"N95/N99" peri-procedure diapers during lower gastrointestinal endoscopies.

It is important to consider lower gastrointestinal endoscopies (LGIE) as aerosol-generating procedures. Thus, it may be better to protect room environments by ensuring patients wearing peri-procedure diapers (PPD) to contain infectious colorectal gas expulsions because fecal SARS-CoV-2 has been detected among COVID-19 patients even after they have undetectable nasopharyngeal SARS-CoV-2. Summarily, PPD among LGIE patients can potentially evolve as standard barrier modality.

Per American Society for Gastrointestinal Endoscopy (ASGE), it is important to consider lower gastrointestinal endoscopies (LGIE) as aerosol-generating procedures [1]. Although personnel managing LGIE can don personal protective equipment to protect themselves, it may be better to protect negative/positive-pressured room environments by ensuring patients wearing peri-procedure diapers (PPD) to contain infectious colorectal gas expulsions because fecal SARS-CoV-2 has been detected among COVID-19 patients even after they have undetectable nasopharyngeal SARS-CoV-2 [2], [3], [4], [5], [6], [7]. PPD among LGIE patients can potentially evolve as standard barrier modality if PPD does not interfere with personnel’s skills and patients’ comfort. For this new normal, LGIE patients will need preoperative counseling regarding donning PPD till they change into their well-fit undergarments post-procedure. Intraoperatively, PPD (non-absorbent clear plastic diaper cover version [8]) will need two slit-holes for allowing well-sealed clear-view access to (a) instrument performing LGIE plus (b) surgical smoke evacuator suctioning fecal aerosols. To confirm SARS-CoV-2 laden colorectal gas expulsions into PPD, inner-surfaces of PPD (either absorbent-material extended-use standard-diaper version or non-absorbent short-term use clear-plastic diaper-cover version) worn by confirmed COVID-19 patients can be tested for deposited SARS-CoV-2 aerosols. While waiting for global researchers’ confirmatory live-demonstrations of stable micro-droplets expulsing with colorectal gases as similar to live-demonstrations of micro-droplets while talking [9], it may be safer to preemptively and empirically use “N95/N99” PPD during LGIE.

Financial interests

None.

Declaration of Competing Interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.