Many tests available to date lack analytical performance regarding sensitivity/specificity and need to be tested and validated before getting approval. Antigen lateral circulation immunoassays present a newer technology with additional scientific and technical difficulties, which mean they are not likely to be fully developed during the pandemic period. impact factors leading to exacerbation of the clinical development of COVID-19-positive patients were identified to perform risk stratification for elective surgery. Based on these impact factors, considerations for patient selection, choice of procedural complexity, duration of process, type of anesthesia, etc., are discussed in this article and translated into algorithms for surgical/anesthesia risk management and clinical management. Current recommendations and published protocols on contamination control, avoidance of cross-contamination and procedural patient flow are examined. A COVID-19 screening guideline protocol for patients planning to undergo elective aesthetic medical procedures is offered and recommendations are made regarding adaptation of current patient information/informed consent forms and patient health questionnaires. Conclusion The COVID-19 crisis has led to unprecedented difficulties in the acute management of the crisis, and the wave only recently seems to flatten out in some countries. The adaptation of surgical DPA-714 and procedural actions for any risk-minimizing management of potential COVID-19-positive patients seeking to undergo elective aesthetic procedures in the wake DPA-714 of that wave will present the next big challenge for the DPA-714 aesthetic medical procedures community. We propose a clinical algorithm to enhance patient security in elective surgery in the context of COVID-19 and to minimize cross-contamination between healthcare workers and patients. New evidence-based guidelines regarding surgical risk stratification, screening, and clinical flow management/contamination management are proposed. We believe that only the continuous development and broad implementation of guidelines like the ones proposed in this paper will allow an early reintegration of all aesthetic procedures into the scope of surgical care currently performed and to prepare the elective surgical specialties better for any possible second wave of the pandemic. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. and to start again carrying out elective, nonurgent medical procedures on COVID-19-unfavorable patients after the epidemic peak has been reached in a given country or region and the pressure on healthcare facilities, healthcare workers and resources has been released by so far that elective surgery procedures can be safely and ethically programmed again. The authors think that answering those two questions is usually of great interest not only for the plastic surgery community, but also for other surgical specialties performing highly elective, nonurgent interventions on a daily basis, which is why specialists from other elective surgery fields were asked to co-author and share their perspective. Nothing will be like before after this pandemic, this often-heard statement will be especially true for healthcare providers and surgeons, as the computer virus will not completely disappear from our societies once the first wave of the pandemic is over [20]. The interventions put into place for computer virus containment, like restriction of movement, steps to enforce physical distancing, cannot be held in place for an unlimited time, as socioeconomic essentials become more pressing and all affected countries will have to work on a staged exit strategy at a given moment. A study focused on the effects of extending or calming physical distancing control steps in Wuhan has suggested that if the steps are gradually relaxed in March, a second wave of cases might occur in the northern hemisphere around mid-summer. The same effect is usually expectable for all other countries at a later date, meaning that the computer virus will prevail in society until a vaccine becomes available [21C23]. Until then, as surgeons, we will have to learn to live with a new fact, and we may have to adapt our clinical workflow and to reformulate Rabbit Polyclonal to CD160 the way we care for patients. This article aims to give some orientation toward this important task and to serve as base for the formulation of specific guidelines from healthcare providers and healthcare administrators. The articles first goal is to make a recommendation on the time frame for the reintroduction DPA-714 of elective procedures based on current healthcare strain projections, the healthcare resilience model and projections of virulence. The second goal is to provide the scientific base for solid elective surgery protocols which may be implemented in the moment when a country or region meets the criteria to implement elective, nonurgent procedures. While we think that both questions can be answered analyzing the plethora of peer-reviewed literature available.