In “The Effect on Trauma Care Secondary to the COVID-19 Pandemic: Collateral Damage from Diversion of Resources,” published in the Annals of Surgery, Elliott R. Haut, MD, PhD; Ira Leeds, MD, MBA, ScM; and David Livingston, MD outline the short- and long-term unintended consequences of the pandemic for the nation’s trauma centers.
The investigators consider the effects of the pandemic on acute inpatient clinical care, physician staffing, trauma center performance improvement, trauma education, injury prevention, pre-hospital care, care after hospital discharge, and trauma research.
Among their findings, redeployed resources have left some trauma centers with lower capacity to treat injured patients and changes in the delivery of direct patient care—including the timing and performance of common procedures—may result in unintentional harm to injured patients. Lack of personal protective equipment (PPE) limits the number of personnel directly treating trauma patients. What’s more, managing trauma patients in the conditions dictated by the COVID-19 environment may delay immediate emergent care, hamper EMS handoffs and disrupt communication in the trauma bay and operating room. There is potential for long-term blood product shortages, with competition spiking for a limited supply, and shortages of sedative and pain medications are resulting in increased complications, they say.
In conclusion, the paper discusses the potential long-term effects of the COVID-19 crisis on the economics of the entire trauma system, as “health systems are already projecting huge losses stemming from the additional non-reimbursed costs of taking care of COVID-19 patients as well as the lost volume of high-margin elective services.” Among other economic pressures, the imminent loss of health care insurance coverage due to rising unemployment rates will add to the stress on trauma centers.
“The key aspect that directly applies to CNTR is the impact COVID might have on trauma research. Many universities have shut down all non-COVID research and researchers have been forced to put our trauma research on hold,” says the paper’s lead author Dr. Elliott Haut.
Dr. Haut is Past-President of the Eastern Association for the Surgery of Trauma (EAST) and Dr. Livingston is President-Elect of the American Association for the Surgery of Trauma (AAST)—both organizations are members of the Coalition for National Trauma Research.