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The Dutch test capacity to detect the SARS-CoV-2 virus has increased enormously since the start of the COVID-19 pandemic. As a consequence of ongoing spreading of the virus, tests are also increasingly being carried out among people without COVID-19 related symptoms. Preventive testing for SARS-CoV-2 is especially performed in sectors in which early detection of the virus is essential, for instance in the professional sports sector. The guideline of the RIVM states that people who have tested positive for SARS-CoV-2 but without COVID-19 related symptoms are advised to stay in isolation for five days from time of the test. However, this guideline is not suitable for people who are diagnosed in a very early stage of the infection as a result of preventive testing. They are likely to leave isolation during the most contagious phase of the infection. In this paper, we argue that people who are positive for SARS-CoV-2, but without COVID-19 related symptoms, after a preventive test should be advised to isolate longer than five days.

Until recently, patients with cancer and distant metastases were considered incurable. However, nowadays, some of these patients are eligible for curative-intent therapy. Surgery of metastases is becoming an increasingly important part of this ever-evolving therapy. The introduction of minimally invasive surgical techniques has resulted in more resections being performed of pulmonary metastases, even in elderly patients. Low postoperative morbidity and mortality rates have been observed after pulmonary metastasectomy. This is also true for elderly patients as age has not been linked to postoperative morbidity. Long-term survival is better for patients undergoing pulmonary metastasectomy compared to non-surgically treated patients. However, selection bias plays an important role as only relatively fit patients can tolerate surgery and their prognosis is therefore better from the onset. The question therefore remains whether pulmonary metastasectomy, a non-evidence-based treatment, is justified.

The standard of care for primary hyperparathyroidism is minimally invasive surgical removal of hyperfunctional parathyroid tissue. Abroad, this minimally invasive approach is often performed in the ambulatory setting. Patients with primary hyperparathyroidism are eligible for outpatient surgery if the risk of conducting the operation is low and various imaging techniques have confirmed the location of the parathyroid adenoma. Of 20 patients with primary hyperparathyroidism who had been treated at our hospital's day surgery department, 5 visited the emergency department the next day because of a tingling sensation; however, minor hypocalcaemia was observed in only 1 of these patients. This relatively high number of emergency-department visits may have been the result of the strict instructions given to the patients or a rapid fall in their serum calcium levels, even without this having resulted in hypocalcaemia. Calcium supplementation is affordable and safe and could reduce the number of visits to the emergency ward after outpatient treatment of hyperparathyroidism.