Massive impact of coronavirus disease 2019 pandemic on gastroenterology and hepatology departments and doctors in Spain

Abstract Background and Aim Significant human and material resources have been diverted to coronavirus disease 2019 (COVID‐19). Healthcare workers are at high risk of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection. We assess the impact of the COVID‐19 pandemic on gastroenterology and hepatology departments and specialists in Spain. Methods This study involves a nationwide survey addressing the impact of COVID‐19 on resources, procedures, and physicians of gastroenterology and hepatology departments in 81 hospitals representative of the Spanish National Health Service. Results Overall, 41.8% of hospital beds and 40.7% of gastroenterology and hepatology beds were allocated to COVID‐19 patient care, as well as 24.8% of gastroenterologists and 58.3% of residents. Outpatient visits, abdominal ultrasounds, and endoscopies were reduced by 81.8–91.9%. Nine large university hospitals had 75% and 89% reductions in therapeutic endoscopies and hepatocellular carcinoma surgery, respectively, with cancelation of elective liver transplant and transjugular intrahepatic portosystemic shunt. Prevalence of infected physicians was 10.6% and was dependent on regional population incidence ( r = 0.74, P = 0.001), with 11% hospitalized and one physician dying. Up to 63.4% of physicians may have been infected before or shortly after Spain entered lockdown, 57% of them having recently performed endoscopies. Adequate protection was acknowledged in > 80% hospitals, but only 2.9% performed regular SARS‐CoV‐2 testing. Conclusions The impact of the COVID‐19 pandemic on healthcare delivery has been massive. A wave of gastroenterology‐related complications is expected because of resource diversion. Gastroenterologists have a high prevalence of infection, although they may have been infected during a first phase of lower awareness and protection. Regular SARS‐CoV‐2 screening, adequate protection, and quick reorganization of healthcare resources are still needed.