Operational Impacts of the coronavirus disease of 2019 (COVID-19) Pandemic and Early Recovery Trends: University of Washington Anatomic Pathology Experience.

Context The novel coronavirus virus severe acute respiratory syndrome coronavirus (SARS-CoV2) causing the coronavirus disease of 2019 (COVID-19) pandemic has resulted in worldwide disruption to the delivery of patient care. The Seattle Washington metropolitan area was one of the first in the United States affected by the pandemic. As a result, the anatomic pathology services at the University of Washington experienced significant changes in operational volumes early in the pandemic. Objective To assess the impact of COVID-19 and both state and institutional policies implemented to mitigate viral transmission (including institutional policies on non-urgent procedures) on anatomic pathology volumes. Design Accessioned specimens from January 2020 to June 2020 was evaluated as COVID-19 and institutional policies changed. The data were considered in these contexts: subspecialty, billable CPT codes, and intraoperative consultation. Comparable data were retrieved from 2019 as a historical control. Results There was a significant reduction in overall accessioned volume (up to 79%) from pre-pandemic levels, during bans on non-urgent procedures when compared to 2020 pre- COVID-19 volumes and historical controls. The gastrointestinal and dermatopathology services were most impacted, while breast and combined head&neck/pulmonary services were least impacted. CPT code 88305, for smaller/biopsy specimens, had a 63% reduction during non-urgent procedure bans. After all bans on procedures were lifted, the overall volume plateaued at 89% of pre-pandemic levels. Conclusions A significant decrease in specimen volume was most strongly associated with bans on non-urgent procedures. While all departmental areas had a decrease in volume, the extent of change varied across subspecialty and specimen types. Even with removing all bans, service volume did not reach pre-pandemic levels.