COVID‐19 and anatomy: Stimulus and initial response

Abstract

The outbreak of COVID-19, resulting from widespread transmission of the SARS-CoV-2 virus, represents one of the foremost current challenges to societies across the globe, with few areas of life remaining untouched. Here, we detail the immediate impact that COVID-19 has had on the teaching and practice of anatomy, providing specific examples of the varied responses from several UK, Irish and German universities and medical schools. Alongside significant issues for, and suspension of, body donation programmes, the widespread closure of university campuses has led to challenges in delivering anatomy education via online methods, a particular problem for a practical, experience-based subject such as anatomy. We discuss the short-term consequences of COVID-19 for body donation programmes and anatomical education, and highlight issues and challenges that will need to be addressed in the medium to long term in order to restore anatomy education and practice throughout the world. The emergence of infectious diseases with the potential to spread rapidly among the human population, such as severe acute respiratory syndrome (SARS) and Zika virus, presents a major threat to global public health (Wolfe et al., 2007; Ventura et al., 2016). However, the recent arrival of a severe respiratory disease, first reported in Wuhan city (Hubei province) China in December 2019 (Wu et al., 2020, Zhu et al., 2020), has generated an unprecedented global response. COVID-19 is caused by a novel and highly pathogenic coronavirus (SARS-CoV-2) that is easily and rapidly transmitted through respiratory droplets (Wu et al., 2020, Zhu et al., 2020). The highly contagious nature of COVID-19, and the potentially life-threatening nature of symptoms for an affected individual, has led to widespread, global attempts to control person-to-person contact and disease spread within and between populations (Wilder-Smith et al., 2020). One major consequence of the ensuing political decisions has been a closure of most university campuses, and with them medical schools and anatomy units/departments. In the following review of actions taken after the COVID-19 outbreak, information was collated from the following 10 universities: Ireland: National University of Ireland Galway (NUIG), Royal College of Surgeons in Ireland (RCSI). Scotland: Universities of Aberdeen, Dundee, Edinburgh and Glasgow. England: University of Cambridge, Imperial College London, University of Oxford. Germany (Bavaria): Ludwig Maximilian University of Munich (LMU). Although there is no a priori rationale for claiming these universities are representative of all affected European universities, the similarities of their response to the COVID-19 pandemic suggest that in this respect at least, they might be. The challenges that have arisen, and/or are likely to arise, over the coming months and years are outlined, and the immediate decisions taken, the rationale for them and their effects are described on an institution-by-institution basis. In the final section, possible longer-term effects and challenges are also discussed. The Principal of the University announced University-wide lockdown on 13 March, to be in place by 20 March. This affected teaching sessions for c.800 undergraduate students on medical, dental, physician associate and science programmes. Fortunately, the majority of practical teaching was able to be completed prior to lockdown, except for Year 3 Medicine students who would have returned after the Easter vacation. The practical element of two, ongoing blended anatomy postgraduate courses was also suspended. At the same time, several surgical skills courses catering for c.100 delegates had to be cancelled. Postgraduate (PhD) student work on cadaveric material also ceased. All anatomy staff commenced working from home by 20 March, and the anatomy building closed to all but essential staff, which comprised two licensed teachers and two technicians. The extensive collection of prosected cadaveric material and freezer content was monitored weekly. As the building is shared by the University and the National Health Service (NHS), it was immediately opened for essential training which was coordinated by staff in the Clinical Skills Centre. To date, no requests have been forthcoming for assistance with mortuary facilities. The Anatomy team donated all basic Personal Protective Equipment (PPE) to the NHS. Currently, the University Senate has agreed a fortnight's delay to the start of the first semester in September. An announcement was made by the Vice-Chancellor on 18 March that by the end of 20 March, the University's normal operations would cease. The teaching term for all three years of preclinical medical students had already ended on 13 March, with completion of an anatomy practical exam for over 300 second year medical students on that day. Most students returned home on or soon after 13 March, students who students and with in in Clinical teaching for students after 13 March, and final year cancelled. courses in and in also c.100 The was to mortuary facilities. donation of was made to the following a was announced on March by the Principal that all teaching would be from March, with an immediate to online The university closed for all but essential on 18 March. of anatomy teaching for most who comprised undergraduate and postgraduate students in anatomical health and medical and students are for a with for Year 3 students However, there was no in that with anatomy sessions students practical on completed collection university or to students had to collection for the All surgical skills work with medical and suspended. most staff commenced working from home on March, staff to the building for essential and and staff to work to for The COVID-19 response of the to for body the assistance from staff to on and at the Anatomy staff had already as as the mortuary at the teaching of the Anatomy which has the to at a and of as of a All teaching at the University of Edinburgh was following an announcement from the Principal on 13 March with a to online teaching and March, all anatomy teaching medical students from as as c.100 students and postgraduate The online postgraduate but with students of to and All anatomy for Year Medicine students as practical for and Anatomy In several postgraduate and courses had to be at the University and at the Royal College of Surgeons of year Medicine students to in 2020, to them to the with the COVID-19 All Anatomy staff, and staff, commenced working from home following a on March, except for two Anatomy and the of who to for was from the University of Edinburgh and in for assistance with COVID-19 place of Anatomy facilities. The University of announced on March that all teaching would be from March, and that had to be in place to online In of had already been made of This with the announcement on 13 March that the of the Royal College of and Surgeons of would be the courses in the Clinical Anatomy a between the College of and of the University of and the a of teaching for the which comprised students in Year and students in 3 of teaching was for the following over medical students in a in the students in who anatomy teaching in and students in However, the of anatomy teaching and had already been completed for these In an of students a Anatomy had two of teaching and a postgraduate student students and a postgraduate that Anatomy a of two most affected by the March, all staff commenced working from as the building in which the Anatomy is was closed and for essential and in of Imperial College closed for teaching on 20 March and all staff, from to work from This with the of the for the of Medicine and anatomy teaching for preclinical medical had already as March, a online anatomy had already been by first year medical 18 and 20 March, medical students in Year their final Year for students for March was with all students to to Year 3 the is no anatomy teaching for in the and the Year anatomy will place The of anatomy to students in their years is online for the of the Imperial College the Anatomy to first year surgical and Skills for in the Postgraduate of The practical of these courses have been and as teaching as possible will be in the practical of online teaching of surgical skills and the likely of to All postgraduate anatomy courses have also been cancelled. Anatomy to the but for current The Anatomy donated for by the NHS. The of closed all university to students and the public on March. who had returned within prior to that from a of the as a by the immediately home for All to work from home 20 March, the a public contact for all resulting in of within the university March, all home for the of the Clinical for of COVID-19 and on the preclinical medical working and with for a term of online All university for in the public potentially the of anatomy staff able to to anatomy education March, the Irish announced a of to the spread of COVID-19, which the closure of all schools and in the with public health and campuses by work or the public health in staff to facilities. 3 in the Galway on in The lockdown affected medical students and as an with from and of the practical sessions able to be and the practical of practical for undergraduate science students and and for and the in was also suspended. 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