Main Article Content
Background: Coronavirus disease had a devastating effect on the World, with significant disruption in healthcare, the burgeoning impact is still unfolding. The inequities and fragilities amongst nations particularly low and medium economic countries whose patients are dependent on out of pocket expenditure to access healthcare, has occasioned varied consequence of the pandemic on patients in the health care setting and it has reshaped how health care is practiced.
Aims: The aim of this review article was to assess the impact of Coronavirus disease on health care utilization by non -COVID patient during the pandemic.
Methods: The review article was carried out with a search engine focused on articles related to impact of Coronavirus disease published between December 2019 till date, which were identified and reviewed.
Conclusion: The review article gave an insight to the significant disruptions in health care services amongst patients witnessed across countries of the world, the disparities in the disruptions were due to heterogeneity amongst nations, national policies and health policies during the pandemic and the socioeconomic realities that ensued. Outpatient services witnessed varying reduction across the globe ranging between 30-50%. Sub-Saharan Africa witnessed disruption as much as 50% depending on load of COVID-19 infection amongst populace. The reason for the interruptions across the world was the fear of contracting the disease, access to health care setting due to lock down and shortage of health care personnel, in addition in sub-Saharan Africa, the economic down turn occasioned by the pandemic reduced household income which in turn reduced expenditure on health since most countries were dependent on out of pocket expenditure to fund health care services.
In-patient care was also not spared of the disruptions witnessed even though emergency care was prioritized. Overall, there was a reported reduction in admissions for respiratory diseases due to non- pharmacological measures aimed at stemming COVID-19 infection which was equally effective for other respiratory diseases. In some countries like United States the reduction in hospital admissions was paralleled by increasing mortality particularly amongst Hispanic blacks as more acute and severe cases were deemed to have presented for admissions. Surgical priority was maintaining emergency services and prioritization of cancer care, there was a measurable reduction in surgical procedures as elective surgeries were postponed or cancelled. Most laparoscopic and endoscopic procedures were cancelled because of the perceived notion that they are aerosol generating and could increase transmission of COVID-19 infection from asymptomatic carriers, however US jettisoned cancellation of its surgical procedures after 35 days considering that it could not cope. The psychosocial impact of the pandemic and health care access spiraled into increasing anxiety and depression for both health care workers and patients, while the fear of stigmatization was rife from contracting the disease.
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
2. World Health Organisation. Coronavirus. 2020. https://www.who.int/health-topics/coronavirus#tab=tab.1
3. Bogoch II, Watts A, Thomas-Bachl A, Huber C, Kraener MUG, Khan K. Pneumonia of unknown aetiology in Wuhan, China: potential for international spread via commercial air travel. J Travel Med 2020;27:taa0 008
4. Mahase E. COVID-19: WHO declares pandemic because of “alarming levels” of spread, severity and inaction. Br Med Journal Publishing Group; 2020. http//www.bmj.com/content/368/bmj.
