• Francisco J Civantos, Jason M Leibowitz, David J Arnold, Vanessa C Stubbs, Jennifer H Gross, Giovana R Thomas, Zoukaa Sargi, Roy R Casiano, Elizabeth J Franzmann, Donald Weed, Cesar Perez, Michael Samuels, Kenneth W Goodman, and W Jarrard Goodwin.
• Department of Otolaryngology, Head and Neck Division, Sylvester Cancer Center/University of Miami Miller School of Medicine, Miami, Florida, USA.
• Head Neck. 2020 Jul 1; 42 (7): 1423-1447.

BackgroundCoronavirus has serially overtaken our metropolitan hospitals. At peak, patients with acute respiratory distress syndrome may outnumber mechanical ventilators. In our Miami Hospital System, COVID-19 cases have multiplied for 4 weeks and elective surgery has been suspended.MethodsAn Otolaryngologic Triage Committee was created to appropriately allocate resources to patients. Hospital ethicists provided support. Our tumor conference screened patients for nonsurgical options. Patients were tested twice for coronavirus before performing urgent contaminated operations. N95 masks and protective equipment were conserved when possible. Patients with low-grade cancers were advised to delay surgery, and other difficult decisions were made.ResultsHundreds of surgeries were canceled. Sixty-five cases screened over 3 weeks are tabulated. Physicians and patients expressed discomfort regarding perceived deviations from standards, but risk of COVID-19 exposure tempered these discussions.ConclusionsWe describe the use of actively managed surgical triage to fairly balance our patient's health with public health concerns.© 2020 Wiley Periodicals, Inc.

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