Impact of COVID-19 pandemic on clubfoot program at tertiary care institute

PURPOSE: The COVID-19 pandemic had serious impact on health care sector. During reprioritisation of the services, elective and non-emergency procedures were suspended, with gradual resumption of services after lockdown was over. In this study we assessed the impact of pandemic on our clubfoot program at a tertiary care institute. Also, we discussed the future challenges and strategies to re-start our clubfoot program. METHODS: Data was collected retrospectively regarding registrations, demography and procedures done at our clubfoot centre. Study period was 25 March to 31 December 2020 and it was compared with same duration from previous years 2019 and 2018. After the data analysis, the findings were discussed on departmental committee meeting, future challenges were considered and strategies were charted out for re-establishing the clubfoot program at our Institute. RESULTS: When compared to previous year, we noted 46% decline in paediatric outpatient registrations and 60% decline in new clubfoot registrations at our centre. The clubfoot follow-up visits reduced by 30% in the pandemic year 2020. 80% of clubfoot registrations were local residents during pandemic year, which was 54%, 58% in year 2019 and 2018 respectively. The percentage of neglected cases remained stable, however, share of relapse cases increased during pandemic year. There was 80% decline in number of tenotomies and 90% decline in other clubfoot surgeries performed during pandemic year 2020 compared to year 2019. CONCLUSION: COVID-19 pandemic had definite disruptive impact on our clubfoot program. With decreased new registrations, follow-up visits and increased relapses, we anticipate a significant increase in clubfoot cases in need of casting & treatment. To deal with pent-up demand and an anticipated wave of relapse and neglected clubfoot cases, we have proposed strategies to re-establish clubfoot program in post-pandemic new-normal. We hope these will prepare us for any adversaries we face.