5. Huang C, Wang Y, Li X et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223): 497-506
6. Tenforde MW, Kim SS, Lindsell CJ, Rose EB, Shapiro NI, Files DC, et al. Symptom duration and risk factors for delayed return to usual health amongst outpatients with COVID-19 in a multistate healthcare system network in United States, March-June 2020. Morbidity and mortality weekly report 2020;69(30):993
7. Ochi S, Hodgson S, Landeg O, Mayner L, Murray V. Disaster drivers, evacuation and medication loss: a systematic literature review. PLOS Curr. 2014;6:ecurrents.disfa4176 30b41766a
8. Leung MST, Lin SG, Chow J, Herky A. COVID-19 and oncology service transformation during pandemic. Cancer Med.2020 Oct;9(19):7171. doi:10.1002/can4. 3384. Epub 2020 Aug 18. PMD:32810386;PMDCID:PMC7461476
9. Abrams EM, Szefler SJ. COVID-19 and the impact of social determinants of health. Lancet Respir Med. 2020;8(7): 659-661. https:// doi org/10.1016/S2213-2600(20)30234-4
10.Courtemanche C, Garuccio J, Pinkston J, Yebowitz A. Strong social distancing measures in the United States reduced the COVID-19 growth rate. Health Affairs 2020;39(7). https://doi.org/10
11. Qian M, Jiang J. COVID-19 and social distancing. Journal of Public Health: from theory to practice 2020. https://doi.org/10.1007/s10389-020-01321-z. PMID:32837835
12. de Matos DG, Aider FJ, Almeida-Neto PFD, Moreira OC, Souza RFD, Marcal AC. Et al. The impact of measures recommended by government to limit the spread of coronavirus (covid-19 on physical activity levels, quality of life and mental health of Brazilians. Sustainability. 2020;12(21):9072
13. Tran BX, Nguyen HT, Le HT, Lat Kin CA, Pham HQ, Vu LG, et al. Impact of COVID-19 on economic wellbeing and quality of life of the Vietnamese during the national social distancing. Frontiers in Psychology. 2020;11
14. United Nations. UN Research Roadmap for the COVID-19 Recovery, 2020. https://www.un.org/en/pdfs/UNCOVID19ResearchRoadmap.pdf
15. Burki TK. Cancer guidelines during the COVID-19 pandemic. Lancet Oncol. 2020; 21:629-630
16. Bini SA, Schilling PL, Patel SP, et al. Digital Orthopaedics: A glimpse into the future in the midst of a pandemic. J Arthroplasty 2020;35:S68-S73
17. Ozah E, Irekpita E. The Impact of Coronavirus Disease (COVID-19) on Patients Visiting Outpatient Urology Clinic in a Nigerian Tertiary Hospital: A Cross Sectional Study. Central African Journal of Public Health 2021; 7:182-188
18. Mazingi D, Navarro S, Bobel MC, Dube A, Mbanje C, Lavy C. Exploring the Impact of COVID-19 on Progress Towards Achieving Global Surgery Goals. World J Surg. 2020;44(8):2451-2457 (doi: 10.1007/s00268-020-05627-7)
19. Rosenthal PJ, Breman JG, Djimde AA, John CC, Kamya MR, Leke RGF, et al. COVID-19: Shining the light on Africa. Am J Trop Med Hyg. 2020; 102(6): 1145-1148
20. Hamm ME, et al. Experiences of American Older adults with pre-existing depression during the beginnings of the COVID-19 pandemic: A multicity, mixed-methods study. Am J. Geriatr. Psychiatry 2020;28:924-932
22. Yamada M. et al. Effect of the COVID-19 Epidemic on physical activity in community dwelling adults in Japan: A cross-sectional online survey. J. Nutr. Health Aging 2020;24:1-3
23. Ettman CK. Et al. Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic. JAMA Netw. Open 2020; 3:e2019686-e2019686
24. Pollard MS, Tucker JS, Green HD. Changes in adult alcohol use and consequences during the COVID-19 pandemic in the US. JAMA Netw. Open 2020;3:e2022942
25. Pfender E. Mental health and COVID-19:implications for the future of telehealth. J Patient Exp 2020;7(4):433-435. https://doi.org/10.1177/2374374373520948436
26. Seyi-Olajide JO, Bode CO, Ihediwa OC, Elebute OA, Alakaloko FM, Ladipo-Ajayi OA. et al. Impact of coronavirus disease 2019 pandemic on paediatric surgery in sub-Saharan Tertiary Hospital: An Observational Study. Niger Postgrad Med J 2022;29:102-109
