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COVID-19 in Gastroenterology Departments: The Impact of the First Wave
Tiago Leal1, Margarida Gonçalves1, Irina Mocanu2
1Department of Gastroenterology, Hospital de Braga, Braga, Portugal.
Insights
The COVID-19 pandemic significantly impacted Portuguese gastroenterology departments, leading to reduced medical activity and postponed procedures. Strategies were implemented to manage the crisis and resume services, with remote consultations proving effective.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Public Health
Background:
- The Coronavirus disease 2019 (COVID-19) pandemic caused global healthcare system strain.
- Portugal implemented an emergency state in March-April 2020, reducing medical activity to mitigate health system pressure.
- Gastroenterology departments faced significant challenges during this period.
Purpose of the Study:
- To assess the impact of COVID-19 on gastroenterology departments in Portugal.
- To identify and evaluate strategies employed by these departments to navigate the pandemic's challenges.
- To understand the consequences of the first COVID-19 wave on gastroenterological services.
Main Methods:
- A cross-sectional study utilizing an online survey.
- Questionnaires were emailed to heads of gastroenterology departments in Portuguese District Hospitals.
- Data collected covered the emergency state (March-April 2020) and the recovery period (May-September 2020), with responses gathered Sept-Oct 2020.
Main Results:
- 21 hospitals participated (80.8% response rate); 28% reported staff infections.
- 66.7% of departments had staff redeployed; 47.6% performed only urgent endoscopies during the emergency state.
- 81% of patients postponed procedures due to infection fears; remote consultations were maintained in 81% of centers.
Conclusions:
- The study offers a snapshot of the first COVID-19 wave's impact on Portuguese gastroenterology.
- Departments adapted by prioritizing urgent procedures and implementing remote consultations.
- Understanding these strategies is crucial for future pandemic preparedness in gastroenterology.
Introduction:
Coronavirus disease 2019 (COVID-19) is a global pandemic that has severely affected health care systems around the world. During the emergency state declared in Portugal in the months of March and April 2020, there was a severe reduction in medical activity in order to reduce the pressure on health systems. This study aimed to assess the impact of COVID-19 in gastroenterology departments across Portugal and the strategies developed to overcome this challenge.
Methods:
This was a cross-sectional study based on an online survey. A detailed questionnaire concerning different aspects of gastroenterology department activity was sent via e-mail to the heads of gastroenterology departments of Portuguese District Hospitals (Núcleo de Gastroenterologia dos Hospitais Distritais). Two periods were assessed, i.e., the emergency state and the recovery period between May and September. The responses were collected between September and October 2020.
Results:
A total of 21 hospitals were enrolled (80.8% response rate). Twenty-eight percent of the responders reported healthcare professionals from their unit infected with COVID-19. At least 1 member (mostly fellows) of the department was deployed to another workplace in 66.7% of the hospitals. During the emergency state, 47.6% of the hospitals only performed urgent/emergent endoscopic procedures. In 38.5% of the hospitals the need to ration personal protective equipment led to the suspension of endoscopic training. Regarding the recovery period, nonurgent procedures were restarted in almost all of the centers. The same was reported for the colorectal cancer screening program. Remarkably, 81% of the responders confirmed that they had postponed procedures at patients' request for "fear of getting infected." Remote consultation was maintained in 81% of the hospitals. Globally, the fellows had resumed their training.
Discussion/Conclusion:
This study provides a snapshot of the impact and consequences of the first wave of the COVID-19 pandemic across Portuguese hospitals. It is important to understand how the gastroenterology world dealt with the first impact of COVID-19 and what strategies were implemented in order to better prepare for what might follow.
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