CoViD-19 and ortho and trauma surgery: The Italian experience

Abstract

CoViD-19 and ortho and trauma surgery: The Italian experienceItaly was the first country to report a case of Coronovirus in Europe and since the onset of the novel coronavirus (SARS-CoV-2) pandemic in China at the end of December 2019, it has been the country with the highest number of deaths worldwide to date ( Table 1 ) [1][2] .This might be explained by the high percentage of elderly people living in Italy, who make up the majority of the deaths. Moreover, the late recognition of this novel Coronavirus as a potentially serious type, unlike a seasonal flu, might have contributed to the wide spread of the disease [3] .The first cases of Coronavirus disease (CoViD) in Italy were detected in Rome, on January 20th, when a Chinese couple on holiday there resulted affected, and then in Codogno, a little village in Lombardy, on February 21st. However, an Italian Study confirmed that the virus had been circulating since the beginning of January [3] .On January 30th the Italian Government declared the state of emergency over the spread of Coronavirus disease.Afterwards, on February 22nd, the "Istituto Superiore di Sanità" (the highest Italian authority in the health-care field) ordered that some detected towns in Lombardy and Veneto, the so-called "red zones", be quarantined for 14 days. Nevertheless, given the rapid spread of the virus, northern Italy was initially locked down on March 7th but then the entire country had to be declared on lockdown on March 11th [4] .These restrictions were deemed necessary to stop virus diffusion, but, as they were not immediately applied to the whole nation, people kept on travelling around and with them did the virus.In a few weeks many changes had to be made to face the increasing need for medicine and ICU wards. Orthopaedics and Traumatology units, as well as each single hospital unit, had to help as much as possible in order to handle the epidemic in the best possible way.The Italian epidemic can be divided in two periods: an early phase, when only few CoViD patients were diagnosed in confined areas, and a second later phase: the former lasted from the middle of January to the country lockdown; the latter started with this declaration and is still on-going at the moment, due to the epidemic emergency state.

Impact of the COVID-19 lockdown on the epidemiology of maxillofacial trauma activity: a French multicentre comparative study

“…Several other articles have been published on the necessary reorganization of surgical departments during the COVID-19 pandemic and the decline in surgical activity resulting from the medical measures implemented in response to this pandemic 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 . However, none of them has precisely evaluated the decline in trauma cases, and especially in maxillofacial trauma cases.…”

How COVID-19 has affected emergent visits to a Latin-American trauma department: Experience at a Peruvian national trauma referral center

“…Accordingly, many strategies have been proposed and implemented, worldwide and in Peru, in an attempt to contain this pandemic, some of them more successful than others [7] , [8] , [9] . To date, considerable information has been published on the impact of the COVID-19 outbreak, including the orthopedic field, in Asia, North America and Europe [10] , [11] , [12] , [13] , [14] , [15] , [16] . However, little is yet known about the impact of the COVID-19 outbreak in Latin America.…”

Orthopaedic surgeons’ perceptions on COVID-19 related changes in practice: an international survey

“…Changes to clinical practice have been largely guided by clinical urgency, patients and medical staff protection and conservation of health-care resources. Having said that, changes to inpatient and outpatient care have been accordingly tailored to reduce the risk of contamination in patients, medical staff and to allow hospitals to free up beds for treatment of patients with positive or suspected COVID-19 [4,5]. All elective surgical procedures should be cancelled and deferred until an opportune time [6].…”

“…The emergence of such a crisis provides a timely opportunity for us to re ect and evaluate the use of novel technologies in the workplace. This includes the adoption of telemedicine and telerehabilitation initiatives, allowing patients to be consulted and followed-up in the comfort of their own homes [4,5,[8][9][10].…”

“…Notably, the most common reason for their unwillingness to treat COVID-19 positive patients is due to their concern of getting the infection and transmitting the virus to their family members. With a better understanding of COVID-19 characteristics, we would expect a gradual increase in the number of medical staff who will be willing to treat infected patients [2,11].The COVID-19 crisis has resulted in people working outside their specialty, providing support toinfectiologist, pneumologist and intensive care physicians [1,5]. We know that virus is likely to cause minor symptoms in majority (more than 80%) of infected people.…”