Neurosurgery services in Dr. Sardjito General Hospital, Yogyakarta, Indonesia, during COVID-19 pandemic: an experience from a developing country

Manusubroto, Wiryawan; Wicaksono, Adiguno S.; Tamba, Daniel Agriva; Sudiharto, Paulus; Pramusinto, Handoyo; Hartanto, Rachmat Andi; Basuki, Endro

Abstract Background Most articles describing the effect of the COVID-19 pandemic on neurosurgical services have been from developed countries. We attempt to report our experience in carrying out neurosurgical services in Dr. Sardjito General Hospital, Yogyakarta, Indonesia, during the time of the pandemic. Methods To collect information on the effect of the pandemic in Indonesia and Yogyakarta, we gathered data from the Indonesian Ministry of Health online database for the national data and local government records for the local data (including records of Dr. Sardjito General Hospital Division of Neurosurgery). Results Compared to other countries, Indonesia has not been severely hit by the impact of COVID-19. To raise the understanding of the natural history of the pandemic, we grouped the period into four different phases: Phase 1 (there was confirmed cases in Indonesia but no cases found in Yogyakarta), Phase 2 (the first case in Yogyakarta detected), Phase 3 (the time when the cumulative cases surpass its peak), and Phase 4 (the pandemic ends). At the time of this writing, we were still in Phase 2 and in this phase, we experienced a decrease in the number of emergency surgical procedures, from an average of 4 to 2.4 procedures per week. Moreover, the number of elective operations dropped from an average of 12 to 9 procedures per week. Conclusions A pandemic, such as COVID-19, reduces both inpatient and outpatient neurosurgical activities. A comprehensive plan can improve both utilization and safety of the neurosurgical staff.