27. Bernacki K, Keister A, Sapiro N, Joo SJ, Mattle L. Impact of COVID-19 on patient and healthcare professional attitudes, beliefs and behaviors toward the healthcare system and on the dynamics of healthcare pathway. BMC Health Services Research 2021;;21:1309. https://doi.org/10.1186/s12913-021-07237-y
28. Devi R, Goodyear-Smith F, Subramaniam K, McCormack J, Calder A, Parag V. et al. The Impact of COVID-19 on the care of Patients with Non-communicable Diseases in Low and Middle- Income Countries: An Online Survey of Patient Perspectives. Journal of Patient Experience 2021; 8:1-8
29. Bullen C, McCormack JC, Calder A, Parag V, Subramaniam K, Majumdar A, et al. The Impact of COVID-19 on care of people living with non-communicable diseases in low and middle income countries: an online survey of frontline healthcare workers in nine countries . Primary Health Care Res Dev. 2021; doi:10.1017/S146342362100030X
30. Kirby T. New variant of SARS-CoV-2 in UK causes surge of COVID-19. Lancet Respir J. 2021;9: E20-E21. Doi:10.1016/S2213-2600(21)00005-9
31. Diabetes New Zealand. Annual diabetes check-up. 2020. Accessed July 14, 2021. https://www.diabetes.org.nz/diabetes-check-ups
32. Palmer K, Monaco A, Kivipelto M, Onder G, Maggi S, Michel JP, et al. The potential long term impact of the COVID-19 outbreak on patients with non-communicable diseases in Europe: cosequences for healthy ageing. Ageing Clin Exp Res. 2020; 32:1189-1194. Doi:10.1007/s40520-020-01601-4
33. Agarwal A, Mann C, Abdella E, Mitiku W, Alebachew A, Berman P. Recurrent Cost in Primary Health care in Ethiopia: Facility and disease specific cost and their components in government primary hospital and health centers. BMC Health Serv Res 2020;20:389
34. Walker PGT, Whittaker C, Watson OJ, Baguelin M, Winskill P, Hamlet A, et al. The impact of COVID-19 and strategies for mitigation and suppression in low and middle income countries. Science. 2020;369(6502):413-422
35. Assefa N, Sie A, Wang D, Korte ML, Hemler EC, Abdullahi YY, et al. Reported Barriers to Health care Access and Service Disruptions Caused by COVID-19 in Burkina Faso, Ethiopia, Nigeria: A telephone Survey. Am J. Trop. Med. Hyg. 2021; 105(2):323-330
36. Karkee R, Morgan A. Providing maternal health services during the COVID-19 pandemic in Nepal. Lancet Glob Health. 2020;8:e1243-e1244
37. Headey D, Heidkamp R, Osendarp S, Ruel M, Scott N, Black R, et al.Impacts of COVID-19 on childhood malnutrition and nutrition related mortality. Lancet. 2020;396(10250):519-521
38. The Global Fund: The impact of COVID -19 for HIV, TB, Malaria Services and System for Health: A Snapshot from 502 health facilities across Africa and Asia. Available from https://theglobalfund. Org. [last accessed on 2022 Mar 29]
39. Adelekan B, Goldson E, Abubakar Z, Mueller U, Alayande A, Ojogun T, et al. Effect of COVID-19 pandemic on provision of sexual and reproductive health services in primary health facilities in Nigeria: a cross sectional study. Reprod Health 2021;18:166
40. Jibhakate NA, Patwardhan SA, Sawant AS, Pathak HR, Patil BP, Kamal H. Impact of COVID-19 pandemic on non-CVID patient’s management in urology: a public hospital experience in Mumbai. Afr J Urol 2021; 27:96. https://doi.org/10.1186/s12301-021-00196-0
41. Yagamuchi S, Okada A, Sunaga S, Kurakawa KI, Yamauchi T, Nangaku M, et al. Impact of COVID-19 pandemic on healthcare service use for non-COVID-19 patients in Japan: retrospective cohort study. BMJ Open 2022;12: e060390. doi:10.1136/bmj-2021-060390
42. Osawa I, Goto T, Asami Y, et al. Physician visits and medication prescriptions for major chronic diseases during the COVID-19 pandemic in Japan: retrospective cohort study. BMJ Open 2021;11:e050938
