Thank you for allowing us to present at the American Orthopaedic Foot and Ankle Society our study on the rate of COVID-19 infection and 30-day mortality between blue and green pathways. It's the results of the Phase 1 and 2 of the UK Foot and Ankle COVID National, or UK Falcon, audit. I'm Lyndon Mason, and I'm presenting on behalf of the UK Falcon Collaborative. As the pandemic hit, we emerged from the first lockdown and there was uncertainty. There were questions. Bofast proposed a UK-wide collaborative of foot and ankle surgeons working together to get vital data on patients during the pandemic, or patients undergoing foot and ankle surgery at participating centres. Phase 1 was the first lockdown, January to July 2020, and Phase 2 would be the second lockdown, September to November 2020. The aims of Phase 2 was to determine the differences between COVID-19 infection, 30-day mortality rates in patients undergoing foot and ankle surgery between green, which are COVID-safe pathways, and blue, which are not COVID-safe methods. There was a multi-centre retrospective and then prospective national trial. A 30-day follow-up was gained on all patients. Data capture was via a standardised spreadsheet for all units. The results were a total of 10,846 patients from 44 centres. Phase 1, there were 6,644 patients, 35 were diagnosed with COVID-19 in the perioperative period, giving an instance of 0.52%. Phase 2, there were 4,204 patients, 43 contracting COVID in the perioperative period, giving an instance of 1.02%. These differences may reflect the lack of tests and availability during the Phase 1. Rates were, however, low. In the instance of COVID-19 per pathway, between the blue and green pathway, there was no significant differences in Phase 1. However, in Phase 2, when the pathways were in place and there were significant differences, 13 times lower COVID-19 on the green pathways. In regards to the mortality rate, the 30-day mortality rate at all cores was 0.36%. Across the full study, Phase 1 had a 25.71% mortality rate in those who contracted COVID. This reduced significantly to 4.65% in Phase 2. Risk of COVID-19 in mortality, Phase 1, the propensity-matched regression analysis showed that this was the strongest independent risk of mortality for the diagnosis of COVID-19. There was no difference, however, between the green and blue pathways. Conclusions, what have we learnt? COVID-19 was rare. Perioperative care for non-co-patients undergoing surgery, even at the height of the pandemics. Significant increase in risk of mortality if COVID-19 was contracted perioperatively. However, this decreased significantly in the second phase. Being on the green pathway significantly reduced the rate of contracting COVID-19, a 13 times the initial decrease. The national audit supports the continuation of elective foot and ankle surgery due in further ways throughout the pandemic. Provided care can be safely provided using green pathways. I would like to acknowledge our members of the British Orthopaedic Foot and Ankle Society, those who have helped produce this very large retrospective audit. The funding received from Leicester Hospital's charity, data handling at Leicester NIHR Biomedical Research Centre. I would like to thank our collaboratives. There were 190 collaboratives on this study. We're very grateful for everyone who inputted. Thank you.

American Orthopaedic Foot and Ankle Society

UK Foot and Ankle COVID National audit

COVID-19 infection rate

30-day mortality rate

green pathway