By the Numbers Analysis of COVID-19’s Effect on a Neurosurgical Residency at the Epicenter

Rothrock, Robert J.; Maragkos, Georgios A.; Schupper, Alexander J.; McNeill, Ian T.; Oermann, Eric K.; Yaeger, Kurt A.; Gilligan, Jeffrey; Bederson, Joshua B.; Mocco, J. D.

Abstract Background The SARS-CoV-2 pandemic has created challenges to neurosurgical patient care. Despite editorials evaluating neurosurgery COVID-19 responses, data reporting COVID-19’s effects on case volume, census, and resident illness are lacking. Objective To present areal-world analysis of neurosurgical volumes, resident deployment, and unique challenges encountered during the SARS-CoV-2 outbreak peak in New York City. Methods Daily census and case volume data were prospectively collected throughout the Spring 2020SARS-CoV-2 outbreak. Neurosurgical census was compared against COVID-19 system-wide data. Neurosurgical cases during the crisis were analyzed and compared to seven-week periods from 2019 and 2020. Resident deployment and illness were reviewed. Results From March 16-May 5, 2020, residents participated in 72 operations and 69 endovascular procedures. This compares to 448 operations and 253 endovascular procedures in January-February 2020 and 530 operations and 340 endovascular procedures over March-May 2019. There was a 59% reduction in neurosurgical census during the outbreak (median 24 patients, 2.75 average total cases daily). COVID-19 neurosurgical admissions peaked in concert with the system-wide pandemic. Three residents demonstrated COVID-19 symptomatology (no hospitalizations occurred) for a total 24 workdays lost (median 7 days). Conclusion These data provide real-world guidance on neurosurgical infrastructure needs during a COVID-19 outbreak. While re-deployment to support the COVID-19 response was required, there remained a significant need to continue to provide critical neurosurgical service.