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Coronavirus pandemic will result in the cancellation of 28 MILLION global surgeries

Millions of elective surgeries could be cancelled around the world as a direct result of disruption from the coronavirus pandemic, a new study revealed.

Researchers from the University of Birmingham say cancelled elective surgeries will lead to patients facing a lengthy wait for the health issues to be resolved. 

Based on a 12-week period of peak disruption to hospital services due to COVID-19, 28.4 million elective surgeries worldwide will cancelled or postponed in 2020.

The modelling study, published in the British Journal of Surgery, indicates that each additional week of disruption will add another 2.4 million cancellations. 

Study authors predict 72.3 per cent of all planned surgeries will be cancelled and the bulk of these will be either orthopaedic or cancer related operations. 

Millions of elective surgeries could be cancelled around the world as a direct result of disruption from the coronavirus pandemic, a new study revealed

Millions of elective surgeries could be cancelled around the world as a direct result of disruption from the coronavirus pandemic, a new study revealed

This map shows the percentage of benign surgeries cancelled by country around the world - with the majority of cancellations happening in wealthier countries

This map shows the percentage of benign surgeries cancelled by country around the world – with the majority of cancellations happening in wealthier countries

The Birmingham team collected detailed information from surgeons across 359 hospitals in 71 countries on plans for cancellation of elective surgery. 

They then put this information through a new data model to estimate the total number of surgery cancellations expected across 190 countries.  

The majority of cancelled surgeries are for benign diseases 

Most of the cancelled surgeries would be operations for benign diseases.  

The study looked at the overall rate of cancellations over 12-weeks of disruption from COVID-19. 

The following percentage of surgery types will be postponed: 

  • 81.7 per cent: benign surgery
  • 37.7 per cent: cancer surgery
  • 25.4 per cent: elective Caesarean sections

They have based the estimates on 12-weeks of disruption as that is the estimate for how long it has taken Wuhan in China to come out of lockdown. 

In the UK alone there will be 516,000 cancelled surgeries and it will cost the NHS at least £2 billion to catch up on the missed operations, the authors say.

The researchers project that worldwide 72.3 per cent of planned surgeries would be cancelled through the peak period of COVID-19 related disruption. 

Most cancelled surgeries will be for non-cancer conditions with orthopaedic procedures cancelled most frequently.

They predict that 6.3 million orthopaedic surgeries could be cancelled worldwide over a 12-week period due to COVID-19. 

They also think 2.3 million global cancer surgeries will be cancelled or postponed.

In the United Kingdom, the NHS advised hospitals to cancel most elective surgeries for 12 weeks – during the peak of the virus outbreak. 

It is estimated that this will result in 516,000 cancelled surgeries, including 36,000 cancer procedures – creating an ongoing backlog for after the disruption. 

If, after the disruption ends, the NHS increases the number of surgeries performed each week by 20 per cent compared to pre-pandemic activity, it will take 11 months to clear the backlog. 

However, each additional week of disruption will lead to the cancellation of an extra 43,300 surgeries, significantly extending the period it will take to clear the backlog.

Aneel Bhangu, Consultant Surgeon and Senior Lecturer at the NIHR Global Health Research Unit on Global Surgery at the University of Birmingham said elective surgeries were cancelled to reduce the risk of patients being exposed to COVID-19.

It was also done ‘to support the wider hospital response, for example by converting operating theatres in to intensive care units’. 

Researchers say more than 72 per cent of all elective operations are being cancelled as a result of coronavirus disruption, as can be seen by the yellow bars in this graph

Researchers say more than 72 per cent of all elective operations are being cancelled as a result of coronavirus disruption, as can be seen by the yellow bars in this graph

The Birmingham team collected detailed information from surgeons across 359 hospitals in 71 countries on plans for cancellation of elective surgery

The Birmingham team collected detailed information from surgeons across 359 hospitals in 71 countries on plans for cancellation of elective surgery

“Although essential, cancellations place a heavy burden on patients and society.

Over 72 per cent of elective surgeries will be cancelled with San Marino cancelling the most at 86.6 per cent

Researchers found that San Marino cancelled the most elective operations of the 190 countries at 86.6 per cent.

The UK cancelled 71.8 per cent of operations and the US will cancel 72.4 per cent of elective surgeries.

Researchers say 72.3 per cent of all planned global surgeries will be cancelled as a result of COVID-19.