43. Sim B, Nam EW. The impact of COVID-19 on Outpatient Visits for All Cause and Chronic Diseases in Korea: A Nationwide Population Based Study. Int. J. Environ. Res. Public Health 2022;19: 5674. https://doi.org/10.3390/ijerph19095674
44. Czeisler ME, Marynak K, Clarke KEN, Salah Z, Shakya I, Thierry JM, et al. Delay or Avoidance of Medical Care Because of COVID-19 Related Concerns-United States, June 2020. MMWR Morb. Mortal. Wkly. Rep. 2020;69: 1250-1257
45. Mantica G, Riccardi N, Terrone C, Gratarola A. Non -COVID-19 visits to emergency departments during the pandemic: The impact of fear. Public Health 2020;183: 4363
46. Mainews. 72.5% of the People Responded Positively to the Policy of Participation in COVID-19 Testing and Treatment of Local Hospitals. Available Online: http://www.bosa.co.kr/news/articleView.html?idxno=2169759 (accessed on 1 May 2022)
47. Xu Z, Fan J, Ding J, Feng X, Tao S, Zhou J, et al. The Impact of COVID-19 on Primary Care General Practice Consultations in a Teaching Hospital in Shanghai, China. Front. Med. 2021;8: 642496. doi:10.3389/fmed.2021.642496
48. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72314 case from the Chinese Center For Disease Control and Prevention. JAMA. 2020;323:1239-1242. doi: 10.1001/jama.2020.2648
49. Sun S, Fu C, Cong J, Li Y, Xie S, Wang P. Epidemiological features and trends of influenza incidence in mainland China: a population based surveillance study from 2005 to 2015. Int. J Infect Dis. 2019; 89:12-20
50. Bottle A, Neale FK, Foley KA , et al. Impact of COVID-19 on outpatient appointments in children and young people in England : an observational study. BMJ Open 2022;12: e060961. doi:10.1136/bmjopen-2022-060961
51. Browne C, Davis NF, Mac Craith ED, Lennon GM, Galvin DJ, Mulvin DW. Prospective evaluation of virtual urology outpatient clinic. Ir. J. Med. Sci. 2018; 187: 251-254. https://doi.org/10.1007/s11845-017-1615-y
52. Evans D, Harman J, Middleton SD, Anakwe RE. Developing a virtual fracture clinic for hand and wrist injuries. J. Hand Surg. Eur. 2018;43:893-894. https://doi.org/10.1177/1753193418778472
53. Sultan AA, Acuna AJ, Samuel LT, Rabin JM, Grits D, Gurd DP, et al. Utilization of telemedicine virtual visits in pediatric spinal deformity patients: a comparison of feasibility and patient satisfaction at a large academic center. J. Pediatr. Orthop. 2020. https://doi.org/10.1097/BPO
54. Williams TC, MacRae C, Swann OV, et al. Indirect effects of the COVID-19 pandemic on pediatric healthcare use and severe disease: a retrospective national cohort study. Arch Dis Child 2021;325:1676-1679
55. Wyatt S, Mohammed MA, Fisher E, et al. Impact of the SARS-CoV-2 pandemic and associated lockdown measures on attendances at emergency departments in English hospitals; a retrospective database study. Lancet Reg Health Eur 2021;2: 100034
56. British Medical Association. The hidden impact of COVID-19 on patient care in the NHS in England, 2020 Jul. Available: https://www.bma.org.uk/media/2841/the-hidden-impact-of-covid_web-pdf.pdf
57. Thorlby R, Fraser C, Gardner T. Non-COVID-19 NHS care during the pandemic/ the Health Foundation. Available: https://www.health.org.uk/news-and-comment/charts-and-infographics/non-covid-19-nhs-care-during-the-pandemic [Accessed7 May 2021]
58. Chammas NK, Hill RLR, Edmonds ME. Increased mortality in diabetic foot ulcer patients: the significance of ulcer type. J Diabetes Res 2016; 2016:2879809
59. Armstrong DG, Wrobel J, Robbins JM. Guest editorial: are diabetes related wounds and amputations worse than cancers? Int Wound J 2007; 4:286-287
60. Deogon GS, Robbins T, Randeva MS, Kyrou I, Sankar S, Randeva HS, et al. Managing high acuity outpatient services during the COVID-19 pandemic :lessons from the acute diabetes foot service. Future Healthcare Journal 2020;7(3):e77-e79
61. Deloitte. What will be the impact of COVID-19 pandemic on healthcare systems? June, 2020. https://www2. Deloitte.com/fr/fr/pages/covid-insights/articles/impact-covid19-healthcare-systems. html.[last accessed 2020sep 28]
