Impact of the State of Emergency on the Characteristics of Surgical Cases during the COVID-19 Pandemic

After the SARS-CoV-2 pandemic spread in Japan, a state of emergency was declared in April 2020. At our hospital, the number of available ORs was restricted in April and May 2020. To evaluate the effect of restrictions of OR capacity on the number/characteristics of surgeries and patients, we retrospectively examined data on patients who underwent surgery in April and May from 2017 to 2020. Values obtained in 2020 were compared with those obtained from the same period in the previous three years.While the total number of surgeries decreased, the number of emergency surgeries remained steady, so the proportion of emergency surgeries increased. The proportion of patients with poor performance status（ASA-PS≥3）increased in both elective and emergency groups. The number of cesarean sections increased, suggesting a tendency for cases to concentrate in perinatal centers with sufficient capacity. In contrast, otorhinolaryngology surgeries decreased, reflecting the trend to avoid risk of infection from upper airway manipulation. Extremity surgeries also decreased due to their deferrable characteristics.These findings suggest the need not only to prevent infection but to prepare for severe cases, emergency cases, and caesarean sections as well. It is important to consider the balance between the clinical needs of the region and the capacity of individual hospital facilities.