The ten countries expected to cancel the most elective surgeries:

  1. San Marino – 86.60 per cent
  2. Austria – 85.90 per cent 
  3. Denmark – 85.00% per cent 
  4. Thailand – 82.10 per cent
  5. Uzbekistan – 81.60 per cent 
  6. St. Lucia – 81.00 per cent 
  7. Botswana – 80.70 per cent
  8. Jamaica – 80.20 per cent 
  9. Indonesia – 80.10 per cent
  10. Nauru – 75.70 per cent 

‘Patients’ conditions may deteriorate, worsening their quality of life as they wait for rescheduled surgery. In some cases, for example cancer, delayed surgeries may lead to a number of unnecessary deaths,’ said Bhangu.

Dr. Dmitri Nepogodiev from the study team said: “Each additional week of disruption to hospital services results in an additional 43,300 surgeries being cancelled.

‘It is important that hospitals regularly assess the situation so that elective surgery can be resumed at the earliest opportunity.’ 

‘The Government must ensure that the NHS is provided with additional funding and resources to ramp up elective surgery to clear the backlog,’ said Nepogodiev.

The research was completed as a collaboration with CovidSurg – a research network focused on the impact of COVID-19 on surgical care. 

Authors say the study demonstrates the major burden of cancelled elective surgery due to the COVID-19 pandemic. 

‘Although a similar proportion of surgery will be cancelled across different country- income settings and geographic regions, the greatest number of cancellations will be in upper middle-income countries,’ they wrote in the paper. 

‘Cancer surgery will be prioritised in most settings, with most cancellations relating to surgery for benign conditions, most frequently orthopaedics.’








