Patient in the otolaryngology office in the time of the covid-19 pandemic in the light of current recommendations, legal regulations and authors’ own experience

Abstract

Generally, COVID-19 is an acute contagious disease caused by the SARS-CoV-2 virus. The main route of human-to-human transmission is through contact with infectious secretions from the respiratory tract. Clinical manifestations vary from mild non-specific symptoms to life-threatening conditions. Since WHO declared COVID-19 a pandemic in March 2020, it has affected many medical, legal, social and economic aspects of everyday life in countries around the world. In this article, the authors present a summary of recommendations for taking care of otorhinolaryngology patients in outpatient settings and the legal basis referring to a risk of infection in doctor’s office. In the selection of articles, the authors used English-and Polish-language online medical databases, typing the following keywords: SARS-CoV-2, COVID-19, otolaryngology, endoscopy, personal protective equipment, and legal re-sponsibility of the physician. The mucosa of the upper respiratory tract is a potential site of virus replication. The specificity of an ear, nose and throat (ENT) examination and a direct patient-doctor contact favor the transmission of the infection. The authors discussed the elements of self-protection of medical personnel and the legal aspects a risk of the patient contracting the infection in the otolaryngology office. In the case of a direct contact with the patient, the following medical personal protective equipment is required: a cap, a mask with an FFP-2 filter, goggles, an apron and gloves. If, during the visit, exposure to secretions or aerosol from the respiratory tract is expected, the personnel should additionally wear a visor and a waterproof apron. The patient’s visit in the clinic should be preceded by telemedicine consultation. Patients should be screened prior to having a direct contact with a phy-sician, using a short patient questionnaire. The questionnaire may consist of simple questions about the characteristic symptoms of the SARS-CoV-2 infection and exposure to a sick person in the past 14 days. The question of staying in the areas of a high infection risk appears of little importance in view of the whole of Poland being perceived as constituting such an area. Due to the spread of the SARS-CoV-2 virus, new procedures for providing medical services have been introduced. In the case of claims on the part of the patient, the only protection the medical personnel or facility can provide is confirmation of scrupulous compliance with medical procedures.