“It ain't over … till it's over!” Risk‐mitigation strategies for patients with gastrointestinal diseases in the aftermath of the COVID‐19 pandemic

Abstract

The available COVID-19 literature has focussed on specific disease manifestations, infection control, and delivery or prioritisation of services for specific patient groups in the setting of the acute COVID-19 pandemic. Local health systems aim to contain the COVID-19 pandemic and hospitals and health care providers rush to provide the capacity for a surge of COVID-19 patients. However, the short, medium-and long-term outcomes of patients with gastrointestinal (GI) diseases without COVID-19 will be affected by the ability to develop locally adapted strategies to meet their service needs in the COVID-19 setting. To mitigate risks for patients with GI diseases, it is useful to differentiate three phases: 1) the acute phase, 2) the adaptation phase and 3) the consolidation phase. During the acute phase, service delivery for patients with GI disease will be curtailed to meet competing health care needs of COVID-19 patients. During the adaptation phase, GI-services are calibrated towards a 'new normal' and the consolidation phase is characterised by rapid introduction and ongoing refinement of services.Proactive planning with engagement of relevant stakeholders including consumer representatives is required to be prepared for a variety of scenarios that are dictated by thus far undefined long-term economic and societal impacts of the pandemic.Since substantial changes -to the delivery of services are likely to occur, it is important that these changes are embedded into quality and research frameworks to ensure that data are generated that support evidence-based decision-making during the adaptation and consolidation phases.

Safety in Endoscopy for Patients and Healthcare Workers During the COVID-19 Pandemic

“…The safety of endoscopy for both patients and healthcare workers is paramount as endoscopy units adapt to the ongoing outbreak and start resuming regular service 92 . Stringent measures taken before, during and after endoscopy can hopefully mitigate the risk of infection.…”

COVID-19 and Gastrointestinal Disease: Implications for the Gastroenterologist

“…Table 1 suggests a modified proposal from that issued by the Kaiser Permanente in Northern California that can serve as reference for other institutions [ 102 ]. Further helpful directions have been suggested by an international group of experts [ 103 ]. They looked at the impact of COVID-19 on GI services and the implications for patients who do not have COVID-19 but do have GI problems during the pandemic.…”

“…These requirements also contribute to the slower running of units despite level 1 PPE. In some areas which did not have a significant viral peak and still have low prevalence, far fewer measures have been required, and endoscopy has been minimally interrupted and indicates what might be achieved by a reappraisal of the services and introduction of strategies of mitigation [ 103 ].…”

Care of inflammatory bowel disease patients during coronavirus disease‐19 pandemic using digital health‐care technology

“…Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection causing the coronavirus disease-19 (COVID-19) pandemic has led to difficulties in providing health-care services throughout the world, including India. 1 The disease originated in Wuhan city, China, in December 2019 and spread throughout the whole world. 2 The first case of COVID-19 was reported in India from Kerala on 30th January 2020.…”