Ophthalmology Non-Vocational Registrar, Department of Ophthalmology, Gisborne Hospital, Hauora Tairāwhiti, Gisborne.
Ophthalmologist, Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medicine and Health Sciences, University of Auckland, Auckland.
N Z Med J. 2021 Jul 9;134(1538):120-127.
In response to the COVID-19 pandemic, the New Zealand government enforced a nationwide 'alert level 4' lockdown from 26 March to 27 April 2020. We assessed the impact of this lockdown on New Zealand's public ophthalmology service.
An anonymous online survey was sent to all New Zealand-based fellows of the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) after lockdown. Respondents provided retrospective assessment of practice patterns and their personal health during the COVID-19 lockdown. This was supported by national-level administrative data, allowing survey findings to be contextualised.
Fifty-seven respondents (response rate 49%) working in the public health system participated. A large majority of respondents reduced elective clinic and surgical volumes by at least 75% (82% and 98%, respectively). National-level information confirmed clinic reduced to 38.2% of normal and elective operating volumes to 11.5%, with virtual visits increasing 17.9-fold. Elective clinic and elective operating volumes promptly recovered to usual volumes on the second month post lockdown. Most respondents (58%) followed the RANZCO triaging guideline, and 28% triaged emergencies only. At a personal level, respondents reported a significant physical health benefit (p<0.001) associated with the lockdown experience, but no change in mental health or social wellbeing.
Publicly employed ophthalmologists experienced dramatic reductions to elective clinic and operating volumes during the COVID-19 lockdown. The prompt recovery of service delivery volumes back to pre-lockdown levels supports the value of a COVID-19 elimination strategy in New Zealand. Virtual visits for selected patients allowed ongoing management without risking virus transmission.
应对 COVID-19 大流行，新西兰政府于 2020 年 3 月 26 日至 4 月 27 日实施了全国范围的“4 级警戒”封锁。我们评估了此次封锁对新西兰公共眼科服务的影响。
封锁结束后，我们向所有在新西兰的澳大利亚和新西兰皇家眼科医师学院（RANZCO）院士发送了匿名在线调查。受访者对 COVID-19 封锁期间的实践模式和个人健康状况进行了回顾性评估。这项工作得到了国家级行政数据的支持，使调查结果具有背景意义。
57 名（应答率为 49%）在公共卫生系统工作的受访者参与了调查。绝大多数受访者将选择性门诊和手术量减少了至少 75%（分别为 82%和 98%）。国家级信息证实，门诊量减少至正常水平的 38.2%，择期手术量减少至 11.5%，虚拟就诊量增加了 17.9 倍。封锁后第二个月，择期门诊和择期手术量迅速恢复到正常水平。大多数受访者（58%）遵循 RANZCO 分诊指南，28%只分诊急症。从个人层面来看，受访者报告称封锁经历带来了显著的身体健康益处（p<0.001），但心理健康或社会福利没有变化。
在 COVID-19 封锁期间，从事公共服务的眼科医生的选择性门诊和手术量大幅减少。服务量迅速恢复到封锁前的水平，支持了新西兰消除 COVID-19 策略的价值。为部分患者提供虚拟就诊，在不增加病毒传播风险的情况下，允许进行持续管理。
