Covid-19: Brain and spine surgery, Abuja

We closed the hospital to new patients in March 2020, even before the government initiated the official lockdown in Abuja. We were acutely aware of the increasing number of positive cases in Abuja, especially patients returning from abroad.

In this regard, any patients returning from outside the country were requested to self-isolate for 14 days, before we would consider them for consultation. In real terms, we finally resorted to the use of phone and Whatsapp videos for reviewing patients.

Tele consultation
Patients call the BASS hotline: 08122221616 and speak with the Customer Service Officers in an open and honest way, describing any specific requests: medical and non-medical. Patients then send in their details by text message and a file is opened for them. Thereafter, they are asked to pay for a phone consultation via bank transfer to the hospital accounts.

The medical issues which require consultation with the spine surgeon or neurosurgeon are transferred to the consultant for specialist management. The doctor can then call for a detailed phone conversation and consultation. If required, the consultation can be switched to Whatsapp video for specific evaluations.

Previous MRI scan results and images can be uploaded for review via email or Whatsapp. New requests for MRI scan, x-rays or blood tests can be requested and sent as a jpeg image to the patient. This can be shown to the diagnostic centres where the tests are carried out. Results can be emailed directly by the diagnostic centre.

Dr Ogungbo of BASS Abuja.

Early discharge
One other way we have adjusted to the Corona virus pandemic is early discharge and home monitoring of patients. We had a few patients in the hospital before the lockdown who were discharged home early. All were reviewed by phone calls and pictures of their wounds sent for the doctors’ review by Whatsapp.

This creativity and especially the availability of apps such as Whatsapp and Skype has enabled us to provide follow up care, have patients send in images of their incisions or areas of concern.

For example, we performed a lumbar pedicle screw fixation for severe low back pain and degenerative lumbar disease. The patient was discharged home with information, advice and pictures of physical exercises to undertake at home. A month later, she is doing great and has returned to near normal activities.

In the future, I think it will allow us to offer care to patients beyond our local geography or who face challenges with transportation. I would expect that a year from now the COVID infection crisis will have passed and/or diminished and most of, if not all, the surgical and outpatient routine (with the addition of more video/phone visits) will have returned to normal.

A learning process
It is hard to say what the new normal will look like, but I think we will continue to institute some of the things we learned during the crisis. I believe that some sort of social distancing and precautions that we adopted during the crisis will continue to be used even when we return to our new normal.

Hand-washing and sanitation, spacing patients for social distancing and telemedicine are likely to continue to be used in some form. Our practice will continue these robust safety measures for patients and staff. Staffs are currently encouraged to wear facemasks and sanitize their hands readily and frequently when interacting with the patient.

We have recently deliberately instituted two ideas in the hospital. The first is a phone call or message to patients on the anniversary of their operations at the hospital. We have encouraged the Customer Service department to call the patients and inquire as to their well-being. This has been appreciated by many patients. I have many patients who just need to talk and are doing so well that their visits via phone calls make us realize how efficient and easy it is for our patients. Some of course use the opportunity to pass on information about their clinical condition to the surgical team.

The second idea is to also call up patients before or on their birthdays as it approaches. This sometimes serves as a useful follow-up strategy and of immense pleasure to the team when patients express their happiness at the call. For a certain part of our patients, this will be used perhaps more in the future.

Reverse medical tourism
The important lesson is perhaps to understand that this did and could occur again, and this will allow us to prepare for the future. I suspect we will see an increase in the surgical case volume for a 12- to 18-month period, as some patients and relatives will be eager to accept the risk of local management in Nigeria.

We believe that our clinical practice will flourish and have higher demand as patients seek out centers that provide the safest environment for their care. There are many Nigerians who will now be prepared to seek out quality care locally rather than tarnishing everyone with the same dirty brush. We need to use this period to highlight the great services we offer and push the brand name.

At BASS, we are ready to assist Nigerians with good outcomes in brain and spine surgery.

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