed.

Victoria has agreements in place with most major private operators which have enabled the state’s hospital bed and staffing capacity to expand.

Private hospitals can determine the level of elective surgery activity they can safely undertake and have extensive plans in place to wind down quickly if needed.

Limiting elective surgery levels in public hospitals is said to be the first time private and public patients have had to comply with different restrictions during the pandemic.

The Royal Victorian Eye and Ear Hospital is the largest public provider of ophthalmology and ENT services in Victoria, delivering more than half of Victoria’s public eye surgery.

In response to the developments, CEO Mr Brendon Gardner said the hospital is continuing to work closely with the DHHS to manage its elective surgeries in accordance with the latest advice.

“The safety of our patients and staff remain paramount in all decisions being made at this time.”

Overall, elective surgery disruption is estimated to have created a backlog of 400,000 operations in Australia, according to the international CovidSurg Collaborative project.

Further highlighting the issue, the Australasian College of Surgeons has said if the hospital system increases weekly surgeries by 20% compared with pre-pandemic activity, it would still take 22 weeks to clear the backlog.

New South Wales, Queensland and Western Australia have recently announced plans for an elective surgery blitz to clear the backlog caused by the pandemic. As part of the plan, it is being proposed that private hospitals perform some of the public work, alongside after-hours surgery lists.