Why surgical patients need Covid-19 vaccine

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Health & Fitness

Why surgical patients need Covid-19 vaccine


vaccinea

Healthcare staff prepares to administer a Covid-19 vaccine. FILE PHOTO | AFP

Summary

  • The scramble for the new Covid-19 vaccines is still on globally.
  • Most countries are trying as hard as possible to get their hands on the few available vaccines to ensure that most of their citizens have been immunised against the viral disease.
  • In most low and middle-income countries such as Kenya, the supply of these novel vaccines is limited.

The scramble for the new Covid-19 vaccines is still on globally. Most countries are trying as hard as possible to get their hands on the few available vaccines to ensure that most of their citizens have been immunised against the viral disease.

In most low and middle-income countries such as Kenya, the supply of these novel vaccines is limited. Were it not for the Covid-19 Vaccines Global Access (COVAX) mechanism, it would have taken ‘ages’ for the vaccines to arrive in most developing countries.

In lieu of the shortage, governments have been forced to make strategic decisions on who should be prioritised for vaccination.

In Kenya, for instance, the focus is on essential workers including health practitioners, security personnel and teachers as well as the elderly above 58 years who are considered to have a greater risk of infection.

Aside from these groups, health experts are urging governments to also consider prioritising patients awaiting surgery, for Covid-19 vaccination.

chronic ailments

This is especially important for patients seeking elective operations — non-emergency surgeries — to help tackle medical conditions such as cancer among other chronic ailments.

Due to their suppressed immunity and the nature of the illness, these people face a greater risk of suffering from the adverse effects of the coronavirus disease and succumbing to resulting complications — mainly respiratory problems — once they are infected.

A new study, published in the British Surgical Journal (BSJ), indicates that vaccinating these patients ahead of the general population could potentially help to avoid thousands of post-operative deaths linked to the virus.

According to the study, which was funded by the National Institute for Health Research in the UK, patients who develop Covid-19 infection after elective surgery have an increased risk (between four- and eight-fold) of death in the 30 days following the operation.

The study sample involved surgery patients in three different age groups: 18-49, 50-69, and people over the age of 70.

Based on the results, the risk was observed across all age groups. But it was highest by a significant margin for those over 70 years.

For example, the post-operative death rate for cancer patients over the age of 70 is 2.8 per cent, based on the new study. But this figure rose to 18.6 per cent in those who also contracted coronavirus.

Based on these high risks, which surgical patients face, scientists calculate that the vaccination of surgical patients — particularly among the elderly and those with cancer — is more likely to prevent Covid-19 related deaths than vaccines given to the population at large.

Overall, the scientists estimate that global prioritisation of pre-operative vaccination for elective patients could prevent an additional 58,687 coronavirus disease-related deaths in one year.

They note that this could be particularly important for low and middle countries where mitigation measures such as nasal swab screening and Covid-19 free surgical pathways, which can reduce the risk of complications related to the virus, are unlikely to be fully implemented.

The Covid-19 free surgical pathways refer to the complete segregation of the operating theatre, critical care units, and inpatient ward areas in hospitals.

This seeks to separate patients infected with the Covid-19 disease from the non-infected ones.

The study was conducted by a collaborative international team of researchers (known as CovidSurg) that were led by experts from the University of Birmingham in the UK.

elective surgery

They analysed data of 141,582 patients from across 1,667 hospitals in 116 countries including Australia, Brazil, China, India, United Arab Emirates, UK and the United States.

“Pre-operative vaccination could support a safe re-start of elective surgery by significantly reducing the risk of Covid-19 complications in patients and preventing tens of thousands of related post-operative deaths,” stated Aneel Bhangu, a lead author of the study from the University of Birmingham in the UK.

“Many countries, particularly low and middle-income nations, will not have widespread access to vaccines for several years. While vaccine supplies are limited, governments are prioritising vaccination for groups at the highest risk of Covid-19 death. Our work can help to inform these decisions.”

Dr Dmitri Nepogodiev, another lead author of the study from the University of Birmingham, noted that restarting elective surgeries, which had been put on hold or cancelled amid the pandemic, is a global priority.

“It’s crucial that policymakers use the data we have collected to support a safe restart to elective surgery. Covid-19 vaccination should be prioritised for these surgical patients ahead of the general population.”

He says vaccination is also likely to decrease post-operative pulmonary (respiratory) complications among infected patients, reducing the use of intensive care units and overall healthcare costs.

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