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AGA pre-procedure testing guideline survey
This survey aims to inform a guideline on how to safely re-open endoscopy centers by using pre-procedure testing.
Current tests for COVID-19 have not been completely validated but even well-established tests are never 100% accurate. In the setting of endoscopy, a false negative test in an asymptomatic individual means this individual has COVID-19, is shedding the virus and may transmit the infection to others.
In order to open your endoscopy unit, the following pre-endoscopy COVID-19 testing strategy (RT-PCR within 48 hours of the appointment) is being implemented: asymptomatic patients who test positive are re-scheduled and in asymptomatic patients who test negative, the procedure is performed with a surgical mask plus face shield. Please review the following statements and assumptions:
The prevalence of asymptomatic patients with COVID-19 in your area is 1% (low prevalence). Patients are screened using the CDC screening checklist.
We assume the risk of COVID-19 infection is 50% if an endoscopist performs an upper endoscopy with no PPE (personal protective equipment) in a patient with COVID-19*
Based on best available evidence, the risk of getting COVID is 20% if wearing a surgical mask and 5% if wearing an N95 with face shield (worst case scenarios).
*Published rates of infection among healthcare workers (in general) range from 5% to 30%; we presume the risk is higher among individuals involved with aerosol generating procedures but we are uncertain if it is 50%.
Now please answer the following question when thinking about opening your endoscopy center:
