03/20/2020
Dear all,
These are unprecedented times that affect us and everyone all over the world. COVID 19 is a pandemic and a rapidly changing target, everyday there is a new plan, It affected every single hospital, healthcare, patients and providers.
We are in a war with two fronts – One to fight the rapidly expending corona epidemic while the other is to protect our patients, our community and ourselves the care givers.
In the mist of the expansion to our area, we took all the necessary (NYDOH guidance) precautions and continue in developing and expanding the Thoracic Surgery Practice at University at Buffalo.
In the last 2 weeks, We did the first video assisted thoracoscopic lobectomy in a patient with lung cancer, the first minimally invasive esophagectomy for esophageal cancer – in our system, for a patient with esophageal cancer. Who was discharged on oral diet, to home, 5 days after his major surgery. We performed yesterday the first Robotic lung resection – for lung cancer, while the patient is already discharged.
With all that, my team (mainly the surgery residents, anesthesia, surgical nurses and techs), are relentlessly working in the forefront, to treat patients with airway issues, empyema, pneumothoraxes and other acute thoracic pathology, including patients who are suspected to have COVID19 infection.
We are committed to continue the fight on this front and hope to be an example for the whole system.
This is all done with care and keeping the protection instructions by the CDC and NYDOH.
In order to contain, flattening the curve and comply with the national effort;
We will defer elective visits for in-patients and out-patients.
Cancel elective surgery.
Assist in developing protocols for space issues and medical supplies shortages, activating emergency plans, making contingency plans, lake of blood products, potential deficiency of hospital beds, ventilators, and more.
We need to join a tier system of prioritizing surgical procedures.
In an effort to protect our staff, and due to regional limited resources of COVID19 testing kits, protecting gear etc.. and avoid the spread of the disease we thought to create a grading systems which may bring sensible use of these resources.
Patients who are admitted with fever, cough and shortness of breath, should be isolated and visited with protected gear of gown, facemasks, eye protectors and gloves.
Patients with these symptoms who were in contact with COVID19 confirmed patients or with a recent visit to pandemic areas – China, Europe, Iran - should be treated with extra precautions and have the team which in contact with them wear n95 masks.
I believe these instructions should be the same for airway procedures as well.
These may change as the information and data evolving.
Stay safe and keep fighting!
Best,
Yaron
Yaron Perry MD, FACS
Clinical Professor of Surgery
Chief Division - Thoracic Surgery
Jacobs School of Medicine and Biomedical Sciences
University at Buffalo,
State University of New York
yperry@buffalo.edu
