The New Normal of ENT OPD: Adapting Safe Practices
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ORIGINAL ARTICLE
The New Normal of ENT OPD: Adapting Safe Practices Aditya Yeolekar1
•
Sudhir Bhalerao2 • Maya Bhalerao2
Received: 4 August 2020 / Accepted: 2 September 2020 Ó Association of Otolaryngologists of India 2020
Abstract The COVID-19 epidemic originating in China has spread rapidly worldwide and converted to pandemic proportions in March 2020. In India and densely populated countries like Brazil and USA the numbers are still rising. Clinicians all over the world are trying to contain it by minimizing the cross-transmission of disease among hospital staff members. In the field of Otorhinolaryngology (ENT) the doctors are exposed to high viral load while examining the patients. Therefore contingency plans are required for dealing with patients in outpatient clinics, and while performing diagnostic endoscopies, minor procedures in OPD and surgeries in operating rooms. Infected patients may shed severe acute respiratory syndrome coronavirus-2 particles into their environment via body secretions. Therefore, Otolaryngologists should be vigilant. In this submission, we share our experience of an innovative practice plan in redesigning the ENT OPD setup, endoscopy set up and OT so as to reduce the risk of transmission of virus not only to doctors but other healthcare workers. We hope that our modifications will serve as a guide for every Otolaryngologist throughout India towards performing their clinical duties confidently without any apprehension and ensuring adequate safety during this testing times in their small set-up/ clinical establishments. Keywords COVID-19 Otolaryngology ENT OPD The New Normal & Aditya Yeolekar [email protected] 1
Department of ENT and HNS, Smt. Kashibai Navale Medical College, Pune 41, India
2
Bhalerao ENT Hospital, PCMC, Pune, India
Introduction The 2019 novel Coronavirus disease (COVID-19) continues to spread rapidly throughout the world in pandemic proportions. The 189th situation report issued by the WHO on July 27, 2020 listed 1, 61, 14, 449 confirmed COVID-19 cases and 6, 46, 641deaths in the world encompassing 213 countries (Weekly Operational Update on COVID-19 9 September 2020—positive cases: 27,486,960). At the time of preparing this article, although the mortality rate of COVID-19 in India (2.23%) is not alarming as compared to other counties around the world, the number of positive patients in India have increased to more than 14 lakhs. Initially it was suggested that animal to human transmission is the mode of spread of the SARS-CoV-2 virus, currently human to human transmission is believed to be the main cause of the spread(Wang and Du 2020) [1]. The virus spreads through minute particles known as aerosols(less than 5 lm) and droplets (more than 20 lm). The spread seems to happen talking out loud, sneezing and coughing in close distances or even distance of 2 m–8 m [2, 3]. The aerosolized SARS-CoV-2 particles can remain active in the air possibly three hours or even more [4]. It can stay on surfaces and can spread as fomites. Therefore the contact the hands
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