Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused more than 5 million cases of coronavirus disease (COVID-19) worldwide and 345,000 deaths as of 25 May 2020.

Based on accumulating international experience of the severe impact of the pandemic on susceptible populations and healthcare systems, hospitals in Canada ceased all non-urgent activity to create capacity and to conserve resources for the anticipated surge of patients with COVID-19. On 19 March 2020, the Ontario Chief Medical Officer of Health formally ordered that all non-essential medical services cease.

By 28 April 2020, the Financial Accountability Office of Ontario reported that 52,700 hospital procedures had been cancelled.

Given the large and growing backlog of patients awaiting medically necessary elective surgery, there is now an urgent need to ramp up surgical activities across the country.

How to safely restart surgical programs in the context of ongoing community spread and localized outbreaks of COVID-19 remains unknown.

Herein, we focus on one specific aspect of this question, namely whether all surgical patients should, in addition to detailed clinical screening (i.e., exposure risk and symptoms) for COVID-19, undergo routine preoperative testing for SARS-CoV-2 with nasopharyngeal swabbing and nucleic-acid-based testing.

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