Elective surgery patients need COVID jabs now

Elective surgery patients need to get COVID-19 vaccines ahead of the general population to reduce the risk of post-op deaths, surgeons warn

Patients waiting for elective surgery need to get a COVID-19 vaccine ahead of the general public to reduce the risk of post-operative deaths, the country’s surgeons warn.

The call from the Royal Australasian College of Surgeons (RACS) comes as research shows those who develop the virus after surgery have four times the risk of death in the 30 day period following an operation.

A patient aged 70 years who is undergoing cancer surgery would usually have a 2.8 per cent mortality rate, this increases to 18.6 per cent if they develop COVID-19 infection.

The impact on patients following operations was investigated by a COVIDSurg Collaborative international team of researchers, which included Royal Australasian College of Surgeons (RACS) fellows and trainees. The study was published in the British Journal of Surgery and the European Journal of Surgery.

They found that global prioritisation of pre-operative vaccination for elective patients could prevent an additional 58,687 COVID-19-related deaths in one year.

“Preoperative vaccination could support a safe continuation of elective surgery by significantly reducing the risk of COVID-19 complications in patients if a significant outbreak occurred in Australia while they are being prepared for surgery,” Australian project lead, Associate Professor Amanda Dawson said.

“Many countries, particularly low and middle-income countries, will not have widespread access to COVID vaccines for several years. While vaccine supplies are limited, governments are prioritising vaccination for groups at highest risk of COVID-19 mortality. Our work can help to inform these decisions,” she said.

Australian co-lead author Dr Jess Vo, from the University of Western Australia said that restarting elective surgery is a global priority.

“Over 15,000 surgeons and anaesthetists from across 116 countries came together to contribute to this study, making it the largest ever scientific collaboration. It’s crucial that policy makers use the data we have collected to support a safe continuation of elective surgery; COVID vaccination should be prioritised for elective surgery patients ahead of the general population,” she said.

During the first wave of the pandemic, up to 70 per cent of elective surgeries were postponed, resulting in an estimated 28 million procedures being delayed or cancelled. While surgery volumes have started to recover in many countries, ongoing disruption is likely to continue throughout 2021, particularly in the event of countries experiencing further waves of COVID-19. Vaccination is also likely to decrease post-operative pulmonary complications, reducing intensive care use and overall healthcare costs.