Online Survey on COVID-19 Exposure in Anaesthetists and Health Risks

SARS-CoV-2 continues to be among the most challenging global health crises for decades. Anaesthesiologists may have contact with COVID-19 patients in numerous settings, e.g. (emergency) surgery or critical care. Ways and mechanisms of SARS-CoV-2 transmission are still under investigation, yet both direct droplet transmission, as well as indirect transmission via aerosols, seem to be routes of infection ^1,2.

During the first spread of infections around the world, reports have emerged that certain interventions in anaesthesia (e.g. endotracheal intubation) may pose a special risk to participating healthcare providers. In a recent prospective survey, a combined primary endpoint of laboratory-confirmed COVID-19 infection or new symptoms requiring self-isolation or hospitalisation occurred in 10.7% of cases in providers involved in tracheal intubations in COVID-19 patients ³.

Another study reported COVID-like symptoms in 26.2% of participants after a work-related exposure, whereas “only” 12.1% became seroconverters (irrespective of work-related or community-associated exposure)⁴. Either way, data suggest that especially anaesthesia-related interventions may be present an extremely high risk since many of the airway procedures performed in anaesthesia and critical care are classified as an aerosol-generating procedure (AGP). AGP are medical procedures that can result in the release of airborne particles (aerosols) from the respiratory tract when treating someone who is suspected or known to be suffering from an infectious agent transmitted wholly or partly by the airborne or droplet route.

It is unclear whether the reported high infection rates were truly related to work-related activities first and foremost, or whether community-acquired cases make up for the major share in infections in these cohorts. Nevertheless, it stands to reason that through the nature of their everyday tasks, anaesthetists are subject to increased risk of SARS-CoV-2 transmission. It is of critical importance for both reasons of the workforce and patient safety to further evaluate the true extent of work-related exposure and infections. As numbers of SARS-CoV-2 cases appear to be on the rise around the world once again, we must seek to learn as much as possible from the previous months and be prepared as well as possible for the future.

In order to achieve this, a group of researchers together with the President of the ESA, Prof. Kai Zacharowski, and with the support of the ESA Board of Directors, initiated a large survey among all member states of ESA asking for past exposure to SARS-CoV-2 / COVID-19 patients among anaesthetists. To get a better understanding of the hazards from occupational exposure, a few questions regarding the availability and implementation of personal protective equipment and preventive measures in the hospital, possible infections related to work-specific tasks but also potential risk from activities outside the hospital were included in the survey.

If you have not done so yet, we would like to kindly ask you to take no more than five minutes to complete our online questionnaire and help us understand better what needs to be done to keep both patients and physicians as safe as possible as the pandemic continues to last. You can find the survey link below.

Thank you very much for your valuable time! We will keep you informed about the results of the survey.

Your valuable contribution is much appreciated!

ESA Board of Directors and Organising Committee ¹

• Benedikt Schmid, Prof. Peter Kranke and Prof. Patrick Meybohm (Department of Anaesthesiology, Critical Care and Pain Therapy, Wuerzburg University Hospital); Prof. Kai Zacharowski (Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt / ESA President)

Results will be presented on the Coronavirus COVID-19 Resource Hub as well as in the format of a journal contribution.

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References

1. Santarpia, J. L. et al. (n.d.) doi:10.1101/2020.03.23.20039446.
2. Sommerstein, R. et al.. Antimicrob Resist Infect Control 9, 100 (2020).
3. El‐Boghdadly, K., Wong, D. J. N., Johnstone, C., et al,.. Anaesthesia (2020) doi:10.1111/anae.15205.
4. Morcuende, M., Guglielminotti, J. & Landau, R.. Anesthesia Analgesia Publish Ahead of Print, (2020).

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