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APSDE-COVID statements: recommendations should be modified according to the prevalence of COVID infection rates
  1. Pradeep Bhandari1,2,
  2. Asma Alkandari1,3
  1. 1 Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth, UK
  2. 2 Faculty of Science, University of Portsmouth, Portsmouth, UK
  3. 3 Gastroenterology, Al-Zahra Hospital, Al Jahra, Kuwait
  1. Correspondence to Professor Pradeep Bhandari, Department of Gastroenterology, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK; deep3570{at}

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We read the article from Chiu et al 1 and would like to congratulate the authors and Asian Pacific Society for producing APSDE (Asian-Pacific Society for Digestive Endoscopy)-COVID statements. The statements make perfect practical sense in the times where robust evidence is lacking. However, there are some conflicting messages coming out and I would like to draw attention toward it.

Figure 1 is suggesting a very extensive algorithm of clinical and laboratory testing to identify the infective potential of the patient and based on that to decide if urgent or semiurgent or elective endoscopy should be performed and the type of personal protective equipment (PPE) to be used. However, statement 2 clearly indicates and quiet rightly so that in the current pandemic we should only perform endoscopy for urgent indications. I feel that the algorithm in figure 1 is …

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