José Güell MD
More than a month ago, EuroTimes spoke with José Güell, Director of Cornea and Refractive Surgery Unit Instituto Microcirugia Ocular of Barcelona, Spain. Professor Guell shared his perspective from Spain, which was then in the midst of severe coronavirus outbreaks. In a second interview, we asked Dr Güell for his thoughts on making the transition back to the clinic.
Looking ahead past the worst days of the coronavirus outbreak, how will things change in your practice? For example, will you be using telemedicine for patient interactions?
We are proceeding carefully, with a plan to begin performing elective surgeries in our clinic on 11 May. We will continue to monitor the situation and will check in two weeks after that to see how things are going.
I expect telemedicine will play a big role. In recent weeks, I have had the opportunity to have a lot of interactions online in conference calls all around the world. It seems that now you don’t need to leave home to interact, you don’t even need to leave your chair. It’s great. I’ve learned that many things I was doing before by mail, phone, email or even WhatsApp, I can now do by teleconference.
Telemedicine works. It also takes much less time to review information and you can respond to patients much faster. If they have good cameras, I can see the outer layers of the eye quite well. I can see PKP patients relatively well. We have already organised a special room in the clinic where we have set up telemedicine stations. It is much better, more practical, and you can charge for it. This will also be great for those who may fear to travel, or who are unable to travel. I believe we have entered the era of telemedicine.
What precautions will you take to screen patients for COVID-19?
We have plans in place. By the time we are operating again all of my staff and patients will have had PCR and antibody tests in advance. Patients with a positive PCR will not be operated for at least another four weeks and until we see a negative test. The same holds for a symptomatic patient even without a positive PCR test.
Will you limit the number of patients who can be in the waiting area?
We have extreme restrictions regarding how many patients are allowed in the waiting room, which does significantly reduce the ability to see patients. Everyone has to wear a mask and gloves. Everyone will be checked in advance at the entrance for fever. Any patient who has a fever or suspicious symptoms will be referred to another area.
What changes do you expect to see during the transition?
The rhythm of surgery will be different than before, because each case will require additional preparation of the patient with mask and so on. Each of our eight operating rooms will need to be cleaned and disinfected after each surgery, and this takes time. We don’t how long this will continue. We are just starting to reduce the backlog of cases. It is also possible that during this period of decompression we might have another peak in COVID cases and the rules may change again.
Nearly 80% of the instruments we were using before were disposable. We don’t have any plans for any additional changes there.
Of course, emergency cases will be treated first, but other than that we have no particular prioritisation of cases. Most patients who were scheduled for the weeks before the outbreak have been called and rescheduled. So far, the response has been quite good. Patients are ready to have their surgeries.
- Jose L. Güell MD,Director of Cornea and Refractive Surgery Unit Instituto Microcirugia Ocular of Barcelona, Spain; Professor of the IMO Master Programme UAB; Lead Professor and Coordinator Anterior Segment Diseases European School for Advanced studies in Ophthalmology (ESASO) Lugano, Switzerland
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