Don't delay surgeries due to Covid: Centre tells hospitals

The Centre on Thursday advised hospitals not to delay surgeries on account of Covid-19 infections in the third wave relying on evidence from AIIMS, Delhi where surgeries conducted during the Omicron-driven wave did not lead to death or Covid-19 related complications as seen in the past.

“The present data indicates that with the current variant (Omicron) surgery is safe and not associated with higher chances of complications or deaths in Covid positive patients unlike the evidence during earlier surges. Patients who need surgery need not be denied surgical intervention presently,” Lav Agarwal, a joint secretary at the Union Health Ministry said.

The advice is on the basis of experiences gathered from 53 OT cases of Covid positive patients at the All India Institute of Medical Sciences, between December 20 and January 20. Twenty one of them received general anaesthesia while the remaining 32 were operated upon under regional anaesthesia. Twenty six of the 32 were C-Sec cases.

Agarwal said there were no complications during surgery and immediate post operative period. Chest X-rays of 21 patients are not suggestive of the infection in the perioperative period, indicating no respiratory complication after general anaesthesia in Covid patients.

While four of the 21 patients died within a week, Covid wasn’t the culprit in any of the cases. “All reported deaths were primarily due to other causes and not linked or aggravated due to Covid-19 infections,” he said.

Experts, however, pointed out that while it would not be proper to vouch for the safety of surgery in the Omicron wave based on a small sample size of 53 patients, the risks during surgeries were much less because of the mild nature of the infection.

“In general, the Omicron variant has been causing a self-limited upper respiratory illness — less than 2% people need hospitalisation or ICU admissions requiring mechanical ventilation. Because the baseline risk is low, and the Omicron variant is attacking the lungs with kid gloves, patients who test positive for SARS-CoV-2 and undergo surgery are likely to have the same post-operative outcomes as those who test negative. Being test positive is no longer a risk factor for adverse outcomes following surgery,” said an internal medicine specialist.

Meanwhile, comparing the clinical profile and vaccination status of two groups of Covid patients admitted in 37 hospitals between November and January, ICMR chief Balram Bhargava said Covid deaths are 50% less among those who are fully vaccinated.

Among the unvaccinated and partially vaccinated, nearly 22% died whereas the mortality dropped to just about 10% among those who are fully vaccinated. Also among the first group 83% had comorbidities whereas in the second group, it rose to 91%.

“Most of the deaths in the Omicron driven third wave took place among those who are unvaccinated,” Balram Bhargava, director general of Indian Council of Medical Research said, urging people to complete their vaccine regimens.

Health ministry data clearly shows a decline in case fatality rate with a rise in vaccination. Similar trends have been seen in Bengaluru, Mumbai and Chennai. More than 96% of India’s adult population has received at least one dose of the Covid-19 vaccine whereas 76% is fully vaccinated.