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TAU Muskuloskeletal, Plastic and Hand Surgery research

Effect of COVID-19 pandemic on emergency care and surgery

Objectives | Background | Research Group | Publications

Objectives

The collaborative multicentre study seeks to examine the effect of the COVID-19 pandemic and the related societal restrictions and healthcare preparedness measures on emergency care demand and on surgical procedures in Finnish population.

The study utilizes data collected from the electronic databases of the participating hospitals on incoming referrals, emergency visits, hospital stays and surgical procedures for the years 2017–2020. Using this data, the project will publish research reports about the effect of the pandemic on incidence trends of emergency visits and surgical procedures on a wide spectrum of medical specialties. All data will be processed completely without any identifiers and as monthly reports. Therefore, the data does not form a personal data register subject to the Act on the Secondary Use of Health and Social Data. In addition, the project will provide research reports determining the transmission potential of the virus.

Background

The COVID-19 epidemic originated in Wuhan, China, in December 2019. The first coronavirus case in Finland was detected at the end of January 2020. In mid-March 2020 the World Health Organization (WHO) declared a global COVID-19 pandemic. Using powers afforded by the Emergency Powers Act, the Finnish government declared nationwide lockdown restrictions on 16 March 2020 due to the rapidly spreading disease. Among other things, the lockdown included the closure of public facilities, such as schools and libraries, the limitation of public gatherings to no more than 10 persons, and the closure of the country’s borders. Moreover, restaurants were closed and public events cancelled. People over the age of 70 were advised to isolate themselves to prevent infection.

Public healthcare prepared for the rapid spread of the coronavirus and for the ensuing potential increase in hospital care demand by cancelling a majority of healthcare visits relating to elective treatment and diagnostics. As a result the availability of appointments in basic healthcare was reduced and in specialised care elective surgical procedures were cancelled or postponed.

The cancellations in elective care have given rise to a concern about a growing treatment backlog caused by the healthcare restrictions and delays and also about an increase in emergency care demand. The growing treatment backlog may lead to issues with healthcare capacity, as the patients seeking treatment present more severe symptoms than before due to delayed examinations and inadequate treatment. The backlog may in time present itself through increased mortality, higher total cost of healthcare as well as through deterioration in health related quality of life of individuals.

The prolonged COVID-19 pandemic and new epidemic waves necessitate reorganizations in the healthcare system to ensure sufficient resources and preparedness for both a worsening epidemic situation and a growing treatment backlog. Without adequate preparation healthcare may find itself in crisis, if the pandemic is further prolonged. Political decision-making and hospital district strategies play a central role in the allocation of healthcare resources and thereby in the minimization of a long-term detrimental effect of the treatment backlog on public health. The research project aims to produce high-quality scientific information on the impact of healthcare restrictions on the treatment backlog and therefore also on emergency care demand. The information we produce can be used in the future to estimate the effects of restrictions on morbidity and thus to plan optimal resourcing in extraordinary situations.

The research group

Leader

Ville Mattila, Professor, TAUH

Principal researchers

Ville Ponkilainen, MD, PhD, Central Finland Central Hospital

Ilari Kuitunen, MD, PhD, Mikkeli Central Hospital

Mikko Uimonen, MD, PhD, Central Finland Central Hospital

Researchers

Aleksi Reito, Docent, Tampere University Hospital

Antti Launonen, Docent, Tampere University Hospital

Juha Paloneva, Professor, Central Finland Central Hospital

Teemu Hevonkorpi, Lic. Med. Central Finland Central Hospital

Saara Jäntti, BM, Tampere University

Mika Ukkonen, Docent, Tampere University Hospital

Esa Jämsen, Professor, Tampere University Hospital

Antti Riuttanen, Lic. Med., Tampere University Hospital

Pasi Rinne, Lic. Med., Vaasa Central Hospital

Minna Laitinen, Docent, Helsinki University Hospital

Joonas Sirola, Professor, Kuopio University Hospital

Miska Vuorlaakso, Lic. Med., Central Hospital of Tavastia Proper

Heikki Seikkula, MD, PhD, Central Finland Central Hospital

Joonas Kuorikoski, Lic. Med., Central Finland Central Hospital

Markku Eskola, Docent, Tampere Heart Hospital

Jarkko Jokihaara, Docent, Tampere University Hospital

Contact

Professor Ville Mattila, ville.mattila@tuni.fi

Peer reviewed research reports in international publications:

