Volume 83 - 2020 - Fasc.2 - Letters
COVID-19 and gastrointestinal endoscopy in Belgium : uncertainty and ambiguity
The world is currently facing a deadly COVID-19 pandemic caused by the 2019 novel coronavirus, and Belgium is no exception with a daily death rate still increasing (written April 2020) (1). Although it is considered a viral airway infection with aerosol droplet transmission, gastrointestinal involvement with faecal-oral transmission is also possible (2). Therefore, all endoscopic procedures in both upper and lower gastrointestinal tract carry an increased risk of viral transmission from infected patients to all personnel in the endoscopy room (endoscopist, endoscopy nurse, trainee, anaesthesiologist, anaesthesiology nurse,...). The risk of viral transmission due to endoscopy being rapidly recognized, has led to the swift development of position statements and guidelines on protective measures world-wide in order to control viral transmission by gastrointestinal endoscopy (3). As of 18 March 2020 the European Society of Gastrointestinal Endoscopy (ESGE) released a position statement with safety guidelines to prevent COVID-19 transmission in endoscopy units (4).
NASH : a welfare disease with emerging questions and adequate answer attempts
We read with great interest the Letter of Pieter Vandekerckhove, Brieuc Van Damme and Lieven Annemans (1) and we would like to thank them for this interesting economic but also anthropological and philosophical point of view, which complements perfectly our document (2).
Our goal with the guidance document (2), in line with the quest for quality that characterizes the AGEB Journal editorial line (3), was to increase awareness of the disease among the medical community and draw the attention to this “new” recognized cause of cirrhosis as well as of general (extra-hepatic) complications. We also wanted to stimulate disease case finding and provide adequate tools to evaluate disease severity in targeted patients. Finally, our objective was also to supply treatment strategies for selected patients, if necessary, even if there is currently still no NASH dedicated drug.