BREAK DOWN OF CANCELLED SURGERIES BY TYPE IN EACH OF 190 COUNTRIES 
  Benign surgery Cancer surgery Obstetrics Overall
Afghanistan 74.90% 70.70% 35.40% 67.60%
Albania 83.80% 44.20% 23.70% 73.10%
Algeria 80.80% 49.70% 26.70% 74.00%
Andorra 83.80% 32.50% 19.40% 73.40%
Angola 75.90% 63.80% 29.70% 69.10%
Antigua and Barbuda 81.00% 43.70% 26.60% 71.10%
Argentina 82.00% 36.70% 22.00% 70.20%
Armenia 81.00% 48.20% 26.40% 74.00%
Australia 85.40% 25.90% 22.50% 73.50%
Austria 85.90% 31.00% 21.20% 74.80%
Azerbaijan 80.80% 48.20% 28.80% 74.00%
Bahamas, The 82.40% 39.70% 24.90% 71.30%
Bahrain 82.40% 37.50% 22.00% 70.70%
Bangladesh 76.00% 61.00% 31.00% 69.10%
Barbados 82.40% 38.80% 23.30% 71.00%
Belarus 82.90% 37.50% 23.50% 71.20%
Belgium 82.70% 27.80% 22.10% 71.70%
Belize 78.00% 50.80% 26.90% 71.90%
Benin 75.20% 69.60% 30.00% 66.80%
Bhutan 77.00% 62.80% 31.80% 70.10%
Bolivia 77.00% 55.40% 26.60% 68.70%
Bosnia and Herzegovina 80.30% 45.90% 24.50% 70.80%
Botswana 80.70% 50.40% 28.10% 74.10%
Brazil 81.20% 43.60% 26.10% 73.50%
Brunei Darussalam 84.50% 35.70% 22.50% 72.00%
Bulgaria 81.10% 39.90% 24.10% 70.30%
Burkina Faso 72.80% 74.00% 37.00% 66.70%
Burundi 73.10% 72.50% 34.40% 66.30%
Cabo Verde 77.10% 59.00% 28.40% 69.40%
Cambodia 74.10% 66.00% 31.50% 68.20%
Cameroon 74.70% 63.40% 34.40% 68.70%
Canada 84.30% 29.10% 17.90% 73.10%
Central African Republic 71.20% 77.10% 36.30% 65.70%
Chad 74.60% 74.10% 37.30% 68.10%
Chile 82.30% 37.30% 23.10% 70.60%
China 79.40% 48.40% 28.00% 72.80%
Colombia 79.20% 44.80% 29.90% 72.30%
Comoros 74.70% 67.00% 33.50% 66.70%
Congo, Dem. Rep. 71.50% 72.30% 37.70% 65.70%
Congo, Rep. 77.20% 66.40% 34.80% 71.00%
Costa Rica 80.40% 42.50% 24.40% 70.30%
Cote d’Ivoire 74.00% 69.70% 32.90% 66.40%
Croatia 82.80% 34.60% 24.30% 70.60%
Cuba 84.30% 41.20% 23.60% 72.90%
Cyprus 83.80% 32.20% 24.50% 73.40%
Czech Republic 83.90% 32.10% 22.70% 73.40%
Denmark 85.00% 31.30% 20.50% 74.10%
Djibouti 76.20% 71.50% 34.80% 68.50%
Dominica 79.90% 53.50% 26.60% 73.80%
Dominican Republic 80.90% 46.90% 29.00% 73.80%
Ecuador 78.20% 49.90% 26.50% 71.90%
Egypt, Arab Rep. 76.60% 57.90% 30.50% 69.20%
El Salvador 78.60% 58.80% 30.00% 70.70%
Equatorial Guinea 78.20% 65.10% 31.70% 71.30%
Eritrea 74.20% 73.70% 35.10% 67.30%
Estonia 83.50% 32.10% 21.20% 73.10%
Eswatini 76.30% 64.20% 31.50% 69.70%
Ethiopia 73.60% 73.60% 34.70% 66.80%
Fiji 80.40% 52.30% 27.10% 74.00%
Finland 83.50% 28.20% 19.00% 72.30%
France 83.00% 32.40% 20.50% 72.70%
Gabon 78.90% 55.00% 28.80% 70.50%
Gambia, The 75.80% 73.50% 36.00% 68.60%
Georgia 80.40% 44.80% 23.20% 70.70%
Germany 85.00% 24.00% 19.70% 72.80%
Ghana 75.80% 64.10% 31.00% 69.30%
Greece 80.80% 32.00% 19.90% 70.90%
Grenada 79.50% 47.10% 25.70% 72.60%
Guatemala 78.90% 60.70% 28.00% 71.00%
Guinea 75.70% 71.80% 34.00% 68.00%
Guinea-Bissau 75.00% 74.30% 36.00% 68.10%
Guyana 77.90% 59.00% 25.60% 69.70%
Haiti 72.10% 69.10% 36.50% 65.60%
Honduras 74.00% 61.00% 28.30% 67.20%
Hungary 83.50% 33.10% 21.30% 70.70%
Iceland 84.80% 27.80% 20.00% 73.30%
India 79.30% 59.70% 28.40% 71.20%
Indonesia 80.10% 54.40% 28.60% 74.10%
Iran, Islamic Rep. 80.60% 41.30% 23.20% 70.20%
Iraq 79.30% 58.50% 28.10% 71.10%
Ireland 87.40% 26.70% 17.40% 75.20%
Israel 85.30% 29.00% 21.20% 73.90%
Italy 84.20% 33.50% 25.20% 74.00%
Jamaica 80.20% 52.40% 29.70% 74.10%
Japan 84.10% 30.10% 21.60% 73.20%
Jordan 79.00% 53.00% 27.70% 73.00%
Kazakhstan 81.90% 37.10% 23.30% 70.30%
Kenya 75.70% 66.00% 33.20% 69.60%
Kiribati 76.90% 60.70% 34.50% 70.10%
Korea, Rep. 85.00% 30.50% 20.40% 74.00%
Kuwait 81.20% 38.50% 27.70% 70.30%
Kyrgyz Republic 77.90% 58.30% 28.90% 70.00%
Lao PDR 76.40% 62.60% 30.90% 69.60%
Latvia 80.70% 35.30% 22.40% 69.00%
Lebanon 79.80% 50.00% 25.00% 73.10%
