On March 18, the CMS announced that all elective esophagogastroduodenoscopies (EGDs), colonoscopies, endoscopies, surgeries and procedures be delayed during the 2019 Novel Coronavirus (COVID-19) outbreak to conserve critical resources such as ventilators and personal protective equipment (PPE) and limit exposure of patients and staff to the SARS-CoV-2 virus. This guidance echoes recommendations issued by AGA, AASLD, ACG and ASGE on March 15.
CMS provided recommendations including a tiered framework to inform health systems as they consider resources and how best to provide surgical services and procedures to those whose condition requires emergent or urgent attention to save a life, preserve organ function and avoid further harms from underlying condition or disease. The recommendations are meant to assist in the management of vital health care resources during this public health emergency.
Ultimately, these decisions remain the responsibility of local health care delivery systems, including state and local health officials, and those physicians who have direct responsibility to their patients. However, CMS urges physicians and health systems to include resource conservation as a consideration in the decision on timing of surgical procedures.