Patients show a wide range of symptoms. Some may be asymptomatic or show minimal clinical signs once infected. Although fever, nausea, and dry cough are the most common signs of infection, diarrhea may be the first sign, especially in the young, and dyspepsia and poor appetite in the elderly. The rate of transmission from infected to healthy is estimated according to the reproductive number (Ro) of 4.08 (study confirmed). Mortality varies widely, but figures from northern Italy are as worrying as possible. People over the age of 60 are most at risk, especially those over the age of 80. According to Wuhan, the mortality rate for severe pneumonia is 10-40%.

SZGH is of the opinion that when an epidemic is declared in the Republic of Slovenia, it is necessary to perform only urgent endoscopic procedures. Transmission through saliva or faeces is a mode of transmission of the virus. By temporarily canceling non-urgent interventions, we can influence the containment of the spread of the disease.

The endoscopic diagnostic and therapeutic interventions to be continued are: acute bleeding from the GIT, dysphagia, reasonable suspicion of malignant disease of the gastrointestinal tract. All emergency ERCP and EUZ and EUZ guided biopsies are performed in case of suspected malignancy. They are performed with water biopsies when malignancy is suspected.

In the SVIT program, we will review all the positives, while the program, ie screening with FIT tests, will be temporarily suspended. We suggest that the above restrictions apply until the epidemic is lifted.

Instructions for endoscopic departments in Slovenia:

Patient triage and protection of medical staff is critical to managing nosocomial transmission of the infection!

Protection of medical staff:

1. Any member of the health care organization who has symptoms of a cold: fever, nausea, and dry irritating cough or a history of contact with a SARS 2 COVID-2019 infected patient should be identified and treated appropriately.
2. A body temperature check is required before starting work for all employees, every day. Staff with catarrhal signs should not perform endoscopies
3. Hand hygiene: staff must wash their hands according to the guidelines (6-step wash) or disinfect their hands with a quick-drying disinfectant (disinfectant) for two minutes
4. Level 2 bioprotection protection is required for staff in direct contact with patients, using a protective coat, apron, N95 face masks, visor or goggles, caps, and shoe protection during endoscopic procedures.
5. Level 3 biosphere protection is required in all endoscopic procedures for COVID-19 confirmed infections or suspected infections
6. The report can be written under the supervision of an endoscopist by another person in a clean room, to avoid transmission of infection
7. After the procedure, the staff is required to remove all protective equipment used, clean the hands before leaving the endoscopic unit and entering the rest area or other work that is separate from working with patients. The use of a general face mask is required in all areas of the healthcare organization
8. Outside the work process, staff are required to stay at home as much as possible. as much as possible

As Covid-2019 is easily removed with many already used disinfectants, there is no need for additional measures. Chlorine-containing detergent should be used for daily floor cleaning.

On behalf of the SZGH Presidency:
Prim Milan Stefanovič, Ph.D. med.
Prof.dr. Bojan Tepeš, Ph.D. med. senior saint
Prof.dr. Borut Štabuc, Ph.D. med. senior saint
All members of the SZGH presidency