AAFPRS Statement on COVID-19

March 22, 2020

Amid ongoing concerns for the safety and wellbeing of our patients, the public, our members and their staff, the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) is actively monitoring developments related to the novel Coronavirus (COVID-19) pandemic. This is an unprecedented, swiftly changing crisis. Our thoughts and concern are with those affected and we are committed to the protection and care of patients, physicians and their staff, and the broader public being served by the medical community. 

Many medical authorities and regulatory agencies are posting statements with recommendations on ways to limit the spread of the virus, as well as preserve necessary resources that may be needed as the pandemic unfolds. These entities include the WHO, CDC, ACS, AMA, as well as national, state, and local governments.
Nearly every public and corporate healthcare facility has imposed restrictions on non-essential utilization of services. On March 18, 2020, The Centers for Medicare and Medicaid Services (CMS) had also issued guidance limiting all non-essential planned surgeries and procedures, including dental, until further notice. This is important to preserve critical resources, such as ventilators and Personal Protective Equipment (PPE).  It is also important to limit exposure of patients and staff to the SARS-CoV-2 virus. These CMS recommendations are in alignment with the pandemic strategies being provided via recommendations from other federal, state and local government entities on the front lines of addressing this crisis—and are also in alignment with measurers already being utilized in many other parts of the globe being severely impacted by COVID-19.

It is from this perspective that the AAFPRS is recommending the following approaches for its members:

1. Prudent and ethical medical judgement, as well as compliance with applicable federal, state and local governmental requirements, should be exercised to postpone elective surgical and non-essential procedures, within the unique circumstances of your practice setting.

  • Different levels of urgency and complexity related to patient needs that take into account the unique nature of each patient’s clinical, social and environmental conditions must always be distinctively assessed via sound physician judgment to discern what is truly elective or non-essential.
  • Since the numbers of COVID-19 patients requiring care are expected to further escalate, any surgical or non-surgical care where it can be determined through sound clinical judgement that a delay is appropriate, should be delayed until general consensus by medical and governing authorities that it is reasonable to resume such activities.
  • This approach minimizes risk to both patients and the health care team—given that asymptomatic patients or medical team members may transmit the virus unknowingly to others. Reducing unnecessary opportunities for transmission is key to reducing the spread of the disease.
  • Additionally, this approach also strategically decreases the use of resources, such as beds, ventilators, and personal protective equipment (PPE), that might be needed elsewhere due to the increasing demands on the healthcare systems.
  • And lastly, given the nature of how the virus spreads via respiratory droplets, there is growing concern and data that suggests that performing nasal surgery generates a higher risk for virus transmission to the medical team conducting the surgery—thus, postponing any surgery that can be delayed also reduces this risk. 

2. Be sure to remain up to date with federal, state and local directives (especially as the nature of recommendations is and will continue to change depending upon the current status of the virus in your own location)—and especially keep current on all CDC guidelines and notifications.
3. Given the swiftly changing and expanding nature of this unparalleled pandemic, it is likely that the expansive need for clinical care may grow to the point where it will exceed the availability of critical care providers.

  • Physicians from other specialties, including our AAFPRS members, may need to be called upon to help manage patients in this large-scale crisis.
  • It is critical for members to stay healthy, should our clinical skills be needed. 
  • Additionally, consider reaching out to your local health departments to be in proactive contact, should the need for your expanded clinical role arise in your community.

4. There already is a scarcity of many key resources required to treat patients with COVID-19 infection—such as beds, ventilators, and personal protective equipment (PPE). This need is also likely to dramatically grow.

  • AAFPRS members should consider potentially donating PPE when possible.
  • Additionally, it may be enormously helpful to consider loaning beds and/or ventilators, should they be required in your community.
  • The AAFPRS will soon be sending out a ventilator survey to members to identify who may be interested in potentially working with government entities and/or major healthcare providers to loan ventilators nationally, as this is where some of the greatest scarcity need is already developing—please be on the lookout for our survey and consider participating.  
  • Consider reaching out to your local health departments and/or Office of Emergency Management (OEM) to be in proactive contact, so that you can ascertain the best ways to make such PPE donations or equipment loans within your own community.
  • It is inspiring to note that positive actions like these are already starting to take place between our AAFPRS members and their communities!
We again urge all of our members to be sure to be safe—protecting yourself, your patients, your staff, and your families will help immensely with the larger efforts to flatten the spread of COVID-19, while also sustaining the long-term quality of life for you and all in our national and global community. We are bound by the Hippocratic Oath which states: “I will prevent disease whenever I can, for prevention is preferable to cure.”

Never before have any of us encountered the challenges and risks we are facing as a result of the COVID-19 pandemic. It is placing incredible stress and pressure on us all. But know that we are in this together—and by utilizing the above strategies, collaborating with each other and our communities, and genuinely supporting one another, we will rise above this crisis…and we will be stronger.

On behalf of the AAFPRS Board,
Mary Lynn Moran, MD
AAFPRS President