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2020 ; 18
(10
): 2287-2294.e1
Nephropedia Template TP
gab.com Text
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English Wikipedia
Plans to Reactivate Gastroenterology Practices Following the COVID-19 Pandemic: A
Survey of North American Centers
#MMPMID32447019
Kushnir VM
; Berzin TM
; Elmunzer BJ
; Mendelsohn RB
; Patel V
; Pawa S
; Smith ZL
; Keswani RN
Clin Gastroenterol Hepatol
2020[Sep]; 18
(10
): 2287-2294.e1
PMID32447019
show ga
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.