With the availability of three safe and effective U.S. Food and Drug Administration-approved vaccines for COVID-19, conversations within the gastroenterology field are increasingly focused on how to resume normal operations in a post-pandemic environment, including endoscopic procedures.
“COVID-19 has changed the landscape of medicine and has had a deep impact on the practice of endoscopy,” said Prateek Sharma, MD, of the University of Kansas School of Medicine, who presented on the topic at DDW® 2021. “It’s crucial that endoscopists learn how to manage their endoscopy unit with this infection.”
Gastroenterology professional societies all agree that endoscopy services can begin to resume if clinics follow guidelines for doing so safely. In that vein, Dr. Sharma highlighted the following checklist of practice strategies that clinicians and organizations can follow to ensure safe and efficient operation:
- Track the prevalence rates of COVID-19 infection in your local community, and seek out local, state and federal guidelines about infection countermeasures.
- Assess changes in the logistics of your health care setting as a result of the virus. For instance, is there now a tent outside your facility where patients need to check in? Is there a triage area for patients? Is your waiting room arranged differently because of social distancing?
- In scheduling procedures, learn whether your facility is in a region where only urgent cases are being handled versus semi-urgent and elective cases. This also requires considering the extent to which telehealth services are needed and how to implement them.
- Develop pre-screening strategies, which should include assessing all patients for possible COVID-19 exposure. This can be performed via questionnaire, polymerase chain reaction testing or both. If your facility requires pre-procedure COVID-19 testing, think about how to triage patients based on positive versus negative test results.
- Ensure the availability of full personal protective equipment (PPE), including a cap, N95 face mask, a face shield or goggles, a gown, boot covers and gloves.
- Establish clear rules for the safe conduct of procedures (e.g., requiring all patients and personnel to wear masks and follow social distancing regulations).
- Prioritize infection control, such as confirming the availability of full PPE, screening staff for COVID on a daily basis and urging all endoscopy staff to get their COVID-19 vaccine.
- Consider post-procedure patient follow-up, such as how to monitor and manage patients who were asymptomatic during endoscopy but tested positive for COVID-19 within 14 days following their procedure.
In addition to this operational checklist, Dr. Sharma said clinicians need to communicate with endoscopy patients about any changes in their procedure (before, during or after) as a result of the pandemic.
“As we are looking at the light at the end of the tunnel, these are lessons learned that we can all put into practice and make our endoscopy units safe for our patients as well as our personnel,” he said. “This issue of COVID-19 and its impact on how we are practicing today and will continue practicing in the near future is become of immense importance.”
Dr. Sharma’s oral presentation of “The new normal: Primer on the post-COVID endoscopy unit” took place on Sunday, May 23, at 10 a.m. EDT, as part of the AGA session “COVID-19 and GI Practice: Learning From the Past As We Build Towards a Better Future.”