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The Coronavirus Effect on US Public Sentiments Regarding Elective Plastic Surgery
Jiaxi Chen1, Edward Ray1 1Department of Surgery, Cedars-Sinai Medical Center, Los Angeles

Background: The SARS-CoV-2 coronavirus (COVID-19) has challenged the United States healthcare systems to rapidly adapt and innovate in multiple fronts. As the course of the COVID-19 pandemic changes, we explore US public sentiments on resuming previously shuttered elective plastic surgery procedures.

Methods: A prospective national survey of US adults was conducted to study US public perception of elective plastic surgery procedures during the COVID-19 pandemic. US adults were recruited during the latter two weeks of September 20, 2020 to participate in a 30-question survey. Google Forms was selected as the survey platform. Amazon Mechanical Turk was selected as the survey distributor and participant base. Study participants were compensated $0.25 each for enrolling. Primary study outcome was defined to be participant response to resuming elective plastic surgery procedures. Binomial logarithmic multivariable regression modeling was employed to analyze the cohort.

Results: 1,000 US adults were recruited to participate, of which 27 participants were excluded for not passing a routine checkpoint question to confirm attentiveness. 973 participants included in study. The majority of participants (86.6%) believe elective plastic surgery should continue in the midst of the present COVID-19 pandemic. Most participants (79.6%) would not delay obtaining plastic surgery by more than 6 months. Most participants expressed concerns of contracting COVID-19 during their procedures at elective surgery centers (67.5%) or at hospitals (68.5%). The majority of participants believed safety practices such as face mask and eye protection (90.3%), hand washing and cleansing commonly used surfaces (87.1%), and social distancing at least 6 feet (86.1%) were important to prevent the spread of COVID-19. Participants who reside in US Midwest (OR 2.3, p<0.05) and participants in age group 41 to 60 years old (OR 2.8, p<0.03) were more likely to resume elective plastic surgery. Participants who had undergone a COVID-19 test (OR 0.13, p<0.04), contracted the COVID-19 infection (OR 0.26, p<0.03), or in the age group 61 years and older (OR 0.41, p<0.02) were less likely to resume elective plastic surgery. The majority of study participants preferred in-person visit over telemedicine for their preoperative visit, (65.1% in-person visit versus 34.9% telemedicine visit). When asked about their postoperative visit, participants preferred in-person visits over telemedicine visits, (59.8% in-person visit versus 40.2% telemedicine visit).

Conclusion: The majority of the US general public (1) agree with resuming elective plastic surgery services, (2) harbor concerns of contracting COVID-19 during their procedures, and (3) agree with the majority of safety protocols taken to prevent the spread of COVID-19. Special attention needs to be given at older US adults and US adults who have come in contact with COVID-19.

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