Young ophthalmologists in the trenches - EuroTimes
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Young ophthalmologists in the trenches

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Young ophthalmologists appear to be among the specialists most at risk for clinical exposure to SARS-CoV-2, a survey conducted during the worst days of New York City outbreak suggests.

Royce Chen MD and colleagues surveyed residency programs throughout the five boroughs of New York City to investigate the effect of the pandemic. The survey was conducted in April and included responses from 2,306 residents participating in 340 residency programmes representing 24 specialty categories.

Some 45.1% of programs reported at least one resident with confirmed COVID-19. A total of 101 resident physicians had positive COVID-19 test results, with another 163 residents presumed positive for COVID-19 based on symptoms. Dr Chen was among those who tested positive for the virus.

Interestingly, ophthalmology residents were among the highest-risk groups, exceeded only by anaesthesiologists and emergency medicine residents.

This is most likely attributable to close proximity to patients during eye exams and inadequate use of personal protection equipment (PPE) in the early days of the outbreak, according to Dr Chen, a retina specialist at Columbia University Irving Medical Centre. He also directs the ophthalmology residency programme there.

The survey highlighted several important issues related to the overall pandemic response. Slightly more than half of the residency programmes reported that residents were waiting for, or were unable to obtain, COVID-19 testing. While most programmes reported it was necessary to quarantine a resident, 14.9% of residents who tested positive were not quarantined. Respondents referred to problems with lack of testing and inadequate PPE. The situation has improved somewhat since the study was conducted, Dr Chen told EuroTimes.

“The PPE situation has improved a lot. I think most hospitals have significantly improved supplies of surgical masks, but certainly physicians are still reusing/extended using N95 masks. Life has changed completely from the days where we used a mask once and then discarded it. I don’t know if we’ll ever return to that state, at least during this pandemic, but on the flip side, even with our current practices where we are still practicing extended use and reuse of masks, our infections rates have dropped a lot.”

Dr Chen advised that all residents need to use at least surgical masks at all times, and their patients need to be surgical masked at well. Masks on patients should not be removed for procedures. The slit-lamp shields are probably a good layer of added protection for ophthalmologists.

“I think ophthalmology residents should take PPE seriously, but they should also take some comfort in the fact that new cases dropped with more availability of PPE and widespread protocols mandating masks for both physicians and patients. We need to feel that we are providing care safely – both for ourselves and for our patients.”

The New York City Residency Program Directors COVID-19 Research Group survey study appeared in pre-print form on medRxiv.org.

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