Use of a new face shield for patients of the endoscopy unit to avoid aerosol exchange in the COVID 19 era
Figure 1. Face shield, front view. In December 2019, a new coronavirus called SARS CoV2 emerged from a zoonotic source in Wuhan, China. One of its main characteristics is its easy propagation through airborne droplets from symptomatic and asymptomatic patients. SARS CoV 2 thus has spread quickly, infecting 2 million people in more than 200 countries. It is the first coronavirus to be considered a pandemic. Its mortality rate ranges from 1% to 10% Unfortunately, health workers have a 3 times greater chance of acquiring the virus compared with the general population, with almost 20% infected in some regions. Because of the method of transmission, endoscopy rooms and digestive endoscopy procedures in general represent an easy method of dissemination. Because these procedures are performed in a contaminated environment, there is a higher risk that patients and health workers will be infected. This concern exists because procedures that take place in the upper GI tract, including gastroduodenoscopy, cholangiography, and EUS, make it easier for particles to become aerosols that exit the infected patient's nasopharynx. This risk can increase even more if a patient sneezes, coughs, retches, or needs to be intubated. Although there is an absence of new data about transmission of the virus as an aerosol, a previous study revealed that health workers who are exposed to this kind of procedure have a 4.66 times greater probability (95% confidence interval, 3.1 6.9) of infection in comparison with others. In addition, there is evidence of microbe dissemination to a distance of as much as 2 m from a patient during endoscopy. Fluids from the patient can be scattered when manipulation devices are used within the endoscope, possibly infecting people nearby and even contaminating light switches and doors; this contamination is made more alarming by the fact that the virus has been found to be viable for several hours on plastics and stainless steel. Taking all this into account, endoscopy can be considered a high risk procedure for COVID 19 transmission. Guidelines recommend the use of personal protection equipment for every procedure, including long sleeved robes, eye protection, gloves, and a mask. It should also be taken into account that the high number of current COVID 19 cases will take time to decrease and
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