62. Kardas P, van Boven JFM, Pinnock H, Menditto E, Wettermark B, Tsiligianni I, et al. Disparities in European healthcare system approaches to maintaining continuity for non-communicable diseases during the COVID-19 outbreak. The Lancet Regional Health-Europe 2021; 4:100099
63. Pendrith C, Nayyer D, Chu C, O’Brien T, Lyons OD, Agarwal P et al. Outpatient visit trends for internal medicine ambulatory care sensitive conditions after the COVID-19 pandemic: a time series analysis. BMC Health Services Research 2022;22:198. https://doi.org/10.1186/s12913-022-07566-6
64. Baum A, Kaboli PJ, Schwartz MD. Reduced in-person and increased telehealth outpatient visits during COVID-19 pandemic. Ann Intern Med. 2021;174(1):129-131
65. Horta BL, Silveira MF, Barros AJD, Hartwig FP, Dias MS, Menezes AMB, et al. COVID-19 and outpatient care: a nationwide household survey. Report in Public Health 2022;38(4): e00194121
66. Hallal PC, Hartwig FP, Horta BL, Silveira MF, Struchiner CJ, Vidaletti LP, et al. SARS-CoV-2 antibody prevalence in Brazil a result from two successive nationwide serological household surveys. Lancet Glob Health 2020;8: e1390-1398.
67. Sutherland K, Chessman J, Zhao J. Sara G, et al. Impact of COVID -19 on healthcare activity in NSW, Australia. Public Health Res Pract. 2020;9:30(4):3042030
68. Haldane V, De Foo C, Abdalla SM, et al. Health Systems Resilience in managing the COVID-19 pandemic: lessons from 28 countries. Nat Med 2021:27:964-980
69. Yarhere IE, Oragui O. Reduced admissions in the children’s emergency room during coronavirus -19 pandemic in the University of Port Harcourt teaching Hospital, Nigeria, Niger J Med 2022;31:378-382
70. Ogundele IO, Alakaloko FM, Nwokoro CC, Ameh EA. Early impact of COVID-19 pandemic on paediatric surgical practice in Nigeria: A national survey of paediatric surgeons. BMJ Open 2020;4: e000732
71. Rosa F, Covino M, Sabia L, Quero G, Fiorillo C, Cozza V, et al. Surgical emergencies during SARS-CoV-2 pandemic lockdown: what happened? Eur Rev Med Pharmacol Sci 2020;24:11919-11925
72. Ode MB, Shitta A, Peter SD, Amupitan I, Yilleng SB. The effect of COVID-19 Pandemic on Elective Surgical Services in Jos, North Central, Nigeria. Journal of Biosciences and Medicine 2021;9:29-37
73. Afolalu OO, Atekoja OE, Oyewumi ZO, Adeyeye SO, Jolayemi KI, Akingbade O. Perceived impact of coronavirus pandemic on uptake of healthcare services in South West Nigeria. Pan African Medical Journal. 2021;40(26). 10.11604/pamj.2021.40.2628279
74. Sevaile S, Youkee D, van Duinen AJ, Bailey E, Bangura T, Mangipudi S, et al. The impact of COVID-19 pandemic on hospital utilization in Sierra Leone . BMJ Global Health 2021;6: e005988.doi:10.1136/bmjgh-2021-005988
75. Bolkan HA, van Dunien A, Samai M, et al. Admission and surgery as indicators of hospital functions in Sierra Leone during the West African Ebola outbreak. BMC Health Serv Res 2018:18: 846.
76. Phull M, Grimes CE, Kamara TB, et al. What is the financial burden to patients of accessing surgical care in Sierra Leone? A cross sectional survey of catastrophic and improverishing expenditure. BMJ Open 2021;11:e039049
77. McIntosh A, Bachmann M, Siedner MJ, Gareta D, Seeley J, Herbst K. Effect of COVID-19 lockdown on hospital admissions and mortality in rural KwaZul-Natal. South Africa:interrupted time series analysis. BMJ Open 2021;11:e047961.doi:10.1136/bmjopen-2020-047961
78. South Africa Department of Health. Disaster management Act 2002(Act No57 of 2002) Alert level 5 during the coronavirus COVID-19 lockdown, government Gazzette no 43148:398 2020
79. South Africa Department of Health. Disaster management Act 2002(Act no 57 of 2002) Alert level1 during coronavirus COVID-19 lockdown , government Gazette No43725:999 2020.
