Proposal for the return to routine endoscopy during the COVID-19 pandemic

Abstract

In response to the coronavirus disease 2019 (COVID-19) pandemic, many jurisdictions and gastroenterological societies around the world have suspended nonurgent endoscopy. Subject to country-specific variability, it is projected that with current mitigation measures in place, the peak incidence of active COVID-19 infections may be delayed by over 6 months. Although this aims to prevent the overburdening of healthcare systems, prolonged deferral of elective endoscopy will become unsustainable. Herein, we propose that by incorporating readily available point-of-care tests and conducting accurate clinical risk assessments, a safe and timely return to elective endoscopy is feasible. Our algorithm not only focuses on the safety of patients and healthcare workers, but also assists in rationalizing the use of invaluable resources such as personal protective equipment.

Figure 1

Algorithm for a return to endoscopy during the COVID-19 pandemic. COVID-19, Coronavirus disease 2019; FN, false negative; iNAAT, isothermal nucleic acid amplification; PPE, personal protective equipment; POC, point of care; PCR, polymerase chain reaction.

Figure 2

The rate of false negatives per 10,000 asymptomatic individuals as determined by test sensitivity and the prevalence of asymptomatic COVID-19. COVID-19, Coronavirus disease 2019.