key: cord-0897416-wxwmlqvh
authors: Gualtieri, G.; Brusciano, L.; Gambardella, C.; Tolone, S.; Lucido, F.S.; del Genio, G.; Terracciano, G.; Docimo, L.
title: Sars-Cov-2 hurricane impacting proctology outpatient clinics and proctologic emergencies. On the verge of phase 2, learning from phase 1. Correspondence
date: 2020-05-19
journal: Int J Surg
DOI: 10.1016/j.ijsu.2020.05.049
sha: 5f202a3b85a971c577447f01168f53b5723dcdbc
doc_id: 897416
cord_uid: wxwmlqvh

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GG: Participated substantially in conception, design and execution of the study, and in the drafting and editing of the manuscript BL: Participated substantially in conception, design and execution of the study, and in the drafting and editing of the manuscript. GC: Participated substantially in conception, design and execution of the study and in the analysis and interpretation of the data. 

The Guarantor is the one or more people who accept full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish. Please note that providing a guarantor is compulsory. Three of these patients subsequently tested by their general doctors for flu and cough occurrence, resulted positive for COVID-19. We were informed at our weekly follow-up phone call. Unfortunately, we were exposed at a high contagion risk with undetected COVID-19 patients, as guidelines did not recommend wearing particular PPE when dealing with asymptomatic subjects. Nevertheless, facing the next phase of the pandemic when visits and surgeries will be gradually reactivated, patients pre-admitting testing appears crucial. Testing all patients is advised, though considering tests sensitivity/specificity, [3] and the international tests shortage due to the worldwide massive request, that could affect their availability.

On the verge of phase 2, it is advisable to keep the telemedicine habit when possible, to avoid physical attendance of hospitals and contain contagion; as to reduce healthcare costs, skipping admissions and readmissions, after the emergency will end. [4, 5] Moreover, if tests are not available or in any acute condition necessitating a close contact with patients, given our past experience, we strongly advice to consider every patient as a COVID-19 subject, regardless the presence of symptoms, and to adopt all the possible precautions taken in COVID-19 wards, because providing healthcare personnel protection and reducing contagion will still be imperative in the next weeks.

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