80. Li Y, Reeves RM, Wang X, et al. Global patterns in monthly activity of influenza virus, respiratory syncytial virus, parainfluenza virus and metapneumovirus: a systematic analysis. Lancet Glob Health 2019;7:e1031-1045
81. Moustakis J, Piperidis AA, Ogunrombi AB. The effect of COVID -19 on essential surgical admissions in South Africa: a retrospective observational analysis of admissions before and during lockdown at a tertiary healthcare complex. S Afr Med J 2020;110:910
82. Xiao H, et al. The impact of the COVID-19 pandemic on health services utilization in China :time series analysis for 2016-2020. Lancet Reg Health West Pac 2021;9:100122
83. Madhuripan N, Cheung HMC, Alicia Cheong LH, Jawaher A, Willis MH, Larson DB. Variable influencing radiology volume recovery during the next phase of coronavirus disease 2019(COVID-19) pandemic. J Am Coll Radiol. 2020;17:855-864
84. Ahmadi S, Kazemi-Karyani A, Badiee N, Byford S, Mohammadi A, Piroozi B, et al. The impact of COVID-19 pandemic on hospital admissions for nine diseases in Iran: insight from an interrupted time series analysis. Cost Effectiveness and Resource Allocation 2022;20: 58. https://doi.org/10.1186/s12962-022-00394-9
85. Kalanj K, Marshall R, Karol K, Tijak MK, Oreskovic S. The impact of COVID-19 on Hospital Admissions in Croatia. Front Public Health 2021; 9:720948. doi:10.3389/fpubh2021.720948
86. Ball S, Banerjee A, Berry C, Boyle JR, Bray B, Bradlow W, et al. Monitoring indirect impact of COVID-19 pandemic on services for cardiovascular diseases in the UK. Heart. 2020; 106: 1890-1897. doi:10.1136/heartjnl-2020-317870
87. Padmanabhan N, Natarjan I, Gunston R, Raseta M, Roffe C. Impact of COVID-19 on stroke admissions, treatments, and outcome at a comprehensive stroke centre in the United Kingdom. Neurol Sci. 2021;42: 15-20. doi:10.1007/s10072-020-04775-x
88. Maringe C, Spicer I, Morris M, Purushotham A, Nolte E, Sullivian R, et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national population-based modelling study. Lancet Oncol. 2020; 21:1023-1034. doi: 10.1016/S1470-2045(20)30388-0
89. Reichardta P, Bollmann A, Hohenstein S, Glass B, Untcha M, Reichardt A, et al. Decreased incidence of oncology admissions in 75 Helios hospitals in Germany during the COVID-19 pandemic. Oncol Res Treat. 2021;44 :71-74. doi:10.1159/00512935
90. Tschaikowsky T, Becker von Rose A, Consalvo S, Pfluger P, Barthel P, Spinner CD, et al. Numbers of emergency room patients during the COVID-19 pandemic. Notfall und Rettungsmedizin. 2020. https://doi.org/10.1007/s10049-020-00757-w PMID: 32837303
91. Dang A, Thakker R, Li S, Hommel E, Mehta HB, Goodwin JS. Hospitalizations and Mortality From Non-SARS-CoV Causes Among Medicare Beneficiaries at US Hospitals During the SARS-CoV-2 Pandemic. JAMA Network Open 2022;5(3):e221754. doi:10.1001/jamanetworkopen.2022.1754
92. Santi L, Golinelli D, Tampieri A, et al. Non-COVID-19 patients in times of pandemic: emergency department visits, hospitalizations and cause specific mortality in Northern Italy. PLoS One.2020; 16(3): e0248995. doi:10.1371/journal.pone.0248995
93. Mackey K, Ayers CK, Kondo KK, et al. Racial disparities in COVID-19 related functions, hospitalizations and death: a systematic review. Ann Intern Med. 2021; 174:362-373. doi:10.7326/M20-6306
94. Cronin CJ, Evans WN. Excess mortality from COVID and non COVID causes in minority populations. Proc Natl. Acad Sci. USA.2021;118(39): e21013866118. doi:10.1073/pnas.2101386118
95. Janke AT, Mei H, Rothenberg C, Becher RD, Lin Z, Venkatesh AK. Analysis of hospital resource availability and COVID-19 mortality across the United States. J. Hosp Med. 2021;16(4): 211-214. doi:10.12788/jhm.3539
96. Baum A, Schwartz MD. Admissions to Veterans Affairs Hospitals For Emergency Conditions During the COVID-19 Pandemic. JAMA. 2020;324(1):96. https://jamanetwork.com/journals/jama/fullarticle/2767061 PMID:32501493
97. World Health Organisation, Coronavirus disease, https//www.who.int/emergencies/diseases/novel-coronavirus-2019 accessed April2, 2020.
