Updated consensus statement on timing of elective surgery following emergence of Omicron variant of SARS-CoV-2

• Updated: 23 February 2022

The Royal College of Surgeons of England has released an updated joint statement with the Association of Anaesthetists, Centre for Perioperative Care, Federation of Surgical Specialty Associations, Royal College of Anaesthetists on surgery for patients who have previously been infected with COVID-19. This replaces the previous join statement issued in March 2021.

At the time, the COVIDSurg Collaborative (a global collaboration of over 15,000 surgeons and anaesthetists working together to collect a range of data on surgery during COVID-19 pandemic) found evidence of increased risk of mortality and other poor outcomes for those who had tested positive for COVID-19 and had surgery in the period 0–6 weeks after diagnosis. This informed our advice that surgery should be avoided within seven weeks of a diagnosis.

This updated joint statement makes the following key recommendations:

• Until strong evidence emerges, the previous recommendation of avoiding planned surgery within seven weeks of testing positive for COVID-19 should remain.
• If surgery is considered urgent enough to have within seven weeks of testing positive, all patients should have their mortality risk calculated, a careful risk-benefit assessment, and a shared decision made.
• Unless critical, no surgery should take place within ten days of a positive COVID-19 test, largely because patients could still be infectious and endanger other patients and staff.

We are grateful to the Chair of our Patient and Lay Group, Sue Denmark, and our Vice-President Tim Goodacre for their work as co-authors.

• Read the consensus statement