The COVID-19 pandemic is disrupting neurosurgical care at medical centers throughout the United States. Institutional and governmental recommendations are not specific to neurosurgery. Protocols are urgently needed to help neurosurgeons triage cases based on acuity, and also to minimize the risk of infection for both patients and peri-operative medical staff. In many academic tertiary care hospitals, there is limited personal protective equipment and staffing shortages.

Given that there is insufficient data to create formal guidelines, physicians from the University of California San Francisco (UCSF) Department of Neurological Surgery and Department of Anesthesia have presented their institutional neurosurgical treatment algorithm during the California COVID-19 shelter in place order. The UCSF protocols are based on outbreak “surge levels,” and using these levels to guide operating room utilization based on the acuity of neurosurgical cases. The protocols and checklists from UCSF, which are published online in Neurosurgery — the official journal of the Congress of Neurological Surgeons (CNS) —  offer some guidance to neurosurgeons in other centers.

Click here to read “Letter: The Coronavirus Disease 2019 Global Pandemic: A Neurosurgical Treatment Algorithm.”

The CNS also offers a related webinar presentation, “UCSF’s Experience with COVID-19 in the Midst of the California Shelter-in-place Order.”  Click here to view the webinar.