ABSTRACT
Background and aims The COVID-19 pandemic challenges health care systems worldwide. In this situation, guidelines for health care professionals in endoscopy units with increased risk of infection by COVID-19 from inhalation of airborne droplets, conjunctival contact and feces are urgently needed. Recently, the European Society of Gastrointestinal Endoscopy (ESGE) and the German Respiratory Society (DGP) issued recommendations. However, real-world data on the conditions and requirements of endoscopy units to adhere to this guidance are missing. Methods We conducted an internet-based survey among German endoscopy units from all levels of care from April 1s t to 7t h , 2020. The survey comprised 33 questions and was distributed electronically by the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS) and the DGP. Results In total, 656 endoscopy units completed the survey. Overall, 253 endoscopy units (39%) cancelled less than 40% of their procedures. Of note, private practices cancelled fewer than 40% of their procedures in 46% compared to 34% in hospital-based units. Complete separation of high-risk and COVID-19 positive patients was achieved in only 20% of the units. Procedural measures were well adopted, with 91% of the units systematically identifying patients at risk and 85% using risk-adapted personal protective equipment (PPE). For the future, shortages in PPE (81%) and/or staff (69%) and relevant financial losses (77%) were expected. Conclusion Concise definitions of non-urgent, elective interventions and endoscopic surveillance strategies are needed to better guide endoscopic activity and cancellations of interventions. In the short term, a lack of PPE can constitute considerable impairment of endoscopy units' operability and patient outcomes.
ABSTRACT
The SARS-CoV-19 pandemic continues to be globally related with significant morbidity and mortality, making protective measures to prevent transmission of the virus still necessary. Healthcare employees are exposed to a higher risk of infection and this is particularly true when performing aerosol-generating procedures such as bronchoscopy.Since the publication of recommendations for performing a bronchoscopy in the times of COVID-19 more than six months ago, the risk situation has not changed significantly, but due to the considerable gain in knowledge in the meantime, an update of the recommendations was necessary.The updated recommendations include the reduction of aerosol formation, the personal protection of the people involved in the procedure, as well as measures to better organize the processes in the endoscopy suite in order to perform bronchoscopic procedures securely even in times of COVID-19.
Subject(s)
COVID-19 , Pandemics , Bronchoscopy , Health Personnel , Humans , SARS-CoV-2ABSTRACT
COVID-19, caused by coronavirus SARS-CoV-2 is a new and ongoing infectious disease affecting healthcare systems worldwide. Healthcare worker are at high risk for COIVD-19 and many have been infected or even died in countries severely affected by COVID-19 like China or Italy. Bronchoscopy causes cough and aerosol production and has to be considered a significant risk for the staff to get infected. Particular recommendations should guide to prevent spreading COVID-19 and to protect healthcare worker when performing a bronchoscopy.