Introduction:
In late December 2019, a cluster of pneumonia cases of unknown aetiology
were reported in Wuhan, Hubei Province, Central China. The causative
agent was subsequently identified as the novel coronavirus (SARS-CoV-2,
previously known as 2019-nCoV). The coronavirus disease 2019 (COVID-19)
was eventually declared as a global pandemic by the World Health
Organisation (WHO), having been detected in over 72 countries worldwide,
with Europe and the United States now deemed the viral epicentres
[1].
Healthcare professionals (HCP) are considered high risk due to a
multitude of factors including exposure to higher viral loads [2]
and aerosolisation [3,4]. The rising number of deaths amongst
healthcare professionals and burden of sick leave secondary to
self-isolation, raises significant safety concerns during patient
assessment and management. This is particularly of concern when
undertaking droplet and aerosol generating procedures (AGP), although
the evidence is derived largely from low quality studies [6].
Postulated mechanisms thought to generate aerosol and droplets include
laryngeal activity (speech & coughing), high velocity gas flow, and
cyclical opening and closure of distal airway. These have been found to
generate particles in a range of sizes, increasing the viral load in
confined spaces, and possibly increasing transmission risk.
Recent literature suggests an increased risk posed to
otorhinolaryngologists, as diagnostic, interventional and therapeutic
procedures involving the upper aerodigestive tract, paranasal sinuses
and middle ear exposes HCPs to both direct and indirect transmission of
SARS-CoV-2 [7]. At the point of formulating this article, elective
clinical workload has been reduced within the United Kingdom.
Two-week-wait clinics have continued due to the prevalence and rising
incidence of head and neck cancers [8], albeit at a significantly
reduced capacity due to lengthened infection control measures.
We describe a novel and cost-effective safety adjunct when undertaking
flexible nasendoscopy (FNE) within ward/ outpatient settings.