Saudi Anesthesia Society and COVID-19 outbreak.

The Corona Virus Infectious Disease 2019 (COVID-19) was first recognized in December 2019. It is caused by a novel coronavirus structurally related to the virus that causes severe acute respiratory syndrome (SARS). Primary mode of transmission is through droplets and close person-to-person contact. The COVID-19 has caused critical challenges to the public health, research and communities at large. Infectious respiratory pandemics often lead to severe acute respiratory failure and acute respiratory distress syndrome (ARDS) intensive care unit (ICU) admission and possible ventilator support. The 34-year-old Wuhan ophthalmologist Li Wenliang, MD, has been hailed in China as a hero for trying to alert authorities to the new virus and its dangers. He was accused by the local Public Security Bureau of “making false comments” that had “severely disturbed the social order”, and told to stop. Dr. Li subsequently died of the disease.[1]

In line with this pandemic, the Saudi Anesthesia Society (SAS) has formed a task force to put interim guidelines for perioperative care of patients undergoing surgical procedures in different subspecialties. Also the task force members have been asked to consider measurements to protect the medical services staff dealing with “suspected/confirmed” cases. The SAS has developed interim guidance on perioperative care of COVID-19 patients who undergo surgery and anesthesia. Patients with “suspected/confirmed” COVID-19 might be scheduled for emergency surgery. So far, the SAS has three interim guidelines for airway management, obstetric and thoracic surgical patient.[234] There are several guidelines published by the Australian Society Anesthesiologists (ASA),[5] Anesthesia Patient Safety Foundation (APSF),[6] World Federation Society Anesthesiologists (WFSA)[7] and local public health agencies, which are very useful and updated; however, they are significantly lacking instructional guidance to the medical professionals. There are reports from China indicated that three ophthalmologists died from the coronavirus, adding the numbers of doctors and nurses who died from the disease to close to hundreds, including a vice president of the hospital, a chair of the gastroenterology department, a chair of the pulmonary department, etc., Covid-19 is very contagious. Actually, we do not know how many patients or Covid-19 carriers exist among us due to the lack of capacity of testing. Therefore, the question of how we can protect ourselves and minimize the possible risk of exposure under current circumstances is important.[8]

In this issue of SJA, there are some of the interim guidelines which were developed by the SAS task force. These guidelines describe the ways how the medical staff deals with the patients who are suspected/confirmed of COVID-19, and in the meantime, how the medical staff can protect themselves from being infected especially if we know that this virus is very contagious. Personal protective equipment (PPE) should be considered for all medical staff to protect themselves. Also, donning/doffing techniques should be followed which provide further protection to the medical staff.

In conclusion, anesthesiologists are experts in airway management and will be on the frontline to manage the patients. Previous experiences with SARS and understanding the current epidemiological factors of the COVID-19, anesthesiologists are much better prepared to protect themselves during aerosol-generating techniques. A good knowledge of infection prevention and control, vigilance in protective measures, strict adherence of donning and doffing of PPE, and taking extra care for the infected patients is of utmost importance. The mission and vision of the SAS will continue monitoring the situation and issuing statement for the sake of patients and our staff when necessary.