German bronchoscopy unit readiness for the COVID-19 pandemic: a nationwide survey

Area of Science:

• Pulmonology and Respiratory Medicine
• Infectious Disease Control
• Healthcare Management

Background:

• The COVID-19 pandemic created unprecedented challenges for healthcare, particularly for aerosol-generating procedures like bronchoscopy.
• Bronchoscopy, a vital diagnostic and therapeutic tool, carries a high risk of infection transmission.
• National guidance exists, but the practical implementation by individual bronchoscopy units remains unclear.

Purpose of the Study:

• To assess the impact of the COVID-19 pandemic on German bronchoscopy units.
• To evaluate the adherence to and challenges in implementing national recommendations for safe bronchoscopy practices.
• To identify perceived threats to the continuity of bronchoscopic activities.

Main Methods:

• A nationwide electronic survey was conducted among 218 German endoscopy units.
• The survey took place from April 1st to April 7th, 2020, distributed via the German Respiratory Society.
• Data was collected on procedural cancellations, patient management, adopted safety measures, and anticipated resource shortages.

Main Results:

• Significant variation in intervention cancellations, with 16% cancelling over 80%.
• 73% of units struggled to completely segregate high-risk patients.
• High adoption rates for risk stratification (95%), staff training (91%), and appropriate PPE use (85%).
• Anticipated shortages in PPE (74%) and staff (68%), alongside financial concerns (63%), were widely reported.

Conclusions:

• Personal protective equipment (PPE) shortages are the most immediate threat to bronchoscopy services.
• There is an urgent need for evidence-based, internationally concerted recommendations adapted to local conditions.
• The study highlights the need for practical guidance to ensure the safe continuation of bronchoscopy during health crises.