We are currently living in the throes of the COVID-19 pandemic that imposes a significant stress on health care providers and facilities. Europe is severely affected with an exponential increase in incident infections and deaths. The clinical manifestations of COVID-19 can be subtle, encompassing a broad spectrum from asymptomatic mild disease to severe respiratory illness. Health care professionals in endoscopy units are at increased risk of infection from COVID-19. Infection prevention and control has been shown to be dramatically effective in assuring the safety of both health care professionals and patients. The European Society of Gastrointestinal Endoscopy (www.esge.com) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (www.esgena.org) are joining forces to provide guidance during this pandemic to help assure the highest level of endoscopy care and protection against COVID-19 for both patients and endoscopy unit personnel. This guidance is based upon the best available evidence regarding assessment of risk during the current status of the pandemic and a consensus on which procedures to perform and the priorities on resumption. We appreciate the gaps in knowledge and evidence, especially on the proper strategy(ies) for the resumption of normal endoscopy practice during the upcoming phases and end of the pandemic and therefore a list of potential research questions is presented. New evidence may result in an updated statement.

ACLS advanced cardiovascular life support ASA American Society of Anesthesiologists BIS bispectral index BLS basic life support BMI body mass index CAPS computer-assisted personalized sedation CORI Clinical Outcomes Research Initiative CPAP continuous positive airway pressure EEG electroencephalogram

This Position Statement from the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology Nurses and Associates (ESGENA) sets standards for the reprocessing of flexible endoscopes and endoscopic devices used in gastroenterology. An expert working group of gastroenterologists, endoscopy nurses, chemists, microbiologists, and industry representatives provides updated recommendations on all aspects of reprocessing in order to maintain hygiene and infection control.

Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this evidence- and consensus-based set of guideline is to provide non-anesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline

Contents ! 1. Introduction 2. Definition of terms 3. Endoscopy−related infections 4. Principles of infection control 5. Chain of infection 6. Health and safety of endoscopy personnel 7. General requirements 7.1. Classification of endoscopic equipment 7.2. Aims of the reprocessing procedure 7.3. Staff requirements 7.4. Reprocessing room 7.5. The reprocessing procedure 7.6. Manual versus automated reprocessing 8. Process chemicals 8.1. Detergents 8.1.1. Detergents with enzymatic boosters 8.1.2. Detergents with alkaline boosters 8.1.3. Detergents with enzymatic and alkaline boosters 8.1.4. Detergents containing antimicrobial active substances 8.