Materials and Methods
The search covered online advice published in English by official sources between the 1st of January and 31st of May. The sources were broadly grouped in international, national and ENT-specific organisations.
The international resources included the World Health Organisation (WHO) and other relevant groups publishing advice relevant to ENT and surgical services (Centre for Medicare and Medicaid Services, American Academy of Otolaryngology and Head and neck, Stanford Group,ENT Canada, American College of Surgeons). The Covid-19 advice page compiled by the Cochrane group was used to select relevant international resources (https://ent.cochrane.org/news/covid-19-coronavirus-disease-ent-hearing-balance) .
National resources included advice from Public Health England (PHE), National Institute for Clinical Excellence (NICE), National Health System website (NHS), Academy of Medical Royal Colleges, Royal colleges (of Surgeons, Radiologists, Pathology, Speech and Language therapy).
ENT-specific organisations included ENT-UK, British Association of Head and Neck Oncologists (BAHNO), British Laryngology Association (BLA), British Rhinological Society, British Otological Society.
Excel was used to record the data by date, title, publishing organisation, type of advice and link. The type of advice referred to areas of concern during the pandemic - PPE, Service prioritisation, General (advice on treatment and/or investigations), cancer, tracheostomy, otology, rhinology, paediatric ENT and service recovery.
The volume of advice published weekly in each of the three main categories - international, national and ENT-specific organisations was reviewed. The number of SARS-CoV2 related deaths recorded during the above period were extracted from the governmental website (reference). This was used to analyse the trajectory of Covid-19 related deaths and the volume of advice published between January and June 2020.
The electronic databases PubMed Central and Cochrane were searched comprehensively from the 30th December 2019 to 31st May 2020. The first search identified all publications related to COVID-19, filtering duplicates and then calculating the number of publications by week.
Next, a subset of these COVID-19 papers relating to ENT was identified. These papers were categorised according to those describing subspecialties within ENT, common ENT symptoms, anatomical areas relevant to ENT, and research relating to personal protective equipment, service prioritisation and recovery following the COVID-19 pandemic.
The official UK government website was used to map daily laboratory-confirmed cases in England and UK deaths across the same time period ((https://coronavirus.data.gov.uk/?_ga=2.237121091.2105726748.1588817632-725862875.1586435801).
Ethical approval was not required because this study was a review and all data
were extracted from published articles