Mass Casualty Committee Report

Mass Casualty Committee Report

Michiyasu Suzuki & Eiichi Suehiro

The Mass Casualty Committee was installed in the WFNS during the Istanbul World Congress in August 2017. Since then, we have been trying to make a specific platform for Neurosurgeons against mass casualty in this committee.

As a first initiative, we conducted a questionnaire survey on EANS. We got the following answers.

• There was little occurrence of the patient corresponding to Neurosurgery from these surveys.
• There was more spinal cord injury than traumatic brain injury in disasters such as earthquakes.
• It should be difficult to explore the problems from past surveys.

As a next initiative, we gave a lecture on head trauma in natural disasters at AASNS conference to let many neurosurgeons know about the current state of neurosurgery in disasters, while publishing in Newsletters/WFNS related to information such as disaster response principles.

• Speaker: Prof Yutaka Igarashi
  Title: Head injury and Natural Disaster
  The AASNS Neurotrauma conference at PGIMER, Chandigarh, 18th November, 2018.

Eventually, a symposium was held at WFNS Congress Beijing 2019, where many neurosurgeons were able to discuss the importance of neurosurgeons in the event of a disaster.

In order to spread a concept of mass casualty/disaster response (MC) throughout the WFNS in 2020 and to improve healthcare globally, we have conducted the following goals:

• Establishment of the neurosurgeons’ role regarding MC.
• Establishment of the systematic care for MC with neurosurgeons, other clinical sectors, and organizations (WHO, government, military, or NGO such as the Red Cross).
• Education of MC to neurosurgeons.

Unfortunately, the pandemic of COVID-19 in 2020 brought us to a completely different world. In Japan, Disaster Medical Assistant Team (DMAT) is administered for outbreaks of the COVID-19. In other words, the outbreak of the COVID-19 is just a disaster. Therefore, we first
conducted a questionnaire survey of the committee members regarding the impact of COVID-19 on neurosurgery.

• Restrictions of neurosurgical emergency patients:
  Many do not seem to be very restricted. However, there are some restrictions in areas with many infected people such as central city.

• Restrictions of elective neurosurgery:
  Elective neurosurgery seems to be limited by around 60-80% in many areas.

• Shortage of medical resources:
  In some areas, medical supplies are still inadequate and need supply.

• Are neurosurgeons forced to treat Covid-19 patients instead of their own job?
  Neurosurgeons do not seem to be driven to infection control.

• How to solve neurosurgical problems during Covid-19 pandemic:
  Ensure neurosurgical bed pool and theatres are protected.

The last question is a very difficult question. From the beginning in this pandemic, WHO directors did not want to apply the concept of global medicine, and each national healthcare system had to solve everything. Practices that have nothing to do with fair and globalized medicine have been observed. We have many complications for COVID-19, including cerebral venous sinus thrombosis, intracerebral hemorrhage, intravascularly treated cerebral arterial thrombosis, polyradiculoneuritis (similar to Guillain-Barré syndrome), and olfactory dysfunction. It needs to be analyzed and reported. The biological behavior of this virus is still unknown.
During this pandemic, we have not yet applied the concept of global health in the world. We would like to disseminate information from our committee in order to get out of this situation as much as possible. In the future, we would like to conduct a questionnaire survey to the neurological surgery societies in each country to investigate and announce the situation and countermeasures under the COVID-19 pandemic.
And we continue to try making a specific platform for Neurosurgeons against mass casualty.