Impact of COVID-19 restrictions on emergency bellwether procedures in South and Southeast Asia
Year: 2026
Type: article
Study design: Observational Study
Abstract: Introduction Around the time COVID-19 was declared a global pandemic, various restrictions and measures were implemented at all levels to limit disease spread and preserve healthcare capacity. Data are lacking in many low- and middle-income countries on how these measures impact healthcare utilisation and outcomes. This study aims to determine the impact of COVID-19 restrictions on volumes of the three emergency bellwether procedures in South and Southeast Asia.Methods This was an interrupted time series study of patients who underwent any of the three emergency bellwether procedures (caesarean section, laparotomy and open fracture fixation) from 1 January 2018 to 31 December 2021 at one of eight institutions in Singapore, Malaysia, Indonesia, India and Vietnam. We compared the weekly volumes, baseline characteristics and outcomes of each procedure across different time periods in each institution defined by different levels of COVID-19 restrictions using selected indicators from a city-level and hospital-level response index.Results Weekly volumes of emergency caesarean section decreased significantly in Guwahati Neurological Research Centre (GNRC) (p=1.62×10 −5) and Ulin General Hospital (UGH) (p<2.2×10−16) but increased in Adam Malik Hospital (AMH) (p=1.45×10−5). For laparotomies, volume increased in Singapore General Hospital (p=2.38×10−5) but decreased in Military Hospital 175 (p=6.30×10−7). The volume of open fracture fixations decreased in GNRC (p=3.08×10−8), AMH (p=1.68×10−6) and UGH (p=8.15×10−6).Conclusions COVID-19 restrictions on the city and hospital level were associated with a decrease in surgical volumes of the three bellwether procedures in some of the institutions. There was some suggestion of surgical capacity limitations in UGH and Military Hospital 175 during periods of more stringent COVID-19 restrictions.
Source: BMJ Public Health
Authors: Sze Ling Chan, Jia Sheng Guan, Sean Shao Wei Lam, Nomal Chandra Borah, Nipanka Goswami, Dipika Dey, Purabi Sarkar, Zairin Noor, Pandji Winata Nurikhwan, Hariadi Yuseran, Tjahyo Kelono Utomo, Sanjib Singh Nepram, Nehar Sinam, Budi Irwan, Muhammad Fahdy, Muhammad Ichwan, Inke Nadia Diniyanti Lubis, Dina Kumala Sari, Ian Chik, Levin Kesu Belani, Nur Azurah Abdul Ghani, Razman Jarmin, April Camilla Roslani, Mee Hoong See, Mukhri Hamdan, Ainee Sarah Ahmad, Hoang Le, Van Thanh Nguyen, Tan Duy Dao, Thanh Tung Ton, Vu Minh Duy Nguyen, Thi-Ngoc Dung Nguyen, Pham Nguyet Thanh Do, Duc Thanh Bui, Quoc Viet Tran, Hiang Khoon Tan, Pierce Kah Hoe Chow, Sachin Mathur
Institutions: SingHealth, Duke-NUS Medical School, Nanyang Technological University, Lambung Mangkurat University, Regional Institute of Medical Sciences, Universitas Sumatera Utara, National University of Malaysia, University of Malaya, University Malaya Medical Centre, Industrial University of Ho Chi Minh City, National University of Singapore, Singapore General Hospital, SingHealth Duke-NUS Academic Medical Centre, National Cancer Centre Singapore
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
Funder: Singapore General Hospital
Award: G1362669050
OpenAlex ID: W7223198749