98. Stevens S. Next step on NHS response to COVID-19. https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/urgent-next-steps-on-nhs-response-to-covid-19-letter-simon-stevens.pdf 2020
99. NHS England. Clinical guide for the management of noncoronavirus patients requiring acute treatment: Cancer,https//www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/specialty-guide-acute-treatment-cancer-23-march-2020.pdf 2020. Accessed April 2, 2020.
100. American College of Surgeons , COVID-19 guidelines for triage of cancer surgery patients, https://www.facs.org/covid-19/clinical-guidance/elective-case/cancer-surgery, 2020. Accessed April 2, 2020
101. Soriede K, Hallet J, Matthews JB, et al. Immediate and long term impact of the COVID-19 pandemic on delivery of surgical services. Br J Surg 2020; https://doi.org/10.1002/bjs.11670
102. Dmitri N, Omar MO, James CG, Elizabeth L, Joana FFS, Tom EFA, et al. Elective surgery cancellations due to COVID-19 pandemic: global predictive modelling to inform surgical recovery plans. BJS. 2020;107:1441-1449
103. Salako O, Okunade K, Allsop M, Habeebu M, Toye M, Oluyede G, et al. Upheaval in cancer care during the COVID-19 outbreak. Ecancermedicalscience. 2020:14: 97. doi:10.3332/ecancer.2020.ed97
104. Ogundele IO, Alakaloko FM, Nwokoro CC, Ameh EA. Early Impact of COVID-19 Pandemic on Paediatric Surgical Practice in Nigeria: A National Survey of Paediatric Surgeons. BMJ Paedatr Open.2020;4(1). doi:10.1136/bmjpo-2020-000732
105. Bickler SW, Telfer ML, Sanno-Duanda B. Need forpaediatric surgery care in an urban area of the Gambia. Trop Doct 2003;33: 91-94
106. Ademe Y, Genetu A, Laeke T, Taye M, Bekele A. Impact of COVID-19 on Surgical Volume: Single Center Experience from Addis-Ababa, Ethiopia. Ethop J Health Sci 2022; 32 (1):37 doi:http://dx.doi.org/10.4314/ejhs.v32i15
107. Lei S, Jiang F, Su W, Chen C, Chen J, Mei W, et al. Clinical Characteristics and Outcomes of Patients Undergoing Surgeries during the Incubation Period of COVID-19 Infection. EClinicalMedicine 2020, https://doi.org/10.1016/j.eclinm.2020.100331.
108. Di Bidino R, Cicchetti A. Impact of SARS-CoV-2 on provided health care. Evidence from the emergency phase in Italy. Front Public Health. 2020;8:583583. doi:10.3389/fpubh.2020.583583
109. Daodu O, Panda N, Lopushinsky S, Varghese TK Jr, Brindle M. COVID-19-Considerations and Implications For Surgical Learners. Ann Surg. 2020;272(1):e22-e23
110. Association of Surgeons of Great & Ireland, Association of Coloproctology of Great Britain and Ireland, Association of Upper Gastrointestinal Surgeons, Royal College of Surgeons of Edinburgh, Royal College of Surgeons of England, Royal College of Physicians and Surgeons of Glasgow, Royal College of Surgeons in Ireland, updated General Surgery guidance on COVID-19, 2nd revision, https://www.resed.ac.uk/news-public-affairs/news/2020/april/updated-general-surgery-guidance-on-covid-19-2nd-revision-7th-april-2020,2020 April 9, 2020.
