Rhinologic Procedures in the Era of COVID-19: Health-care Provider Protection Protocol.

Mohamed A Taha,Paul J Waguespack,Megan M Stevenson,Charles R Bowie,Luke A Corsten,Richard F Rathbone,Richard Stanger,Christian A Hall,Brittany A Zito,Henry P Barham

doi:10.1177/1945892420927178

Abstract

IntroductionSARS-CoV-2 has been identified as the pathogen causing the outbreak of Coronavirus Disease 2019 (COVID-19) that started in Wuhan, China, in December 2019. SARS-CoV-2 has human-to-human transmission ability and universally contagious to all populations. The main transmission patterns are respiratory droplets transmission and contact transmission. The purpose of this study is to propose a protocol that may be used as a guide to reduce the incidence of COVID-19 infections among otolaryngology care teams.MethodsA prospective cohort study was conducted to show the efficacy of our protocol to prevent transmission to health-care providers from March 11, 2020 through April 14, 2020. The protocol consisted of a series of protective measures that we applied to all health-care providers, then testing of our providers for COVID-19 using reverse transcription polymerase chain reaction along with immunoglobulin M (IgM) and immunoglobulin G (IgG) testing at the end of the study period to ensure effectiveness.ResultsOur protocol resulted in zero transmissions to our health-care providers during the duration of the initial study. We were involved in greater than 150 sinonasal, skull base, open airway, and endoscopy procedures during this study. At the conclusion of the initial 5 weeks, we had no health-care providers test positive for SARS-CoV-2.ConclusionAccording to our proposed protocol, we were able to provide care for all patients in clinic, hospital, emergent, intensive, and surgical settings with no transmission of SARS-CoV-2 by symptomatology and post evaluation testing.

Highlights

SARS-CoV-2 has been identified as the pathogen causing the outbreak of Coronavirus Disease 2019 (COVID-19) that started in Wuhan, China, in December 2019
The disease was subsequently named Coronavirus Disease—2019 (COVID-19) by the World Health Organization (WHO) and has been designated SARS-CoV-2.2 Significant concern has arisen within the global community to the potential risks of infectious transmission of SARS-CoV-2 to the surgical team during endoscopic sinonasal and skull base surgery
As information has rapidly evolved, it has become clear that the presence of elevated viral load in the upper airway mucosa impacts skull base cases and virtually all diagnostic and therapeutic intranasal procedures routinely performed by Otolaryngologists

Summary

Introduction

SARS-CoV-2 has been identified as the pathogen causing the outbreak of Coronavirus Disease 2019 (COVID-19) that started in Wuhan, China, in December 2019. A cluster of viral pneumonia cases associated with a novel Coronavirus (2019-nCoV) was first identified in Wuhan, Hubei Province, China, in December 2019 and has rapidly spread around the world, causing a global health crisis.[1] The disease was subsequently named Coronavirus Disease—2019 (COVID-19) by the World Health Organization (WHO) and has been designated SARS-CoV-2.2 Significant concern has arisen within the global community to the potential risks of infectious transmission of SARS-CoV-2 to the surgical team during endoscopic sinonasal and skull base surgery. No evidence-based data to guide best practices far We hope this will be one of the first of many studies coming from our scientific community, we have attempted to evaluate the literature regarding aerosol generating procedures and evaluate a protocol to protect our patients and our colleagues in the face of this new threat. When patient care is required, appropriate measures should be taken to prevent transmission from potentially infected patients to other patients or health-care providers.[9]

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