Last year, the AGA stated that pre-endoscopy COVID testing is not needed:

• AGA Update: Pre-endoscopy COVID Testing Is Not Needed (Sept 2021)
• AGA Guidelines: Pre-endoscopy COVID-19 Testing No Longer Needed (May 2021)
• These guidelines were applicable to institutions with adequate PPE and pre-op screening for COVID symptoms

This has turned out to be good advice:

A Hann et al. Gut 2022; http://dx.doi.org/10.1136/gutjnl-2022-327053. Open Access! Impact of pre-procedural testing on SARS-CoV-2 transmission to endoscopy staff

In this retrospective study, “during a 20-month period until December 2021 using PPE and three different test approaches: no testing (n=4543), rapid antigen (RA) testing (n=682) and RT-PCR testing (n=10 465). In addition, 60 endoscopies were performed in patients with proven COVID-19. Not a single staff member became infected with SARS-CoV-2 during the 20 months analysed; vaccination rate of the team was 97%.”

The authors note that routine testing of clinical team was not performed; thus, they cannot exclude the possibility of asymptomatic infections.

My take (borrowed in part from authors): “PPE is highly effective for avoidance of SARS-CoV-2 transmission during upper or lower GI endoscopies.” Pre-op testing for COVID has many downsides: increased costs, delays in care, potential exacerbation of health disparities, and detrimental effects to endoscopy efficiency (especially with inconclusive results)