As the country and region normalize from the effects of the COVID-19 outbreak, we wanted to put down some thoughts concerning our own diary over the past several months.

As we have pointed out in other articles, we were blessed at CMD to have remained open throughout the pandemic. As we were considered an essential service, we continued to provide spinal, pain, orthopedic and hand care throughout the crisis, albeit on a reduced level. Certainly the majority of patients were reluctant to come to the office during the height of the viral pathology loads, but we did maintain open office hours and supplemented with our telemedicine platforms.

Overall, orthopedic and spinal trauma was lessened as a result of inactivity, as well as the interesting phenomenon of less illness being reported both to pediatricians and internal medicine doctors, etc., which corroborates the understanding that much of illness has to do with our much-needed but price-paid social interaction.

As only urgent or semi-urgent spinal cases were allowed to be done via executive order, our surgeries were somewhat limited; however, we did have the occasion to operate during the period for several infection cases and pressing pathologies. Of note, there were no significant complications; however, those patients who had been COVID-positive at some point in time during the pandemic were noted to have higher bleeding rates, which has also been pointed out anecdotally by other spine surgeons. This anecdotal evidence is contrary to the initial publications of other non-orthopedic specialties, which have noted issues with increased clotting and, in severe cases, stroke. In addition, surgery during that time noted increased drainage from patients, but no definitive increase in infection rates.

As it relates to personal protective gear, staff and patients are accommodating! It takes some time to get used to wearing a mask for the entirety of the day, with most patients, at the beginning of the pandemic, not entering the office in a mask. At its height, the majority of patients came already donning a mask, and we provided for those who did not have.

We were also blessed to have several patients who recovered successfully from COVID-19, including some of the more publicized younger ones, who were intubated and then successfully recovered.

If you have been delaying seeking spinal, pain, orthopedic and hand care, now is a good time to call us!

Wishing you all the best of health and hoping to see you all on good occasions and in good health!

By Jonathan Lewin, MD