Personal Protective Equipment for Endoscopy in Low-Resource Settings During the COVID-19 Pandemic: Guidance From the World Gastroenterology Organisation.

Desmond Leddin, David Armstrong, Raja A Raja Ali, Alan Barkun, Amna S Butt, Ye Chen, Harshit S Khara, Yeong Yeh Lee, Wai Keung Leung, Finlay Macrae, Govind Makharia, Reza Malekzadeh, Elias Makhoul, Anahita Sadeghi, Jean-Christophe Saurin, Mark Topazian, Sandie R Thomson, Andrew Veitch, Kaichun Wu

Journal: Journal of clinical gastroenterology 2020;54(10):833-840

PMID: 32909973

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Abstract

Performance of endoscopic procedures is associated with a risk of infection from COVID-19. This risk can be reduced by the use of personal protective equipment (PPE). However, shortage of PPE has emerged as an important issue in managing the pandemic in both traditionally high and low-resource areas. A group of clinicians and researchers from thirteen countries representing low, middle, and high-income areas has developed recommendations for optimal utilization of PPE before, during, and after gastrointestinal endoscopy with particular reference to low-resource situations. We determined that there is limited flexibility with regard to the utilization of PPE between ideal and low-resource settings. Some compromises are possible, especially with regard to PPE use, during endoscopic procedures. We have, therefore, also stressed the need to prevent transmission of COVID-19 by measures other than PPE and to conserve PPE by reduction of patient volume, limiting procedures to urgent or emergent, and reducing the number of staff and trainees involved in procedures. This guidance aims to optimize utilization of PPE and protection of health care providers.

Address: Department of Medicine, Dalhousie University, Halifax, NS.; Department of Medicine, Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON.; Department of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.; Department of Medicine, McGill University, Montreal, QC, Canada.; Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.; Department of Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.; Department of Medicine, Geisinger Medical Center, Danville, PA.; Department of Medicine, School of Medical Sciences Universiti Sains Malaysia, Kota Bharu, Malaysia.; Department of Medicine, University of Hong Kong, Hong Kong.; Department of Medicine, The Royal Melbourne Hospital, Parkville, Vic., Australia.; Department of Gastroenterology and Human Nutrition All India Institute of Medical Sciences, New Delhi, India.; Digestive Disease Research Institute, Department of Internal Medicine, Tehran University of Medical Sciences, Tehran, Iran.; Department of Gastroenterology and Hepatology, University Hospital Notre Dame des Secours, Holy Spirit University of Kaslik, Kaslik, Lebanon.; Department of Medicine, Hôpital Edouard Herriot, Lyon, France.; Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.; Department of Medicine, Groote Schuur Hospital, Cape Town, South Africa.; Department of Gastroenterology, Royal Wolverhampton Hospitals NHS Trust and Nuffield Hospital, Wolverhampton, UK.; Department of Medicine, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an, China.

DOI: 10.1097/MCG.0000000000001411

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MeSH Terms: COVID-19, Coronavirus Infections, Endoscopy, Gastrointestinal, Female, Gastroenterology, Global Health, Health Resources, Humans, Infection Control, Infectious Disease Transmission, Patient-to-Professional, Internationality, Male, Occupational Health, Pandemics, Personal Protective Equipment, Pneumonia, Viral, Poverty, Practice Guidelines as Topic, Societies, Medical