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Background: The occurrence of the COVID-19 pandemic in late December 2019 created a worldwide emergency. It affected most surgical subspecialties in many ways. Therefore, we aimed to quantitate the early effect of COVID-19 on elective and emergency orthopedic surgeries. Moreover, to identify the most affected orthopedic subspecialties during this crisis. Materials and methods: Our study was conducted in a tertiary hospital in Saudi Arabia. We included all patients who underwent orthopedic procedures from January 1, 2020 - June 30, 2020, with the same period of 2019 for comparison. Emergency procedures were considered if a patient had an acute fracture, joint dislocation, compartment syndrome, infection, and infected non-union. Results: The impact of procedure cancellation in the early COVID-19 phase was significant. Our department procedures decreased in the 2nd quarter of 2020 by 75.6% from the previous quarter of the same year and 61.1% from the 2nd quarter of 2019. No admission restrictions were made for oncology and trauma patients, though they had a reduction in their cases. The most affected subspecialties in our study were sports medicine, upper limb, arthroplasty, and pediatrics. Conclusion: During the COVID-19 crisis, elective surgeries were held in our hospital and most of Saudi Arabia. Our cohort showed a significant decrease during this period. All subspecialties were affected by elective procedure cancellation, but some were affected more because of the elective nature of their operations, such as sports and upper limb, pediatric, and arthroplasty.
RESUMEN
BACKGROUND: Healthcare providers working in Saudi Arabia come from various nationalities, cultures, and training backgrounds. This study aimed to assess the perceptions of healthcare providers working in Riyadh hospitals about ethical dilemmas and solutions. METHODS: This is a cross-sectional study among physicians working in Riyadh's private and governmental hospitals between June and December 2017. The study collected information on demographics, knowledge about medical ethics, the sources of such knowledge, and common ethical issues in general and the top ethical issues and dilemmas encountered in their daily practice. RESULTS: A total of 455 physicians from government and private hospitals were enrolled in the study. The mean age of the participants was 34.29 ± 10.5 years, females were 29.7% and mean years of practice was 13.0 ± 11.5. The top ethical issues identified by the participants were "disagreement with the patients' relatives about treatment" (91%), patient disagreement with decisions made by professionals (84%), treating the incompetent patient (79%), conflict with administration policy and procedures (77%), scarcity of resources (72%), and making decision about do-not-resuscitate or life-sustaining treatment (68%). There were significant differences in dealing with ethical issues in relation to gender, confidence about ethical knowledge, nationality, seniority, training site, and private or government hospitals academic and nonacademic. CONCLUSION: Healthcare providers in Riyadh hospitals face multiple ethical challenges. In addition to improvement in ethics knowledge through educational program among healthcare professional, there is a valid need for healthcare professionals and other sectors within society to engage in serious and continuous dialogue to address these issues and propose recommendations.