COVID‐19 pandemic consciousness: droplet contamination and aerosolization during pleural decompression

Abstract

that revealed marked dilatation of the caecum and ascending colon, with intestinal pneumatosis and patent mesenteric vessels. The colonoscopy showed normal mucosa with atonic right colon. A colon decompression tube was inserted. Unfortunately, his clinical conditions progressively worsened and the patient deceased after 2 days. The clinical manifestations of COVID-19 are multiform, and patients with abdominal symptoms should be thoroughly evaluated with bowel sonography, followed by CT scan and colonoscopy if necessary, because the abdominal examination often underestimates the severity of the eventual underlying disease. Moreover, when COVID-19 patients need abdominal surgery, we encourage surgeons to investigate the intestinal blood flow intraoperatively (i.e. using fluorescence imaging), to look for intestinal vascular damage in surgical specimens and to perform microbiota and peritoneal fluid analysis whenever possible, to gain new significant data.

SARS‐CoV‐2 infection rate in Antananarivo frontline health care workers, Madagascar

“…However, evaluations of PPE use and IPC were self‐reported, and the results should be interpreted with caution. Studies conducted elsewhere show that HCWs who manage severe or critically ill patients are at higher risk of infection 25–28 . We found that compared to those who had no contact with a deceased patient, having at least one exposure to a deceased patient was associated with a higher risk of infection, but the difference was not statistically significant.…”

“…Studies conducted elsewhere show that HCWs who manage severe or critically ill patients are at higher risk of infection. 25 , 26 , 27 , 28 We found that compared to those who had no contact with a deceased patient, having at least one exposure to a deceased patient was associated with a higher risk of infection, but the difference was not statistically significant. Our study might have had a lack of power, as we had less information on exposure to infected and deceased patients.…”

Standard pleural interventions are not high-risk aerosol generating procedures

“…Pleural fluid management systems such as underwater seal chest tube bottles have also been seen as a source of aerosol generation with several studies advocating the use of antiviral filters. Duffy and colleagues assessed aerosol generation by bubbling air at different rates through an underwater seal bottle (4) , sampling a maximum aerosol concentration of particles (within the same size range to those studied here, 0.3–10µm) during the bubbling process of ∼4100ft -3 , caused by atomization of the water. This equates to a peak concentration of ∼0.14cm -3 , which is similar to the peak concentrations that we observed during the fluctuations of sampled aerosol concentration during pleural procedures.…”

“…Therefore, Level 2 PPE should be worn (FFP3 mask, long sleeved gown, gloves, eye protection)”. On the basis of this evidence, pleural procedures are not aerosol generating and additional PPE (above that indicated for routine patient care) is not required, although eye protection should be worn given the risk of splash (4) .…”