Effect of the COVID-19 Pandemic on the Activity of Physicians Working in the Areas of Head and Neck Surgery and Otorhinolaryngology

Kowalski, Luiz Paulo; Imamura, Rui; Castro Junior, Gilberto de; Marta, Gustavo Nader; Chaves, Aline Lauda Freitas; Matos, Leandro Luongo; Bento, Ricardo Ferreira

doi:10.1055/s-0040-1712169

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Brasil

International Archives of Otorhinolaryngology

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Sumário

Original Researches, Special Article COVID-19 • Int. Arch. Otorhinolaryngol. 24 (3) • Jul-Sep 2020 • https://doi.org/10.1055/s-0040-1712169 copy

Effect of the COVID-19 Pandemic on the Activity of Physicians Working in the Areas of Head and Neck Surgery and Otorhinolaryngology

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Introduction

Coronavirus disease 2019 (COVID-19) is an acute infection caused by the new coronavirus (SARS-CoV-2) and it is highly transmissible, especially through respiratory droplets. To prepare the health system for the care of these patients also led to a restriction in the activity of several medical specialties. Physicians who work with patients affected by diseases of the head and neck region constitute one of the populations most vulnerable to COVID-19 and also most affected by the interruption of their professional activities.

Objective

The aim of the present study was to assess the impact of the COVID-19 pandemic on the practice of head and neck surgeons and otorhinolaryngologists in Brazil.

Methods

An anonymous online survey of voluntary participation was applied, containing 30 questions regarding demographic aspects, availability of personal protective equipment (PPE), and impact on the routine of head and neck surgeons and otorhinolaryngologists, as well as clinical oncologists and radiation oncologists who work with head and neck diseases.

Results

Seven hundred and twenty-nine answers were received in a period of 4 days, ∼ 40 days after the 1^st confirmed case in Brazil. With professionals working in public and private services, there was a high level of concerns with the disease and its consequences, limited availability of PPE and a significant decrease in the volume of specialized medical care.

Conclusion

The study demonstrated a direct impact of the COVID-19 pandemic on the clinical practice of specialties related to the treatment of patients with diseases of the head and neck region already in the beginning of the illness management in Brazil.

Keywords
COVID-19; pandemics; occupational groups; health personnel; work

Area of expertise	Head and neck surgery		Otorhinolaryngology		Clinical oncology		Radiation oncology		Total		P-value^* * P-value (chi-square test).
	228	31.3%	293	40.2%	111	15.2%	97	13.3%	729	100.0%	P-value^* * P-value (chi-square test).
Years after residency
Resident	7	3.1%	3	1.0%	6	5.4%	10	10.3%	26	3.6%	< 0.001
< 5 years	36	15.8%	39	13.3%	27	24.3%	25	25.8%	127	17.4%
5-10 years	45	19.7%	57	19.5%	27	24.3%	21	21.6%	150	20.6%
10-20 years	73	32.0%	84	28.7%	36	32.4%	28	28.9%	221	30.3%
20-30 years	41	18.0%	71	24.2%	13	11.7%	7	7.2%	132	18.1%
> 30 years	26	11.4%	39	13.3%	2	1.8%	6	6.2%	73	10.0%
Geographic area of practicing
North	8	3.5%	4	1.4%	3	2.7%	5	5.2%	20	2.7%	0.486
Northeast	44	19.3%	47	16.0%	20	18.0%	18	18.6%	129	17.7%
Central West	21	9.2%	22	7.5%	4	3.6%	7	7.2%	54	7.4%
Southeast	135	59.2%	185	63.1%	69	62.2%	59	60.8%	448	61.5%
South	20	8.8%	35	11.9%	15	13.5%	8	8.2%	78	10.7%
Area
Metropolitan	173	75.9%	200	68.3%	78	70.3%	74	76.3%	525	72.0%	0.188
Countryside	55	24.1%	93	31.7%	33	29.7%	23	23.7%	204	28.0%	0.188
Type of service
Private	34	14.9%	138	47.1%	46	41.4%	28	28.9%	246	33.7%	< 0.001
Public	13	5.7%	8	2.7%	9	8.1%	17	17.5%	47	6.4%
Both	181	79.4%	147	50.2%	56	50.5%	52	53.6%	436	59.8%

Reduction in outpatient care	Private		Public		P-value^* * P-value (chi-square test).
Reduction in outpatient care	N	%	N	%	P-value^* * P-value (chi-square test).
100% (full-stop)	118	17.1%	83	16.9%	< 0.001
75-99%	226	32.7%	86	17.5%
50-74%	169	24.4%	95	19.3%
25-49%	76	11.0%	70	14.3%
1-24%	50	7.2%	69	14.1%
No change	53	7.7%	88	17.9%
Total	692	100%	491	100%

Reduction in outpatient care	Head and neck surgery				Otorhinolaryngology				Clinical oncology				Radiation oncology
	Private		Public		Private		Public		Private		Public		Private		Public
	N	%	N	%	N	%	N	%	N	%	N	%	N	%	N	%
100% (full-stop)	38	17.2%	22	11.2%	75	26.0%	56	36.4%	4	4.0%	4	5.6%	1	1.2%	1	1.4%
75-99%	96	43.4%	43	21.9%	115	39.8%	36	23.4%	5	5.0%	5	6.9%	10	12.2%	2	2.9%
50-74%	51	23.1%	51	26.0%	75	26.0%	25	16.2%	25	25.0%	9	12.5%	18	22.0%	10	14.5%
25-49%	24	10.9%	38	19.4%	17	5.9%	4	2.6%	22	22.0%	16	22.2%	13	15.9%	12	17.4%
1-24%	9	4.1%	23	11.7%	3	1.0%	9	5.8%	26	26.0%	24	33.3%	12	14.6%	13	18.8%
No change	3	1.4%	19	9.7%	4	1.4%	24	15.6%	18	18.0%	14	19.4%	28	34.1%	31	44.9%
Total	221	100%	196	100%	289	100%	154	100%	100	100%	72	100%	82	100%	69	100%

	No		Yes		P-value^* * P-value (chi-square test).
	N	%	N	%	P-value^* * P-value (chi-square test).
Area of expertise
Head and neck surgery	187	82.0%	41	18.0%	0.004
Otorhinolaryngology	246	84.0%	47	16.0%
Clinical oncology	80	72.1%	31	27.9%
Radiation oncology	68	70.1%	29	29.9%
Risk of severe forms of COVID-19
No	324	77.5%	94	22.5%	0.127
Yes, low risk	159	80.7%	38	19.3%
Yes, high risk	98	86.0%	16	14.0%
Years after residency
Resident	22	84.6%	4	15.4%	0.858
< 5 years	99	78.0%	28	22.0%
5-10 years	116	77.3%	34	22.7%
10-20 years	181	81.9%	40	18.1%
20-30 years	104	78.8%	28	21.2%
> 30 years	59	80.8%	14	19.2%

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[1] Address for correspondence Luiz P. Kowalski, Avenida Enéas de Carvalho Aguiar, 255, 8° andar, sala 8174, São Paulo, SP, Brazil (e-mail: lp_kowalski@uol.com.br).