Some doctors from the Papa Giovanni XXIII Hospital in Bergamo have sent a letter to the New England Journal of Medicine, urging reflection on the model of hospital management during pandemics.
In a pandemic, patient-centered care is inadequate and must be replaced by community-centered care. Solutions for Covid-19 are required for the entire population, not only for hospitals.
The need to shift the focus from individual patients to the community is a new and counterintuitive concept but is proving essential for addressing extraordinary events.
We are learning that hospitals might be the main Covid-19 carriers, as they are rapidly populated by infected patients, facilitating transmission to uninfected patients. Patients are transported by our regional system, which also contributes to spreading the disease as its ambulances and personnel rapidly become vectors. Health workers are asymptomatic carriers or sick without surveillance; some might die, including young people, which increases the stress of those on the front line.
The need to identify solutions that allow for securing and tracking any movement within the hospital to understand the contacts of infected individuals with all staff or other potentially uninfected patients would provide a comprehensive system for detecting potential infection risks.
We need dedicated Covid-19 hospital pavilions and operators, separated from virus-free areas.
The economic sustainability of having a separation between areas dedicated to the care of infected patients and “virus-free” areas, and the need to have dynamic structures that can be easily adapted in a flexible and scalable manner to the emergency, can be achieved through technological solutions capable of rapidly identifying and defining safe areas and supporting staff in monitoring the movements of infected patients to prevent accidental contacts.
The definition of “logical” containment elements and localization allows for flexibility and scalability, as well as a high level of security in managing procedures.
Here is the full article: https://catalyst.nejm.org/doi/full/10.1056/CAT.20.0080
