Plans to Reactivate Gastroenterology Practices Following the COVID-19 Pandemic: A Survey of North American Centers. Clin Gastroenterol Hepatol 2020 Sep;18(10):2287-2294.e1
Date
05/25/2020Pubmed ID
32447019Pubmed Central ID
PMC7242181DOI
10.1016/j.cgh.2020.05.030Scopus ID
2-s2.0-85089412387 (requires institutional sign-in at Scopus site) 20 CitationsAbstract
BACKGROUND & AIMS: Practices dramatically reduced endoscopy services due to the COVID-19 pandemic. Because practices now are considering reintroduction of elective endoscopy, we conducted a survey of North American practices to identify reactivation barriers and strategies.
METHODS: We designed and electronically distributed a web-based survey to North American gastroenterologists consisting of 7 domains: institutional demographics, impact of COVID-19 on endoscopy practice, elective endoscopy resumption plans, anesthesia modifications, personal protective equipment policies, fellowship training, and telemedicine use. Responses were stratified by practice type: ambulatory surgery center (ASC) or hospital-based.
RESULTS: In total, 123 practices (55% ASC-based and 45% hospital-based) responded. At the pandemic's peak (as reported by the respondents), practices saw a 90% decrease in endoscopy volume, with most centers planning to resume elective endoscopy a median of 55 days after initial restrictions. Declining community prevalence of COVID-19, personal protective equipment availability, and preprocedure severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing availability were ranked as the 3 primary factors influencing reactivation timing. ASC-based practices were more likely to identify preprocedure testing availability as a major factor limiting elective endoscopy resumption (P = .001). Preprocedure SARS-CoV-2 testing was planned by only 49.2% of practices overall; when testing is performed and negative, 52.9% of practices will continue to use N95 masks.
CONCLUSIONS: This survey highlights barriers and variable strategies for reactivation of elective endoscopy services after the COVID-19 pandemic. Our results suggest that more widespread access to preprocedure SARS-CoV-2 tests with superior performance characteristics is needed to increase provider and patient comfort in proceeding with elective endoscopy.
Author List
Kushnir VM, Berzin TM, Elmunzer BJ, Mendelsohn RB, Patel V, Pawa S, Smith ZL, Keswani RN, North American Alliance for the Study of Digestive Manifestations of COVID-19Author
Zachary Smith DO Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
BetacoronavirusCoronavirus Infections
Cross-Sectional Studies
Digestive System Diseases
Digestive System Surgical Procedures
Disease Transmission, Infectious
Gastroenterology
Humans
Pandemics
Personal Protective Equipment
Pneumonia, Viral
Surveys and Questionnaires
United States
