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COVID-19: community CPAP and NIV should be stopped unless medically necessary to support life
  1. Joseph Barker1,
  2. Oluwatobiloba Oyefeso2,
  3. David Koeckerling3,
  4. Nadeesha Lakmal Mudalige4,
  5. Daniel Pan5
  1. 1 Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
  2. 2 Department of Primary Care, Royal Free London NHS Foundation Trust, London, UK
  3. 3 Department of Medical Sciences, University of Oxford, Oxford, Oxfordshire, UK
  4. 4 Department of Population Health, London School of Hygiene & Tropical Medicine, London, UK
  5. 5 Department of Respiratory Sciences, University of Leicester, Leicester, UK
  1. Correspondence to Dr Joseph Barker, University of Leicester, Leicester LE1 7RH, UK; joseph.barker{at}

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Dear Editor,

Data from the severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) outbreak suggest high viral load at the time of transmission is associated with worse clinical outcomes.1 Non-invasive ventilation (NIV), including CPAP, is currently listed by the WHO as a high-risk aerosol-generating procedure putting healthcare workers at risk and necessitates the use of personal protective equipment.2 3

The current UK guidance does not account for high-dose viral transmission risk to family and carers in patients using community NIV and CPAP for treatment of chronic respiratory disease, especially obstructive sleep apnoea.

National Health Service …

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  • Contributors All authors contributed equally to manuscript authorship and revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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