ABSTRACT
BACKGROUND: COVID-19 has erupted into our lives and forced rapid changes in all fields of medicine, causing a rush for publications that inevitably caused a shift away from the paradigm of evidence-based medicine (EBM). The objective of the present report is to assess and quantify this process. METHODS: We compared the levels of EBM of the publications in the ophthalmic literature on COVID-19 at the beginning of the pandemic and compared it to those of articles published the prior year during April 2019 for the three highest ranking journals in the field of comprehensive ophthalmology. RESULTS: COVID-19 publications ranked significantly lower (p<0.001). Time between submission and acceptance was significantly shorter for the COVID-19 publications (p<0.001), and significantly more publications were accepted without revisions (P<0.001). CONCLUSION: Though a shift away from EBM may be unavoidable in the early stages of a pandemic, we suggest that for the benefit of reliable information and informed decision-making, it is time to go back to EBM.
ABSTRACT
PURPOSE: To evaluate the risk of transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after exposure to a COVID-19+ physician in a retina clinic. METHODS: A retrospective observational study. Records of 142 patients and 11 staff members from a single retina clinic that were exposed to a COVID-19+ ophthalmologist were reviewed. All 153 individuals were placed in quarantine for 14 days. They were contacted after the quarantine period to inquire about symptoms consistent with COVID-19, and the results of diagnostic test for SARS-CoV-2 when performed. RESULTS: All patients (n = 142) were contacted successfully. The mean age was 72.8 ± 13.6 years; 54.2% (n = 77) were females. Twenty-three patients (16.2%) were exposed during an ophthalmic exam, 111 (78.2%) during intraocular injection, 4 (2.8%) underwent exam and injection, 3 (2.1%) underwent surgery, and one patient (0.7%) had laser photocoagulation. Half of the patients (50%; n = 71) were in contact with the COVID-19+ physician while he was symptomatic. Forty-four patients (31%) wore a mask on the day of their visit. 11.3% (n = 16) of the patients, and all involved staff had been tested for the virus and all were negative. One patient (0.7%) reported transient cough and sore throat, and the remaining 141 (99.3%) patients and 11 (100%) staff did not develop symptoms. CONCLUSIONS: Low risk for SARS-CoV-2 transmission in the ophthalmic setting was observed when universal safety measures such as social distancing, meticulous hand hygiene, enlarged breath shields, and mask wear during procedures were taken.