Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has put unprecedented challenges on the medical community. Physicians and other health care workers who perform and participate in examinations and procedures within the head and neck region and airway are at particularly high risk of exposure and infection from aerosol and droplet contamination. Specific data on the risk of infection in otolaryngologists–head and neck surgeons are not available. However, one of the earliest reports from Wuhan, China, where severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified, found 40 health care workers among the first consecutive 138 patients hospitalized.¹ During the severe acute respiratory syndrome (SARS) outbreak of 2003 in Canada, 51% of the 438 cases were health care workers, and 3 died from SARS-related causes.² While the figures are worrying, other data suggest that through the use of careful hygiene, health care workers can stay safe. A case report of early COVID-19 experience from Singapore³ revealed that none of the 41 health care workers who took care of a patient with severe pneumonia before their diagnosis of COVID-19 became infected themselves or developed symptoms. These health care workers had been present during intubation and extubation of the patient; they were present for at least 10 minutes at a distance of less than 2 m from the patient, with 85% wearing a surgical mask and the remainder wearing N95 masks.