Background The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services. Objectives This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures. Conclusion As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.

Since 1998, the Global Initiative for Obstructive Lung Disease (GOLD) has worked with health care professionals, medical researchers, and public health officials around the world to optimize the prevention, treatment, and management of COPD. GOLD has continually worked to ensure COPD management strategy recommendations are aligned with current published research. The 2017 GOLD report represents a major revision to GOLD strategy guidelines, the first such major revision in the last 5 years. As such, the 2017 report has significant implications for the diagnosis of COPD, the management of stable disease, and the treatment of exacerbations. As respiratory therapists (RTs) are front-line clinical professionals throughout the COPD continuum of care, a thorough understanding of the new GOLD recommendations for practice is critical. New recommendations regarding diagnosis, severity assessment, and both pharmacologic and nonpharmacologic treatment of COPD are presented, and suggestions for how RTs can integrate these recommendations into COPD care practices are provided.

The practice of dentistry has been dramatically altered by the coronavirus disease 2019 (COVID-19) pandemic. Given the close person-to-person contact involved in delivering dental care and treatment procedures that produce aerosols, dental healthcare professionals including dentists, dental assistants and dental hygienists are at high risk of exposure. As a dental clinic in a comprehensive cancer center, we have continued to safely provide medically necessary and urgent/emergent dental care to ensure that patients can adhere to their planned cancer treatment. This was accomplished through timely adaptation of clinical workflows and implementation of practice modification measures in compliance with state, national and federal guidelines to ensure that risk of transmission remained low and the health of both immunocompromised cancer patients and clinical staff remained protected. In this narrative review, we share our experience and measures that were implemented in our clinic to ensure that the oral health needs of cancer patients were met in a timely manner and in a safe environment. Given that the pandemic is still on-going, the impact of our modified oral healthcare delivery model in cancer patients warrants continued monitoring and assessment.

I read with great interest the relatively recent editorial by Dr Richard Russell entitled "COVID-19 and COPD: A Personal Reflection". 1 I especially focused on the line "Anxiety can drive malbehavior." Indeed, we healthcare personnel treating patients with respiratory diseases may not be completely absolved of anxiety-driven malbehavior in this COVID-19 world, as we try to come to grips with an indefatigable virus and wrap our heads around ways to slow it down and stop it. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has brought into sharp focus how healthcare personnel must approach the treatment of patients with respiratory disease. While we wait for the clinical or quantitative evidence necessary to establish true best practices, there is a concern that healthcare personnel, patients, and healthcare systems are prioritizing one form of therapy over another based on assumptions or partial information rather than evidence. This is certainly an issue that requires further consideration.Consider the large-scale dispensing of albuterol metered-dose inhalers (MDIs) to hospitalized patients with COVID-19, which has resulted in severe shortages of albuterol MDIs in some parts of the United States. 2 This is not a supply chain problem but rather an acute crisis caused by the sharp increase in MDI use driven by the concern that nebulizers used by hospitalized patients with COVID-19 could potentially spread the SARS-CoV-2 virus. 3 This concern could potentially extend to home use of nebulizers. But is this an appropriate use of now-limited resources, such as MDIs, or is this a reflexive reaction to a perceived risk with aerosol-generating procedures? Does the answer depend on the setting of care? Unfortunately, there is no precedent to guide the treatment of patients with respiratory disease in the current situation because experience from previous episodes of mass infection do not appear to be scalable to the worldwide SARS-CoV-2 pandemic.At a time when public health information is in a state of rapid flux, rather than using a one-size-fits-all policy, the more sensible approach would be to use a righttool-for-the-right-patient strategy based on what we know. Thus, nebulizers should remain the preferred option for patients who require that treatment, especially in light of the severe shortage of MDIs. This approach does not conflict with recent COVID-19 guidance and can serve as an example for encouraging best practices even after the pandemic.

Objective: To review the role of pharmacists in educating and monitoring patients with chronic obstructive pulmonary disease (COPD) on inhalation technique. Data Sources: A PubMed search (January 2000 to May 2020) was performed using the following keywords and associated medical subject headings: adherence, chronic obstructive pulmonary disease/COPD, education, inhaler, pharmacist, and technique. Study Selection and Data Extraction: The search was conducted to identify English language articles highlighting the importance of correct inhaler technique in COPD management and benefits of pharmacist inhaler training such as improved adherence, quality of life (QoL), and disease control. Randomized controlled trials, retrospective studies, observational studies, systematic reviews, and meta-analysis reporting pharmacist training were included. Data Synthesis: This review summarizes that incorrect inhaler use negatively affects treatment outcomes, prognosis, and QoL. Pharmacists are in a unique position to educate and monitor patients with COPD on optimal inhaler technique and an individualized, multifactorial approach to COPD management involving pharmacists could provide cost-effective patient care and improve adherence and minimize inhaler misuse. Several strategies used by pharmacists can optimize patient inhaler use, such as face-to-face technique demonstrations, the “teach-back” method, telemonitoring, instructional videos, or informational leaflets. An individualized action plan involving education and regular monitoring of inhaler use further enhances optimal adherence and disease management. Conclusions: As pharmacists are easily accessible to both patients and health care providers, they are ideally placed to play an important role in the enhancement of education on, and continuous assessment of, optimal inhaler technique, thereby improving adherence, disease control, and QoL.