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Spreading covid-19 by aerosol effect

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Firstly,  I want to say, that I did not want to write this with everything that is going on.  I did not want to criticise the NHS. But when a gynaecologist posts on twitter asking whether it is safe to do outpatient hysteroscopy and say they are concerned at this because hysteroscopies are aerosol generating procedures and there will always be some blood in some cases, I felt I needed to comment.  

A lot of this could be solved by using CO2. CO2 was abandoned, not solely but mainly because of the cost. It also endangers staff as close patient contact is necessary. A recent, large trial showed a 3% infection rate for outpatient hysteroscopy with vagioscopic and higher with speculum.  After speaking to someone at Olympus, he thought one possible infection route might be the camera stack, as it is not always wiped down after every procedure despite a disposable sheath surrounding it. First, the aerosol effect might bounce about and second, with time constraints, incorrect removal of sheath etc. might result in transfer of infection.  

Is there anyone who knows if aerosol blood from a patient with covid-19 is dangerous?   

There has never been a greater need for sedation with analgesia for hysteroscopy, because light and mild sedation does not need intubation, which is currently a big concern, although there are steps that can be taken to reduce this.

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Sorry for the delay in response. i feel that it should only be done with C02 and that PPE for staff, including a disposable mask  for patients, needs to made available and a extra 15 mins on the 30 mins allocated  to be allowed for cleaning.                                      

Preferably disposable equipment as this only adds a £50 the camera stack must be swapped.  I can not believe it is currently not  when a manufacturer say its a potential source of infection it means it is source or infection.                                                               

I believe with the current practices  outpatient hysteroscopy should not be done.                                                                                                                                                                         

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