9 8 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • M A Y 2 0 2 0
N
asal decoloniza-
tion should be
part of a multi-
faceted approach to stop
the transmission of the
new coronavirus in sur-
gical settings and to pro-
tect staff and patients
from infection.
Elective surgeries will
be performed again, and
when they are you'll be faced with the reality of having to treat every
patient as a carrier of COVID-19 due to the virus's prevalence within
the community, it's high asymptomatic rate — 40% to 50% of infected
patients don't show symptoms — and testing effectiveness that's
somewhat limited because the viral load is initially higher in the nasal
or oral pharynx before moving to the lower respiratory tract after
seven days of infection. We're also dealing with an elevated transmis-
sion pressure in health care due to the virus's widespread community-
associated spread. For these reasons, it's best to treat the nares of
every patient undergoing surgery.
My colleagues and I have been studying the epidemiology of disease
transmission in the perioperative space for 14 years by exploring various
modes, vectors, methods and reservoirs of origin in how pathogenic
infectious microorganisms move. The modeling we've done on disease
transmission has been largely about the behavior of clinicians — it
relates to compliance with basic preventative measures.
Nasal Decolonization Helps Control COVID-19
Treating the nares should be part of efforts to limit transmission risks.
Infection Prevention
Randy W. Loftus, MD
• THE NOSE HAS IT Patient decolonization aids
in the prevention of perioperative viral spread.