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vascularsurgeons (n¼131 [24.5%]) had either operated on a pa-tient or placed a central line (including hemodialysiscatheters) on a patient with a confirmed COVID-19infection (Table II).Ninety-five vascular surgeons (17.8%) noted operatingon a patient with a confirmed COVID-19 infection. Inthe majority of cases, the surgeons waited outside theoperating room during the intubation (53.6%), andmost used N-95 masks during the operation. Whenasked about their interaction within the operating roomsduring the pandemic, some specific commentsincluded,“I chose to wear excessive PPE on all patientsduring this time,”“I have not operated since early Marchwithout an N95,”and“I have elected to do nearly all op-erations without intubation.”Central line placement on apatient with confirmed COVID-19 infection was per-formed by 96 of 535 vascular surgeons (17.9%). The major-ity indicated they had adequate PPE (94.8%). Ninety-sixrespondents (17.9%) operated on a patient who was laterfound to have a COVID-19 infection. In these circum-stances, few were subsequently self-quarantined (6%)and/or tested for COVID-19 (10.4%).Four respondents (0.7%) reported testing positive forCOVID-19. A total of 147 (47.5%) indicated they wereconsidered at high risk of being infected with COVID-19. Most were male (83%), and in practice for more than20 years (54.4%). One-third of these respondents (34%)noted that they had operated on or placed a centralline in a patient with confirmed COVID-19, with 14.3% ofrespondents being from New York State. Only two testedpositive for COVID-19.The Northeast had the most respondents who reportedoperating on a patient with COVID-19 or who was laterfound to be COVID-19 positive, and the West/Southwestregion had the least (22.5% vs 9.4%;P¼.006).COVID-19-related changes in outpatient services.Themajority of vascular surgeons reported disruption to theiroutpatient clinic/ambulatory center schedules (440/493[89.2%]). Changes included limited clinic/ambulatorycenter hours (350/493 [71%]) and use of telehealth (400/493 [81.1%];Table III). A total of 15 respondents (2.8%)noted that owing to the crisis they offered no clinic andno telehealth services.Two-hundred three respondents (47.7%) indicated thatthey have an office-based laboratory (OBL). Of those, 99(48.8%) were still open, with the majority performing ur-gent procedures only and focused on peripheralarterial disease and dialysis access (Table III). Regionalvariation was identified with more OBL practicesclosing in the Northeast (65.2%) and Midwest (80.4) ascompared with the Southeast (31.5%) and West/South-west (35.1%).Fig 1.The geographic distribution of 535 vascular surgeonswho responded to the survey. The regions were classifiedas Northeast (Connecticut, Delaware, Maine, Maryland,Massachusetts, New Hampshire, New Jersey, New York,Pennsylvania, Rhode Island, and Vermont), Midwest (Illi-nois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri,Nebraska, Ohio, South Dakota, and Wisconsin), Southeast(Alabama, District of Columbia, Florida, Georgia, Kentucky,Louisiana, Mississippi, North Carolina, Oklahoma, SouthCarolina, Tennessee, Virginia, and West Virginia) and West/Southwest (Arizona, California, Colorado, Hawaii, Idaho,Nevada, New Mexico, Oregon, Texas, Utah, andWashington).774Mouawad et alJournalofVascularSurgeryMarch 2021 COVID-19-related changes in vascular laboratoryscheduling.Most of the respondents (96.7%) have avascular laboratory, and the majority of vascular labswere performing urgent outpatient studies (351 [74.4%];Table III). Some vascular laboratories limited imaging tolife- or limb-threatening studies and others stratifiedimaging
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