Proposal of the Slovenian Association of Gastroenterology and Hepatology (SAGH) for action in the field of gastrointestinal endoscopy at the declaration of the SARS 2 epidemic COVID-19
Following the outbreak of the COVID-19 epidemic in Wuhan, China and the declared global pandemic with outbreaks in individual parts of the world and especially the EU, the epidemic was declared today, 12 March 2020, also in the Republic of Slovenia.
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.
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