ABSTRACT:
Disruption of Surgical Services in LMICs During Viral Outbreaks Viral outbreaks severely strain healthcare systems in low- and middle-income countries (LMICs), impacting essential surgical services. Limited infrastructure, workforce shortages, and infection control challenges make surgical services vulnerable. This study evaluated the disruption of surgical services in LMIC hospitals during viral outbreaks.

OBJECTIVES:
- Assess changes in elective and emergency surgical volumes - Understand workforce allocation and redeployment - Examine infection control constraints - Identify adaptive strategies to maintain surgical service delivery

METHODS:
A multi-center cross-sectional survey was conducted across 6 tertiary hospitals in Nigeria. Data were collected on surgical service trends during outbreak periods using staff reports, institutional protocols, and hospital operation logs.

RESULTS:
- Elective procedures reduced by 42.7-57.3% relative to pre-outbreak periods - Emergency surgeries delayed in 18.6-34.2% of cases due to staff shortages, limited PPE, and infection control measures - 63.4% of surgical staff redeployed or engaged in outbreak response duties - Adaptive measures reported in 78.9% of surgical units, including staggered operating schedules and prioritization of urgent procedures

CONCLUSIONS:
Viral outbreaks significantly disrupt essential surgical services in LMICs, reducing elective and emergency procedures, straining workforce allocation, and requiring adaptive operational strategies. Findings highlight the importance of LMIC-specific pandemic preparedness, including contingency planning, infection control, and perioperative prioritization. Addressing these gaps can strengthen health system resilience and ensure continuity of essential surgical care during future outbreaks.