key: cord-0874111-1mxdt73k
authors: Corley, Douglas A.; Peek, Richard M.
title: COVID-19: Guidance for What Clinicians and Scientists Should Do and When
date: 2021-04-29
journal: Gastroenterology
DOI: 10.1053/j.gastro.2021.04.011
sha: 5ae6fd2e385a568c0dab0e42e83fafc66ab7bd6f
doc_id: 874111
cord_uid: 1mxdt73k

nan

T he rapidly evolving global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its resulting coronavirus disease (COVID-19) sowed confusion regarding the actual risk to patients and healthcare workers, the portfolio of presenting symptoms, what actions healthcare workers should take, and when to act. 1 A global Biogen management meeting on February 27, 2020 in Boston, purportedly resulted in at least 70 linked infections within two weeks, which was amplified by broader dissemination from post-meeting travel. 2 This single event likely substantially contributed to viral spread within Massachusetts and transmission to other states; this high level of infectivity was confirmed by repeated waves of infections, many paralleling easing of restrictions in the summer and fall of 2020. The global spread of the virus, high mortality in China, Italy, the United States, and other countries, and other events raise important questions for our disciplines for maintaining care, even as the pandemic has claimed the lives of over 1 of every 1000 people in some countries, including the United States.

Articles rapidly published in Gastroenterology and other journals have helped answer these questions. Our editors worked tirelessly to rapidly evaluate hundreds of submissions and move many from submission to publication within days to a few weeks. These articles evaluated critical questions including how much more dangerous is this pathogen than influenza and similar viruses? Should we stop elective procedures (and what were the impacts of slowdowns on screening and other care)? Are there specific symptoms relevant to gastroenterologists and hepatologists? Should we hold in-person research and clinical meetings? How should geographic regions without many cases respond? What is the impact on potentially vulnerable populations, including those within certain race/ethnicity groups, across different countries, or with predisposing conditions such as immunosuppression and liver transplantation? As gastroenterologists, and as an epidemiologist and a basic scientist, we followed events closely and aimed to rapidly publish novel, timely, accurate, and impactful work that informed science and health care practices.

You all are leaders within your healthcare setting, community, and family and your actions will continue to influence and decrease the potential human and economic damage from COVID-19, including mitigating collateral harm from procedures cancelled or deferred.

The articles published in this Virtual Special Issue demonstrate the importance of GI symptoms, the relative safety of continuing immunosuppression, the feasibility and effectiveness of rapid conversions to telemedicine, viral impacts on specific organs such as the pancreas and liver, controversies over the influence of certain medications (eg, acid suppression), and authoritative AGA rapid analyses and recommendations. We hope you find these useful for your practice and valuable for understanding the virus' mechanisms and effects.

During 2021, we look forward to evaluating the influence of vaccinations, long-term effects of infections, modifications in clinical care and training during and beyond the pandemic, and other investigations. We encourage you to continue to submit your impactful studies and we promise to continue rapid evaluations and decisions.

We thank you for your efforts in research and clinical care and hope you and yours stay well in these unusual times, through 2021 and beyond.

Continue to frequently check updated recommendations. The following are excellent, official, frequently updated resources for healthcare providers and patients: 

Naming the coronavirus disease (COVID-19) and the virus that causes it

Massachusetts declares state of emergency as coronavirus spreads