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ASA/APSF revises COVID guidelines to delay elective procedures

27 Mar 2022

Seven-week delay for Covid+ patients; more new workflows included



By: Angela Anderson, DO, Surgical Services Medical Director

New guidelines, protocols, and recommendations are constantly being published as we navigate the pandemic. Here are the latest two updates:

  1. The ASA/APSF has updated guidelines on a recommended delay time for elective procedures after a patient has tested COVID-positive. They specify a delay of seven weeks for unvaccinated patients. The evidence is not clear for vaccinated patients, so they recommend a seven-week delay for all COVID-positive patients who need an elective procedure that can be safely delayed 90 days. 

    If the procedure is more urgent, we still recommend trying to wait 10 to 20 days if possible to decrease the potential of spreading the virus. Read the joint statement from ASA and APSF here:

    https://www.asahq.org/about-asa/newsroom/news-releases/2022/02/asa-and-apsf-joint-statement-on-elective-surgery-procedures-and-anesthesia-for-patients-after-covid-19-infection

    Also read the multidisciplinary consensus statement from the Association of Aneasthetists, Centre for Perioperative Care, Federation of Surgical Specialty Association, Royal College of Anaesthetists, and the Royal College of Surgeons of England. This article has a risk calculator that surgeons should discuss with COVID patients so they understand and accept the risk of having surgery before the seven-week waiting period.

  2. The Salem Health Infection Prevention team recommends if a home COVID test is positive, we should treat that as the patient’s date of positivity.  If the procedure is needed within 90 days of that test, we will not retest the patient unless they’ve had new symptoms that could be a reinfection. 

Please refer to the Salem Health policy on when to discontinue airborne precautions to know when patients can be safely treated as noninfectious. If a patient’s home test is negative, and needs to have a procedure, we will still require a PCR test within three days of their procedure.

We have updated the workflows that include these guidelines on the hospital intranet COVID resource page. They are also linked below: