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almost daily reflection on the different recommendations that can be made. Several recommendations or statements have already been posted or published in order to ensure safety against the virus in endoscopy units before, during, and after procedures. Two other important questions related to the COVID-19 epidemic should also be considered: How to reduce the workload in endoscopy? and How to reschedule the cases that have been postponed? The survey reported by Bilal et al. deals with the first subject. Of note is that the method used for the survey is original and adapted to this period of epidemic: The survey was conducted on Twitter using the “Twitter poll” option. As acknowledged by the authors, the sample is certainly not representative (2,500 followers of the author) but the idea is interesting. First issue: Why and how to reduce the workload in endoscopy? In other words, why and how should we reconsider the indications? Why reconsider the indications? The main reasons for this delicate question are: ▪ To reduce risk of healthcare personnel and patient exposure to the infection of the virus, which is present in saliva, expectorations and feces. ▪ To reduce risk to patients associated with transportation to the hospital and stay at the hospital, because hospitals also receive patients suspected of being infected with COVID-19. ▪ To avoid a shortage of personal protective equipment (PPE) for personnel who are in charge of taking care of patients with COVID-19. Unfortunately, this is probably the main reason in many countries, including so-called developed countries. This is a major drawback related to globalization. For example, two-thirds of medical gloves are produced in only one country (Malaysia). It is also due to a lack of anticipation of the epidemic by the health authorities. ▪ To avoid having to manage complications of endoscopy that may require surgery and resuscitation at a time when intensive care unit beds have to be prioritized for patients with COVID-19. ▪ To reallocate human resources (nurses, anesthesiologists) and sedatives in order to increase the number of intensive care beds.

COVID-19: How to select patients for endoscopy and how to reschedule the procedures?