Lesotho 73.90% 70.80% 36.80% 67.10%
Liberia 75.00% 72.90% 35.70% 68.00%
Libya 78.50% 53.40% 27.80% 72.70%
Lithuania 83.60% 34.00% 21.10% 73.50%
Luxembourg 84.10% 29.40% 20.90% 73.10%
Madagascar 73.50% 70.60% 34.10% 66.30%
Malawi 74.00% 69.20% 34.20% 66.50%
Malaysia 81.50% 41.00% 26.10% 70.90%
Maldives 78.90% 54.80% 27.70% 73.20%
Mali 73.40% 72.70% 35.50% 66.70%
Malta 84.40% 31.20% 19.50% 73.60%
Marshall Islands 78.00% 55.60% 32.30% 70.30%
Mauritania 74.70% 70.10% 34.00% 67.10%
Mauritius 82.20% 40.30% 23.50% 71.20%
Mexico 80.70% 41.80% 25.00% 70.40%
Micronesia, Fed. Sts. 77.00% 62.20% 30.80% 69.90%
Moldova 79.20% 52.80% 29.10% 73.20%
Monaco 84.70% 24.50% 17.70% 72.60%
Mongolia 79.40% 51.40% 29.10% 73.20%
Montenegro 81.40% 42.90% 24.50% 71.10%
Morocco 78.00% 58.10% 31.50% 70.40%
Mozambique 75.20% 74.00% 34.50% 68.00%
Myanmar 76.00% 64.60% 30.00% 69.30%
Namibia 74.80% 58.40% 30.20% 67.70%
Nauru 82.20% 53.80% 26.90% 75.70%
Nepal 76.50% 66.30% 28.50% 69.70%
Netherlands 85.40% 26.90% 19.50% 73.70%
New Zealand 84.30% 29.00% 24.50% 73.20%
Nicaragua 77.00% 56.40% 30.00% 69.20%
Niger 74.00% 76.20% 35.40% 67.50%
Nigeria 74.80% 68.00% 33.70% 66.90%
North Macedonia 79.90% 45.90% 25.80% 72.70%
Norway 86.20% 23.40% 19.80% 73.70%
Oman 83.10% 35.00% 22.90% 70.80%
Pakistan 77.50% 64.00% 31.60% 68.10%
Palau 84.40% 39.10% 25.80% 72.70%
Panama 81.00% 42.90% 23.90% 70.80%
Papua New Guinea 74.50% 66.40% 31.30% 66.10%
Paraguay 79.50% 48.70% 28.20% 72.90%
Peru 78.40% 46.70% 25.10% 71.60%
Philippines 78.90% 55.10% 27.90% 73.20%
Poland 83.70% 35.10% 20.20% 73.70%
Portugal 81.70% 34.90% 19.00% 69.50%
Qatar 82.80% 34.20% 22.70% 70.40%
Romania 82.50% 35.30% 24.20% 70.50%
Russian Federation 81.60% 36.90% 23.40% 70.10%
Rwanda 76.00% 67.20% 35.90% 68.10%
Samoa 76.50% 55.80% 28.80% 71.40%
San Marino 86.60% 26.10% 18.80% 74.50%
Sao Tome and Principe 75.70% 60.60% 32.40% 69.00%
Saudi Arabia 82.50% 34.70% 23.50% 72.70%
Senegal 77.10% 69.60% 33.90% 68.80%
Serbia 82.50% 41.30% 22.40% 71.50%
Seychelles 81.00% 39.50% 22.70% 70.00%
Sierra Leone 74.00% 75.80% 35.00% 67.40%
Singapore 85.20% 27.40% 18.70% 73.50%
Slovak Republic 82.40% 32.80% 22.70% 72.40%
Slovenia 82.80% 32.10% 22.80% 72.50%
Solomon Islands 78.30% 68.20% 32.80% 69.30%
South Africa 77.50% 56.30% 28.30% 69.40%
South Sudan 72.90% 74.60% 36.00% 66.60%
Spain 82.20% 31.80% 22.20% 72.00%
Sri Lanka 82.40% 44.70% 24.40% 72.20%
St. Kitts and Nevis 78.60% 46.80% 24.70% 69.70%
St. Lucia 81.00% 50.80% 26.80% 74.40%
St. Vincent and the Grenadines 79.20% 50.70% 26.10% 72.80%
Sudan 74.60% 72.30% 35.90% 67.60%
Suriname 79.30% 50.50% 28.20% 73.00%
Sweden 85.40% 28.20% 17.40% 73.80%
Switzerland 85.10% 24.30% 20.20% 73.00%
Syrian Arab Republic 77.70% 70.20% 33.70% 69.30%
Tajikistan 78.60% 57.20% 30.40% 70.70%
Tanzania 75.20% 68.30% 35.60% 67.60%
Thailand 82.10% 44.00% 26.80% 74.30%
Timor-Leste 74.80% 61.20% 32.40% 68.30%
Togo 76.50% 71.40% 37.80% 69.20%
Tonga 80.00% 54.60% 26.70% 74.00%
Trinidad and Tobago 80.10% 41.30% 26.70% 69.90%
Tunisia 80.30% 50.90% 23.90% 73.60%
Turkey 81.10% 38.20% 22.50% 69.90%
Turkmenistan 79.10% 54.40% 29.60% 73.40%
Tuvalu 77.80% 55.10% 28.80% 72.40%
Uganda 75.20% 69.30% 33.00% 67.20%
Ukraine 80.80% 46.30% 22.70% 73.40%
United Arab Emirates 83.20% 33.00% 21.30% 72.90%
United Kingdom 82.80% 28.80% 18.80% 71.80%
United States 83.00% 31.10% 17.50% 72.40%
Uruguay 80.10% 39.70% 23.20% 69.40%
Uzbekistan 81.60% 52.80% 27.30% 75.10%
Vanuatu 78.70% 65.20% 29.60% 71.50%
Venezuela, RB 80.20% 50.40% 28.60% 73.70%
Vietnam 80.00% 57.00% 28.30% 71.40%
Yemen, Rep. 73.60% 70.90% 36.10% 66.80%
Zambia 77.40% 61.80% 31.80% 70.40%
Zimbabwe 75.20% 66.20% 33.20% 69.20%

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