OBJECTIVES: Strategic planning for coronavirus disease (COVID-19) care has dominated the agenda of medical services, which have been further restricted by the need for minimizing viral transmission. Risk is particularly relevant in relation to endoscopy procedures. This study aimed to describe a contingency plan for a tertiary academic cancer center, define a strategy to prioritize and postpone examinations, and evaluate the infection rate among healthcare workers (HCWs) in the endoscopy unit of the Cancer Institute of the State of São Paulo (ICESP). METHODS: We created a strategy to balance the risk of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to mitigate the effects of postponing endoscopic procedures in oncological patients. A retrospective analysis of prospectively collected data on all endoscopies between March and June 2020 compared with those during the same period in 2019 was carried out. All HCWs were interviewed to obtain clinical data and SARS-CoV-2 test results. RESULTS: During the COVID-19 outbreak, there was a reduction of 55% in endoscopy cases in total. Colonoscopy was the most affected modality. The total infection rate among all HCWs was 38%. None of the senior digestive endoscopists had COVID-19. However, all bronchoscopists had been infected. One of three fellows had a serological diagnosis of COVID-19. Two-thirds of all nurses were infected, whereas half of all technicians were infected. CONCLUSIONS: In this pandemic scenario, all endoscopy services must prioritize the procedures that will be performed. It was possible to maintain some endoscopic procedures, including those meant to provide nutritional access, tissue diagnosis, and endoscopic resection. Personal protective equipment (PPE) seems effective in preventing transmission of COVID-19 from patients to digestive endoscopists. These measures can be useful in planning, even for pandemics in the future.
OBJECTIVES: Strategic planning for coronavirus disease (COVID-19) care has dominated the agenda of medical services, which have been further restricted by the need for minimizing viral transmission. Risk is particularly relevant in relation to endoscopy procedures. This study aimed to describe a contingency plan for a tertiary academic cancer center, define a strategy to prioritize and postpone examinations, and evaluate the infection rate among healthcare workers (HCWs) in the endoscopy unit of the Cancer Institute of the State of São Paulo (ICESP). METHODS: We created a strategy to balance the risk of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to mitigate the effects of postponing endoscopic procedures in oncological patients. A retrospective analysis of prospectively collected data on all endoscopies between March and June 2020 compared with those during the same period in 2019 was carried out. All HCWs were interviewed to obtain clinical data and SARS-CoV-2 test results. RESULTS: During the COVID-19 outbreak, there was a reduction of 55% in endoscopy cases in total. Colonoscopy was the most affected modality. The total infection rate among all HCWs was 38%. None of the senior digestive endoscopists had COVID-19. However, all bronchoscopists had been infected. One of three fellows had a serological diagnosis of COVID-19. Two-thirds of all nurses were infected, whereas half of all technicians were infected. CONCLUSIONS: In this pandemic scenario, all endoscopy services must prioritize the procedures that will be performed. It was possible to maintain some endoscopic procedures, including those meant to provide nutritional access, tissue diagnosis, and endoscopic resection. Personal protective equipment (PPE) seems effective in preventing transmission of COVID-19 from patients to digestive endoscopists. These measures can be useful in planning, even for pandemics in the future.
Authors: Tomazo Antonio Prince Franzini; Ana Paula Samy Tanaka Kotinda; Diogo Turiani Hourneaux de Moura; Márcia Lopes Vicente Badana; Marion Sielfeld de Medeiros; Patrícia Goulart Rodrigues Lima; Brigitte Feiner de Mello; Rafael Priante Kayano; Maria José Carvalho Carmona; Marcelo Cristiano Rocha; Aléia Faustina Campos; Thomas R McCarty; Thaís Guimarães; Maria Luisa do Nascimento Moura; Christopher C Thompson; Eduardo Guimarães Hourneaux de Moura Journal: Clinics (Sao Paulo) Date: 2020-06-12 Impact factor: 2.365
Authors: Ian M Gralnek; Cesare Hassan; Ulrike Beilenhoff; Giulio Antonelli; Alanna Ebigbo; Maria Pellisè; Marianna Arvanitakis; Pradeep Bhandari; Raf Bisschops; Jeanin E Van Hooft; Michal F Kaminski; Konstantinos Triantafyllou; George Webster; Heiko Pohl; Irene Dunkley; Björn Fehrke; Mario Gazic; Tatjana Gjergek; Siiri Maasen; Wendy Waagenes; Marjon de Pater; Thierry Ponchon; Peter D Siersema; Helmut Messmann; Mario Dinis-Ribeiro Journal: Endoscopy Date: 2020-04-17 Impact factor: 10.093
Authors: Lennard Yw Lee; Jean-Baptiste Cazier; Vasileios Angelis; Roland Arnold; Vartika Bisht; Naomi A Campton; Julia Chackathayil; Vinton Wt Cheng; Helen M Curley; Matthew W Fittall; Luke Freeman-Mills; Spyridon Gennatas; Anshita Goel; Simon Hartley; Daniel J Hughes; David Kerr; Alvin Jx Lee; Rebecca J Lee; Sophie E McGrath; Christopher P Middleton; Nirupa Murugaesu; Thomas Newsom-Davis; Alicia Fc Okines; Anna C Olsson-Brown; Claire Palles; Yi Pan; Ruth Pettengell; Thomas Powles; Emily A Protheroe; Karin Purshouse; Archana Sharma-Oates; Shivan Sivakumar; Ashley J Smith; Thomas Starkey; Chris D Turnbull; Csilla Várnai; Nadia Yousaf; Rachel Kerr; Gary Middleton Journal: Lancet Date: 2020-05-28 Impact factor: 79.321