There is a concern of continuity of care for bowel cancer and Inflammatory Bowel Disease (IBD) patients as the National Bowel Screening programme is put on hold during the COVID-19 crisis.
As we enter into Alert Level 3, national bowel screening will still be on hold even though breast screening will resume.
Colonoscopy bowel screening procedures are not permitted under Alert Level 3 or 4.
NZ Society of Gastroenterology recently released a position statement on provision of Gastrointestinal Endoscopy in the COVID era, stating the procedure created a risk of viral transmission as GI endoscopy is regarded as an aerosol generating procedure.
COVID-19 has been found in stool samples of patients with symptoms but also in those without symptoms which poses the risk of greater COVID infection to staff performing these procedures.
"The NZ Governments intent is to reduce any non-essential exposure to the COVID-19 virus, and to take all reasonable measures to limit its spread. This will unfortunately further delay the roll out of the National Bowel Screening programme," says Bowel Cancer Foundation Trust CEO, Georgina Mason.
IBD Patients & COVID-19
We cannot forget the impact this also has on IBD patients with diseases such as Crohn’s Disease and ulcerative colitis. These patients also require colonoscopy surveillance to help manage inflammation flare ups which can be very detrimental to their ongoing health.
Some of the symptoms presented by COVID-19 patients have been fever, diarrhoea and stomach pains which are the same symptoms that most IBD patients suffer during a flare up.
There have been calls among NZ Gastroenterologists to test IBD patients who present with these symptoms so they can distinguish between the two and rule out COVID-19.
Urgent endoscopies can still be performed with caution but the severity of the inflammation would have to justify this procedure.
If Alert Level 2 goes ahead next week we will hopefully see the backlog of colonoscopies start to be cleared.