This is a challenging time but amid the concern, there are uplifting stories of how people are looking out for each other and communities pulling together. The children’s rainbows of hope in windows and the national clap for carers to celebrate the work of the NHS and care workers on Thursday were much appreciated.
Information is useful—but too much information can be unhelpful. I have limited news updates to new information from consensus sources. We don’t generally benefit from watching the news over and over. Try to focus instead on the things you need to get done. Value the rest of the time to relax with your family or friends and reach out to those who may not have such good support networks as you may have.
The bulletins below have some reassuring observations for our patients.
I hope that these help guide your practice while working differently.
1 )Statement “Gastrointestinal endoscopy in children and COVID 19 pandemic” – ESPGHAN Endoscopy Special Interest Group
http://www.espghan.org/societal-papers/covid-19-informational-statements/
“..elective procedures – especially those such as upper gastrointestinal (GI) endoscopy which is an ‘aerosol-generating procedure’ (AGP) – should be put on hold at present. Equally ileocolonoscopy, given that we know now that COVID-19 can be excreted in stools. Local and physician judgment should occur when determining which patients require urgent endoscopic diagnostic testing, but these should be kept to a minimum. Obviously, life-saving endoscopy such as GI bleeding and button battery ingestion are mandatory and should not be deferred. In the event of endoscopy being required a full personal exposure protection package should be worn by those in the immediate vicinity of the endoscopy including an FPP3 mask or equivalent”
3) Letter from Lorenzo d’Antiga, Italy “Coronaviruses and immunosuppressed patients” https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/lt.25756
Preliminary experience so far show that children under 12 years of age do not develop coronavirus pneumonia regardless of their immune status although they get infected and can spread the infection. Immune suppressed patients are not at risk for severe pulmonary disease compared with the general population.
2) Article “COVID-19 and paediatric inflammatory bowel diseases: global experience and provisional guidance (March 2020) from the Paediatric IBD Porto group of ESPGHAN”. see PDF attached https://bspghan.org.uk/jpgn-s-20-00391
Preliminary data for PIBD patients during COVID-19 outbreak are reassuring.
IBD per-se does not currently seem to be a risk factor for acquiring SARS-CoV-2, nor for a more severe infection. Standard IBD treatments including biologics should continue at present
4) Surveys – please report cases of COVID-19
- a) “PedIBD and Covid-19” ESPGHAN Porto IBD Group https://research.szmc.org.il/redcap/surveys/?s=FP38CNWRLE
- b) “EoE/EGID and COVID-19 ”
http://www.espghan.org/societal-papers/covid-19-informational-statements/
https://redcap.clalit.co.il/redcap/surveys/?s=PHLW7EC8WD
Best wishes
Sue Protheroe
President 30 March 2020