Barriers for resuming endoscopy service in the context of COVID-19 pandemic: A multicenter survey from Egypt

Elshaarawy, Omar; Lashen, Sameh Aldesoky; Makhlouf, Nahed A; Abdeltawab, Doaa; Zaghloul, Mariam Salah; Ahmed, Rasha M; Fathy, Hayam; Afifi, Shimaa; Abdel-Gawad, Muhammad; Abdelsameea, Eman; Abd-Elsalam, Sherief; Mohamed, Salem Youssef; Tag-Adeen, Mohammed; Tharwat, Mina; Alzamzamy, Ahmed; Bekhit, Ahmed Nasr; Eid, Alshaimaa M; Awad, Abeer; Aamr, Mohammad; Dayem, Waleed A Abd El; Wifi, Mohamed-Naguib; Alboraie, Mohamed

BACKGROUND: The current coronavirus disease 2019 (COVID-19) pandemic has affected routine endoscopy service across the gastroenterology community. This led to the suspension of service provision for elective cases. AIM: To assess the potential barriers for resuming the endoscopy service in Egypt. METHODS: A national online survey, four domains, was disseminated over a period of 4 wk in August 2020. The primary outcome of the survey was to determine the impact of the COVID-19 pandemic on the endoscopy service and barriers to the full resumption of a disabled center(s). RESULTS: A hundred and thirteen Egyptian endoscopy centers participated in the survey. The waiting list was increased by ≥ 50% in 44.9% of areas with clusters of COVID-19 cases (n = 49) and in 35.5% of areas with sporadic cases (n = 62). Thirty nine (34.8%) centers suffered from staff shortage, which was considered a barrier against service resumption by 86.4% of centers in per-protocol analysis. In multivariate analysis, the burden of cases in the unit locality, staff shortage/recovery and the availability of separate designated rooms for COVID-19 cases could markedly affect the resumption of endoscopy practice (P = 0.029, < 0.001 and 0.02, respectively) and Odd’s ratio (0.15, 1.8 and 0.16, respectively). CONCLUSION: The COVID-19 pandemic has led to restrictions in endoscopic volumes. The staff shortage/recovery and the availability of COVID-19 designed rooms are the most important barriers against recovery. Increasing working hours and dividing endoscopy staff into teams may help to overcome the current situation.