COVID-19 Preprocedural Testing: What About the False Positives?

In the COVID-19 era, preprocedural patients are almost uniformly screened for symptoms, asked to quarantine preoperatively, and then undergo a test of uncertain validity with very low pretest probability. A small percentage of these tests return positive. As a result, surgical procedures are delayed and patients are required to quarantine. Are these asymptomatic patients truly positive for COVID-19? What are the impacts of these test results on the patient and the health care system? In the following commentary, we review how the uncertain validity of reverse transcription polymerase chain reaction testing combined with a low-prevalence population predisposes for false-positive results. As a mitigation strategy, we ask that readers refocus on the fundamental principal of diagnostic testing: pretest probability.

Misconceptions About Negative Pressure Rooms and Their Impact Aboard USNS Comfort in New York City.

The outbreak of novel coronavirus disease 2019 (COVID-19) has had a momentous impact on the field of otolaryngology due to the high number of aerosol-generating procedures involving the upper aerodigestive tract. These procedures bear significant risk to the provider and clinical environment due to the possibility of viral aerosolization. While significant attention has been appropriately paid to personal protective equipment during this pandemic, an understanding of industrial hygiene is also necessary for the safe delivery of health care to mitigate the risk of exposure to other patients and health care workers. We provide a review of air ventilation practices and their role in reducing pathogen spread. In addition, we share our experiences with effectively treating COVID-19-positive patients aboard the USNS Comfort through proper environment control measures.