Recommendations for the Operation of Endoscopy Centers in the setting of the COVID‐19 pandemic – World Endoscopy Organization guidance document

Abstract

Severe Acute Respiratory Syndrome Corona Virus 2 (SARS‐CoV‐2) is the etiologic agent causing the disease Corona Virus Disease 19 (COVID‐19), resulting in a worldwide pandemic. Non‐emergent endoscopy services have been disrupted as incidence and hospitalizations were rising. It is anticipated that the peak incidence may be leveling off in many parts of the world, but there is a concern for resurgence of the virus activity. Thus, it is important for endoscopy units to have plans in place during peak times of the epidemic and when resuming endoscopic services as the pandemic wanes. The global endoscopy community is faced with the challenge of providing care during this time. The WEO‐COVID guidance task force has provided this resource document based on the current evidence and consensus opinion. These World Endoscopy Organization (WEO) recommendations are meant to guide endoscopists worldwide, should be interpreted in light of specific clinical conditions and resource availability and may not apply in all situations. This guidance document does not supersede the need to check for all local regulations and legislations.

The Impact of the COVID-19 Pandemic on Gastrointestinal Endoscopy Activity in a Tertiary Care Center from Northeastern Romania

“…The potential for transmission is high during aerosol-generating procedures such as GI endoscopy. Thus, the prioritization of these procedures has been advocated by many international endoscopy organizations such as World Endoscopy Organization (WEO, Munich, Germany) [ 11 ], European Society of Gastrointestinal Endoscopy (ESGE, Munich, Germany), European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA, Munich, Germany) [ 12 ], Asian Pacific Society for Digestive Endoscopy (APSDE, Japan) [ 13 ], American Society for Gastrointestinal Endoscopy (ASGE, Downers Grove, USA) [ 8 ], and American Gastroenterological Association (AGA, Bethesda, USA) [ 14 ]. These societies have issued recommendations such as the mandatory use of personal protective equipment (PPE) and the requirement for negative pressure rooms, and also suggest viral testing based on polymerase chain reaction (PCR) where available, thus substantially increasing the costs of GI endoscopy and potentially leading to an even further decrease of the number of procedures [ 15 ].…”

Gastrointestinal Endoscopy in the Era of COVID-19

“…Procedure scheduling during the peak and post-peak has been an area of great challenge for hospitals (31). Increased endoscopy staff furloughs further complicated this challenge (32).…”

Perspective gastrointestinal endoscopy infection control strategy against COVID‐19: Workflow and space management for the operation of endoscopic centers

“…All endoscopic centers should establish infection control strategies (ICS) tailored to individual resources based upon updated national and academic guidance for COVID‐19 without superseding local advisories and institutional guidelines 1 . Endoscopic administrators have to customize control measures and adjust with the rapidly evolving local and global pandemic and prepare for the upcoming resurgence due to relaxation of social distancing norms.…”

“…The semi‐urgent and elective patients stayed in Beijing for 14 days, and they underwent PCR within one week before the procedures 2 . Ideally, the molecular test was performed within 72 h of the procedures 1 to minimize the remote prospect of nosocomial transmission through asymptomatic carriers due to the false‐negative test results or viral shedding at the time of reservation. Highly sensitive, reliable, and speedy point‐of‐care tests should be used, but unfortunately, barriers to routine pre‐procedural testing include unavailability, cost‐effectiveness, and times required for durability in conventional PCR in most Japanese facilities.…”

“…The essential steps including patient triage, risk stratification, and the proper use of PPE to prevent peri-procedural viral transmission have been guided by international organizations. 3,4 Consolidating these guidelines, the latest WEO recommendations 1 and the PUMCH ICS, 2 we are transforming, following endoscopic center ICS, the Japanese Rural University Hospital designated for COVID-19. First, the subjects should undergo prescreening for COVID-19 symptoms and history.…”