COVID-19: Advice from the Canadian Association of Gastroenterology for Endoscopy Facilities, as of March 16, 2020

The above guidance (Figure 1) reflects the current limited evidence available, but further guidance may be required as the situation rapidly evolves.CAG would like to highlight an important article by Repici et al. who had first hand experience with performing endoscopic procedures during this outbreak.1 This article discussed measures, with specific focus on patient management and risk stratification based on procedural types and patient-related risk factors, personal protection equipment (PPE) and process for wearing and removing PPE, which have been implemented in their hospitals to reduce dissemination of COVID-19 infection. It is important to note that the proposed measures are based on current limited understanding of the incubation period, mechanisms of transmission, clinical course and the duration of infectivity. As well, the evidence supporting the use of these measures is largely based on prior experience from other coronaviruses (e.g., SARS-CoV and MERS-CoV). Figure 1 summarizes CAG guidance on infection prevention and control for COVID-19 when performing endoscopic procedures (as of March 16, 2020).