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Surgery in a Time of UncertaintyA Need for Universal Respiratory Precautions in the Operating Room

Educational Objective
To understand the recommendation for precautions needed to reopen operating rooms
1 Credit CME

Much has been learned about coronavirus disease 2019 (COVID-19) in the past 4 months, but still much remains unknown. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is well characterized but how widely it has spread throughout the population is not known, nor is it known why some individuals who are infected with the virus do not develop symptoms, whereas other individuals develop serious COVID-19 disease with a high mortality rate. COVID-19 has had a devastating effect on the world, bringing normal activities and the economy to a near halt.

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Article Information

Corresponding Author: Edward H. Livingston, MD, JAMA, 330 N Wabash Ave, Chicago, IL 60611 (edward.livingston@jamanetwork.org).

Published Online: May 7, 2020. doi:10.1001/jama.2020.7903

Conflict of Interest Disclosures: None reported.

References
1.
Centers for Disease Control and Prevention. Standard precautions for all patient care. Accessed April 25, 2020. https://www.cdc.gov/infectioncontrol/basics/standard-precautions.html
2.
Wang  W , Xu  Y , Gao  R ,  et al.  Detection of SARS-CoV-2 in different types of clinical specimens.   JAMA. Published online March 11, 2020. doi:10.1001/jama.2020.3786PubMedGoogle Scholar
3.
Bai  Y , Yao  L , Wei  T ,  et al.  Presumed asymptomatic carrier transmission of COVID-19.   JAMA. 2020;323(14):1406-1407. doi:10.1001/jama.2020.2565PubMedGoogle ScholarCrossref
4.
Bourouiba  L .  Turbulent gas clouds and respiratory pathogen emissions: potential implications for reducing transmission of COVID-19.   JAMA. Published online March 26, 2020. doi:10.1001/jama.2020.4756PubMedGoogle Scholar
5.
Ong  SWX , Tan  YK , Chia  PY ,  et al.  Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient.   JAMA. Published online March 4, 2020. doi:10.1001/jama.2020.3227PubMedGoogle Scholar
6.
Lu  J , Gu  J , Li  K ,  et al.  COVID-19 outbreak associated with air conditioning in restaurant, Guangzhou, China, 2020.   Emerg Infect Dis. 2020;26(7). doi:10.3201/eid2607.200764PubMedGoogle Scholar
7.
World Health Organization. Infection prevention and control during health care for confirmed, probable, or suspected cases of pandemic (H1N1) 2009 virus infection and influenza-like illnesses. Updated December 16, 2009. Accessed April 25, 2020. https://www.who.int/csr/resources/publications/cp150_2009_1612_ipc_interim_guidance_h1n1.pdf
8.
Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19): decontamination and reuse of filtering facepiece respirators. Accessed April 25, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/decontamination-reuse-respirators.html
9.
ARA. Decontamination and reuse of N95 filtering facepiece respirators (FFRs). Accessed April 28, 2020. https://www.ara.com/sites/default/files/ARAReviewN95FFRDecontamination.pdf
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