  1. The effect of societal restrictions on emergency and urgent surgeries
    Ponkilainen V, Kuitunen I, Hevonkorpi TP, Paloneva J, Reito A, Launonen AP, Mattila VM. The effect of nationwide lockdown and societal restrictions due to COVID-19 on emergency and urgent surgeries. Br J Surg. 2020 Sep;107(10):e405-e406. doi: 10.1002/bjs.11847. Epub 2020 Aug 7. PMID: 32770538; PMCID: PMC7436678.
  2. The effect of societal restrictions on emergency department visits
    Kuitunen I, Ponkilainen VT, Launonen AP, Reito A, Hevonkorpi TP, Paloneva J, Mattila VM. The effect of national lockdown due to COVID-19 on emergency department visits. Scand J Trauma Resusc Emerg Med. 2020 Dec 4;28(1):114. doi: 10.1186/s13049-020-00810-0. PMID: 33276799; PMCID: PMC7716110.
  3. The effect of societal restrictions on incidence of sexually transmitted diseases
    Kuitunen I, Ponkilainen V. COVID-19-related nationwide lockdown did not reduce the reported diagnoses of Chlamydia trachomatis and Neisseria gonorrhoeae in Finland. Sex Transm Infect. 2021 Jan 4:sextrans-2020-054881. doi: 10.1136/sextrans-2020-054881. Epub ahead of print. PMID: 33397798; PMCID: PMC7783371.
  4. The effect of societal restrictions on appendicitis
    Jäntti S, Ponkilainen V, Kuitunen I, Hevonkorpi TP, Paloneva J, Ukkonen M, Mattila VM. Trends in appendicectomy during the COVID-19 pandemic. Br J Surg. 2021 Jan 27;108(1):e35-e36. doi: 10.1093/bjs/znaa086. PMID: 33640937; PMCID: PMC7799189.
  5. Covid-19 chains of transmission in ice hockey
    Kuitunen I, Uimonen MM, Ponkilainen VT. Team-to-team transmission of COVID-19 in ice hockey games – a case series of players in Finnish ice hockey leagues. Infect Dis (Lond). 2021 Mar;53(3):201-205. doi: 10.1080/23744235.2020.1866772. Epub 2021 Jan 11. PMID: 33423589.
  6. The effect of societal restrictions on the number of severely injured patients
    Riuttanen A, Ponkilainen V, Kuitunen I, Reito A, Sirola J, Mattila VM. Severely injured patients do not disappear in a pandemic: Incidence and characteristics of severe injuries during COVID-19 lockdown in Finland. Acta Orthop. 2021 Feb 4:1-5. doi: 10.1080/17453674.2021.1881241. Epub ahead of print. PMID: 33538233.
  7. The effect of societal restrictions on oncological surgery
    Kuitunen I, Ponkilainen VT, Uimonen MM, Paloneva J, Launonen AP, Mattila VM. Postponing elective surgery due to COVID-19 did not decrease the oncological surgery rate in Finland. Br J Surg. 2021 Feb 28:znab046. doi: 10.1093/bjs/znab046. Epub ahead of print. PMID: 33655303.
  8. The effect of societal restrictions on common ENT surgeries for children
    Haapanen M, Renko M, Artama M, Manninen IK, Mattila VM, Uimonen M, Ponkilainen V, Kuitunen I. Tympanostomies and tonsillar surgery in children during the COVID-19 pandemic in Finland. Laryngoscope Investig Otolaryngol. 2021 Jul 15;6(4):878-884. doi: 10.1002/lio2.622.
  9. The effect of societal restrictions on urological surgeries
    Uimonen M, Kuitunen I, Seikkula H, Mattila VM, Ponkilainen V. Healthcare lockdown resulted in a treatment backlog in elective urological surgery during COVID-19. BJU Int. 2021 Jul;128(1):33-35. doi: 10.1111/bju.15433.
  10. The effect of societal restrictions on older patients in emergency departments
    Uimonen M, Kuitunen I, Jämsen E, Ponkilainen V, Mattila VM. Emergency visits by older adults decreased during COVID-19 but increased in the oldest old. J Am Geriatr Soc. 2021 Jul;69(7):1738-1740. doi: 10.1111/jgs.17143.
  11. The effect of societal restrictions on emergency department visits and procedures due to coronary artery disease
    Uimonen M, Ponkilainen V, Kuitunen I, Eskola M, Mattila VM. Emergency department visits due to coronary artery disease during COVID-19 in Finland: A register-based study. Scand J Public Health. 2021 Sep 8:14034948211038422. doi: 10.1177/14034948211038422.
  12. The effect of societal restrictions on lower limb amputations
    Vuorlaakso MA, Uimonen MM, Kuitunen IM, Ponkilainen VT, Mattila VM. During the COVID-19 pandemic in Finland, the number of minor lower limb amputations decreased, whereas major amputations increased. Br J Surg. 2021 Sep 27;108(9):e292-e293. doi: 10.1093/bjs/znab186.
  13. The effect of societal restrictions on children’s injuries
    Kuorikoski J, Kuitunen I, Uimonen MM, Mattila VM, Ponkilainen VT. Incidence of pediatric injury visits decreased, while trauma surgeries remained stable during the first and second waves of the COVID-19 pandemic in Finland: a register-based study. 2021. World Journal of Pediatric Surgery.
  14. The effect of societal restrictions on emergency visits due to abdominal pain
    Jäntti S, Ponkilainen VT, Kuitunen I, Ukkonen M, Hevonkorpi T, Mattila VM. Trends in acute abdominal pain visits to EDs and rate of abdominal surgeries during the COVID-19 pandemic in Finland: A retrospective register study. 2021. Scandinavian Journal of Surgery.
  15. The impact of the pandemic on elective surgery waiting times and volume
    Uimonen M, Kuitunen I, Paloneva J, Launonen AP, Ponkilainen V, Mattila VM. The impact of the COVID-19 pandemic on waiting times for elective surgery patients: A multicenter study. PLoS One. 2021 Jul 6;16(7):e0253875. doi: 10.1371/journal.pone.0253875
  16. In 2020, the coronavirus pandemic extended the waiting times for elective surgery especially among younger patients
    Uimonen MM, Kuitunen I, Ponkilainen VT, Mattila VM. Prioritizing Elective Surgery During the COVID-19 Pandemic Has Caused Age-Related Inequality: a Multicenter Study. SN Compr. Clin. Med. 4, 25 (2022). doi.org/10.1007/s42399-021-01080-2