Pre-operative COVID-19 testing and decolonization

Initially, our medical centers faced planning for inpatient, ER, and critical care surge capacity, cohorting COVID-positive patients, modeling case numbers, counting ventilators and estimating utilization rates of PPE.2 While the numbers increased across the Unites States of America, we began to plan for the surge capacity at our hospital, the University of Alabama at Birmingham. A positive screening test resulted in case postponement for two weeks with planned retesting. Since the initiation of this pre-operative COVID-19 process until May 5, we have tested 2437 asymptomatic patients and have found 18 positive results. Several tangible benefits of presurgical testing include PPE conservation and the protection of healthcare workers from inadvertent exposure to COVID-19.5 A known COVID-19 status provides considerable reassurance to the perioperative team and therefore a safer working environment. Testing also provides an element of additional patient safety and reduction in healthcare expense and resource utilization, as performing surgery on asymptomatic COVID-19 positive patients is associated with a 44% increase in postoperative ICU admissions and a 20.5% mortality rate.6 Our process involves surgeons posting cases to the operating room schedule at least 72-h in advance of the desired surgery date.