Table 1 The triage system during the coravirus-19 pandemic, as proposed by Haft et al. [4]. Covid-19- coronavirus disease 2019
Essential services | Deferred |
|---|---|
Tier 1 (0–30% inpatient Covid-19 load, mild reduction in operative capacity) | |
All in-patients waiting for surgery, including emergency services | Asymptomatic outpatients |
Outpatients who are at greatest risk of adverse events | Truly elective interventions |
Asymptomatic or minimally symptomatic | |
Severe mitral regurgitation | |
Atrial septal defect and/or patent foramen ovale surgery | |
Asymptomatic aneurysm with demonstrated stable size | |
Isolated arrhythmia procedures | |
Tier 2 (30–60% inpatient Covid-19 load, moderate reduction in operative capacity) | |
All in-patients waiting for surgery, including emergency services | Asymptomatic outpatients and patients with anatomy and physiology suggesting delay can be provided with reasonable safety |
Outpatients with progressive symptomatology who have demonstrated failure of medical management | |
Symptomatic coronary artery disease | |
Asymptomatic coronary artery disease with impaired systolic function | |
Tier 3 (60–80% inpatient Covid-19 load, severe reduction in operative capacity) | |
All in-patients who cannot be discharged safely without surgical intervention/correction, including emergency services | All patients who are outpatients |
Patients deteriorating while waiting would need to meet criteria for admission before consideration for surgery | |
Tier 4 (> 80% inpatient Covid-19 load, minimal operative capacity) | |
Only emergency services based on resource availability | All inpatients judged to be stable and capable of waiting |
All outpatients | |