Society of swallowing and dysphagia of Japan: Position statement on dysphagia management during the COVID-19 outbreak

Abstract

On April 14, the Society of Swallowing and Dysphagia of Japan (SSDJ) proposed its position statement on dysphagia treatment considering the ongoing spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The main routes of transmission of SARS-CoV-2 are physical contact with infected persons and exposure to respiratory droplets. In cases of infection, the nasal cavity and nasopharynx have the highest viral load in the body. Swallowing occurs in the oral cavity and pharynx, which correspond to the sites of viral proliferation. In addition, the possibility of infection by aerosol transmission is also concerning. Dysphagia treatment includes a broad range of clinical assessments and examinations, dysphagia rehabilitation, oral care, nursing care, and surgical treatments. Any of these can lead to the production of droplets and aerosols, as well as contact with viral particles. In terms of proper infection control measures, all healthcare professionals involved in dysphagia treatment must be fully briefed and must appropriately implement all measures. In addition, most patients with dysphagia should be considered to be at a higher risk for severe illness from COVID-19 because they are elderly and have complications including heart diseases, diabetes, respiratory diseases, and cerebrovascular diseases.

A Scoping Review of Psychosocial Risks to Health Workers during the Covid-19 Pandemic

“…For example, in speech therapy practice, one of the greatest challenges is the difficulty in communicating with patients through expressions and gestures to demonstrate movements, which is impaired due to the use of PPE. In addition, speech therapists and HCWs who provide swallowing therapy, are occupational groups at a high risk of infection, as the procedures performed require proximity to the patients’ faces and contact with the oral mucosa and body fluids, such as saliva and respiratory droplets [ 84 , 85 ]. All these factors are considered to increase anxiety and moral distress among HCWs and further affect their psychological well-being and mental health.…”

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“…These may be a good option for a group of patients reluctant to have face-to-face visits. Interruptions in regular therapies, like speech and language therapy or physiotherapy, have been highlighted as a problem across a range of countries [5,9,11].…”

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“…• Speech therapy in patients with a negative viral load should be conducted with appropriate PPE. In the case of patients with suspected or confirmed COVID-19, care is not recommended, due to the risk of aerosol generation (9) . However, there are still controversies in the literature.…”