Some are being deployed to new intradepartmental roles, others lateralized to provide care for coronavirus patients. The reassignment of staff is a common, often temporary, response to expanding coverage in a crisis.
The most experienced neurosurgeons are from the most vulnerable age groups, so their wisdom and skills may be best used via telemedicine encounters, guiding ethical decisions on appropriate neurosurgical interventions, or preserved for neurosurgery-specific cases. Attendings with critical care experience may need to oversee medical ICU care. Residents adept in neurocritical care and placing central lines can undergo intensive skills training to bolster competence and confidence in intubation and ventilator management. Residents staffing neurosurgery services can work remotely when possible to place orders, write notes, call consults, and conduct virtual visits with patients, to provide a buffer in case onsite residents become ill and/or require quarantine. Many centers are assigning “contaminated” and “clean” teams to respective wards. Meanwhile, the reduction in neurosurgical patient censuses permits redeployment of remaining faculty, residents, and advanced-practice providers to support COVID-19–specific care.
In geographic locations currently facing or anticipating the wave of COVID-19 patients, neurosurgeons can begin task sharing to strengthen workforce systems, while continuing to triage operative cases and invest in contingency plans if the pandemic is prolonged 2).