Surgical capacity is disaster preparedness: A scoping review of how surgery and anesthesiology departments responded to COVID-19


  • Matthew T. Hey, MD
  • Madeleine Carroll, MD
  • Lili B. Steel, BSc
  • Mayte Bryce-Alberti, MD
  • Radzi Hamzah, MD, MPH
  • Rachel E. Wittenberg, MPH
  • Anam Ehsan, MBBS
  • Hodan Abdi, MD
  • Latoya Stewart, MD
  • Raina Parikh, MD
  • Raisa Rauf, MD Candidate
  • Jacqueline Cellini, MLIS, MPH
  • Kiana Winslow, BA
  • Isaac G. Alty, MD
  • Craig D. McClain, MD, MPH
  • Geoffrey A. Anderson, MD, MPH, FACS



surgical capacity, coronavirus disease 2019 response, pandemic preparedness, surgical disaster response, anesthesia disaster response


Objective: This study evaluated how surgical and anesthesiology departments adapted their resources in response to the coronavirus disease 2019 (COVID-19) pandemic.

Design: This scoping review used the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol, with Covidence as a screening tool. An initial search of PubMed, Embase, Web of Science, Global Index Medicus, and Cochrane Systematic Reviews returned 6,131 results in October 2021. After exclusion of duplicates and abstract screening, 415 articles were included. After full-text screening, 108 articles remained.

Results: Most commonly, studies were retrospective in nature (47.22 percent), with data from a single institution (60.19 percent). Nearly all studies occurred in high-income countries (HICs), 78.70 percent, with no articles from low-income countries. The reported responses to the COVID-19 pandemic involving surgical departments were grouped into seven categories, with multiple responses reported in some articles for a total of 192 responses. The most frequently reported responses were changes to surgical department staffing (29.17 percent) and task-shifting or task-sharing of personnel (25.52 percent).

Conclusion: Our review reflects the mechanisms by which hospital surgical systems responded to the initial stress of the COVID-19 pandemic and reinforced the many changes to hospital policy that occurred in the pandemic. Healthcare systems with robust surgical systems were better able to cope with the initial stress of the COVID-19 pandemic. The well-resourced health systems of HICs reported rapid and dynamic changes by providers to assist in and ultimately improve the care of patients during the pandemic. Surgical system strengthening will allow health systems to be more resilient and prepared for the next disaster.

Author Biographies

Matthew T. Hey, MD

Program in Global Surgery and Social Change, Harvard Medical School; Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts

Madeleine Carroll, MD

Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts; Department of Surgery, Yale New Haven Hospital, New Haven, Connecticut

Lili B. Steel, BSc

Division of Nutritional Sciences, Cornell University, Ithaca, New York

Mayte Bryce-Alberti, MD

Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts

Radzi Hamzah, MD, MPH

Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts

Rachel E. Wittenberg, MPH

Harvard Medical School, Boston, Massachusetts

Anam Ehsan, MBBS

Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts

Hodan Abdi, MD

Program in Global Surgery and Social Change, Harvard Medical School; Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts

Latoya Stewart, MD

Columbia University Vagelos College of Physicians and Surgeons, New York, New York

Raina Parikh, MD

Department of General Surgery, University of Connecticut, Storrs, Connecticut

Raisa Rauf, MD Candidate

Chobanian & Avedisian School of Medicine, Boston University, Boston, Massachusetts

Jacqueline Cellini, MLIS, MPH

Countway Library, Harvard Medical School, Boston, Massachusetts

Kiana Winslow, BA

Program in Global Surgery and Social Change, Harvard Medical School, Boston, Massachusetts

Isaac G. Alty, MD

Program in Global Surgery and Social Change, Harvard Medical School; Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts

Craig D. McClain, MD, MPH

Program in Global Surgery and Social Change, Harvard Medical School; Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children’s Hospital, Boston, Massachusetts

Geoffrey A. Anderson, MD, MPH, FACS

Program in Global Surgery and Social Change, Harvard Medical School; Division of Trauma, Burn, and Surgical Critical Care, Brigham and Woman’s Hospital, Boston, Massachusetts


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How to Cite

Hey, M. T., M. Carroll, L. B. Steel, M. Bryce-Alberti, R. Hamzah, R. E. Wittenberg, A. Ehsan, H. Abdi, L. Stewart, R. Parikh, R. Rauf, J. Cellini, K. Winslow, I. G. Alty, C. D. McClain, and G. A. Anderson. “Surgical Capacity Is Disaster Preparedness: A Scoping Review of How Surgery and Anesthesiology Departments Responded to COVID-19”. American Journal of Disaster Medicine, vol. 19, no. 2, Apr. 2024, pp. 119-30, doi:10.5055/ajdm.0466.