Hospital surge capacity in a tertiary emergency referral centre during the COVID‐19 outbreak in Italy

Abstract

Summary The first person‐to‐person transmission of the 2019 novel coronavirus in Italy on 21 February 2020 led to an infection chain that represents one of the largest known COVID‐19 outbreaks outside Asia. In northern Italy in particular, we rapidly experienced a critical care crisis due to a shortage of intensive care beds, as we expected according to data reported in China. Based on our experience of managing this surge, we produced this review to support other healthcare services in preparedness and training of hospitals during the current coronavirus outbreak. We had a dedicated task force that identified a response plan, which included: (1) establishment of dedicated, cohorted intensive care units for COVID‐19–positive patients; (2) design of appropriate procedures for pre‐triage, diagnosis and isolation of suspected and confirmed cases; and (3) training of all staff to work in the dedicated intensive care unit, in personal protective equipment usage and patient management. Hospital multidisciplinary and departmental collaboration was needed to work on all principles of surge capacity, including: space definition; supplies provision; staff recruitment; and ad hoc training. Dedicated protocols were applied where full isolation of spaces, staff and patients was implemented. Opening the unit and the whole hospital emergency process required the multidisciplinary, multi‐level involvement of healthcare providers and hospital managers all working towards a common goal: patient care and hospital safety. Hospitals should be prepared to face severe disruptions to their routine and it is very likely that protocols and procedures might require re‐discussion and updating on a daily basis.

Brazil Health Care System preparation against COVID-19

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Pedagogy in a pandemic – COVID‐19 and virtual continuing medical education (vCME) in obstetrics and gynecology

“…An area of universal concern amongst the trainees is loss of procedural training opportunities 1 due to the deferment of non‐urgent surgical cases 11 and team segregation of sonographic units. While the loss of this hands‐on experierence is not easily substituted, we have tried to address this through the use of archived videos 12 and live telementoring 13 by experienced staff.…”

Intervention strategies against COVID-19 and their estimated impact on Swedish healthcare capacity

“…[41][42][43][44][45][46][47][48][49] Intensive care capacity is projected to become a particular bottleneck, as shown in other countries. [50][51][52] For Sweden, this is in particular worrisome considering the relatively low availability of beds prior to the pandemic compared to other European countries 22 24 and recent reports challenging Swedish disaster preparedness. 53 We predict that aggressive suppressive measures can substantially reduce this healthcare capacity deficit but only if implemented in a timely manner.…”