Restoring Pulmonary and Sleep Services as the COVID-19 Pandemic Lessens: From an Association of Pulmonary, Critical Care, and Sleep Division Directors and American Thoracic Society-coordinated Task Force

Ann Am Thorac Soc. 2020 Jul 14. doi: 10.1513/AnnalsATS.202005-514ST. Online ahead of print.


Background: In March 2020, the United States Centers for Disease Control and Prevention recommended cancelation of elective medical services in response to the COVID-19 pandemic. The daily case rate is now declining in many states and there is a need for guidance about the resumption of elective clinical services for patients with lung disease or sleep conditions.

Methods: Volunteers were solicited from the Association of Pulmonary, Critical Care, and Sleep Division Directors (APCCSDD) and American Thoracic Society (ATS). Working groups developed plans by discussion and consensus for resuming elective services in pulmonary and sleep medicine clinics, pulmonary function testing laboratories, bronchoscopy and procedural suites, polysomnography laboratories, and pulmonary rehabilitation facilities.

Results: The community new case rate should be consistently low or have a downward trajectory for at least 14 days before resuming elective clinical services. In addition, institutions should have an operational strategy that consists of patient prioritization, screening, diagnostic testing, physical distancing, infection control, and follow-up surveillance. The goals are to protect patients and staff from exposure to the virus, account for limitations in staff, equipment, and space that are essential for the care of COVID-19 patients, and provide access to care for patients with acute and chronic conditions.

Conclusions: Transmission of SARS-CoV-2 is a dynamic process and, therefore, it is likely that the prevalence of COVID-19 in the community will wax and wane. This will impact an institution's mitigation needs. Operating procedures should be frequently reassessed and modified as needed. The suggestions provided are those of the authors and do not represent official positions of the APCCSDD or the ATS.