111. Dobbs TD, Gibson JAG, Fowler AJ, Abbott TE, Shahid T, Torabi F, et al. Surgical activity in England and Wales during the COVID-19 pandemic: a nationwide observational cohort study. Br J Anaesth. 2021 Aug; 127(2):196-204. doi:10.1016/j.bja.2021.05.001. Epub2021
112. NHS. Waiting list hits 14 year record high of 4.7 million people. BMJ.2021;373:n995. doi:10.1136/bmj.n995
113. Abram J, Gasteiger L, Putzer G, Spraider P, Mathis S, Hell T et al. Impact of COVID-19 Related Lockdown on Frequency of Acute AND Oncological Surgeries- Lessons Learned from an Austrian University Hospital. Front Public Health 2021; 9:625582. doi:10.3389/fpubh.2021.625582.
114. Mattingly AS, Rose L, Eddington HS, Trickey AW, Gullen MR, Morris AM, et al. Trends in US Surgical Procedures and Health Care System Response to Policies Curtailing Elective Surgical Operations During the COVID-19 Pandemic. JAMA Network Open. 2021;4(12): e2138038. doi:10.1001/jamanetworkopen.202138038. https://jamanetwork.com/accessed November25,2022.
115. Centers for Medicare and Medicaid Services. Non emergent, elective medical services and treatment. Recommendations. Accessed November 17,2021. https://www.cms.gov/files/document/cms-non-emergent-elective-medical-recommendations.pdf.
116. American College of Surgeons. COVID-19: elective case triage guidelines for surgical care. Accessed November 17,2021. https://www.facs.org/-/media/files/covid19/guidance_for_triage_of_nonemergent_surgical_procedures.ashx
117. Centers for Medicare and Medical Services. Opening up America again: Centers for Medicare & Medicaid Services(CMS) recommendations:re-opening facilities to provide non-emergent non-COVID 19 healthcare: phase1. Accessed June8,2021, https:www.gov/files/document/covid-flexibility-reopen-essential-non-covid-services.pdf
118. Vindegaard N, Benros ME. COVID-19 pandemic and mental health consequences: systematic review of current evidence. Brain Behav Immun. 2020;89:531-542. doi:10.1016/j.bbi.2020.05.048
119. Lim J, Broughan J, Crowely D, O’Kelly B, Fawsitt R, Burke MC, et al. COVID-19’s impact on primary care and related mitigation strategies: A scoping review. Eur J Gen Pract 2021;27(1):166-175. Available from: https://doi.org/10.1080/13814788.2021.1946681 PMID:34282695
120. Yao H. The more exposure to media information about COVID-19, the more distressed you will feel. Brain Behav Immun.2020; 87:167-169. doi:10.1016/j.bbi.2020.05.031
121. Vahratian A, Blumberg SJ, Terlizzi EP, Schiller JS. Symptoms of Anxiety or Depressive Disorder and Use of Mental Health Care Among Adults During the COVID-19 Pandemic-United States, August 2020-February 2021. MMWR Morb Mortal Wkly Rep 2021;70:490-494
122. Seo JH, Kim SJ, Lee M, Kang JI. Impact of the COVID-19 pandemic on mental health service use amongst psychiatric outpatients in a tertiary hospital. J Affect. Disord.2021;290:279-283
123. Saladino V, Algeri D, Auriemma V, The psychological and social impact of COVID-19: New perspectives of well being. Frontiers in Psychology. 2020;11:577684
124. Spurr L, Tan HL, Wakeman R, et al. Psychosocial impact of the COVID-19 pandemic and shielding in adults and children with early onset neuromuscular and neurological disorders and their families: a mixed method study. BMJ Open 2022;12:e055430. doi:10.1136/bmjopen-2021-055430