Long-term hospital management in the presence of COVID-19: A practical perspective

Abstract

In December 2019, a novel pneumonia caused by a previously unknown pathogen emerged in Wuhan, China. Whereas, thus far, the large majority of people infected by SARS-CoV-2 develop mild inconsequential respiratory symptoms, a minority of mostly fragile, immunecompromised, often aged individuals with chronic medical conditions, develop a severe form of acute respiratory distress syndrome (ARDS) and shock leading to death. Thanks to the early implementation of a social distancing strategy, some regions have seen only a moderate but significant increase in the number of SARS-CoV-2 infection. Although, a significant increase in severe and critical COVID-19 patients was noted, requiring significant investment in dedicated personnel and allocation of specific hospitalization and intensive care unit (ICU) infrastructure and resources, but the medical systems’ functioning was not completely disrupted. As the development of a readily available vaccine against the new coronavirus is expected to take about 1.5 - 2 years, most hospitals will have to address the problems and challenges of caring for regular patients, some of them high-risk patients for SARS-CoV-2 infection, while caring in parallel for a low to moderate number of COVID-19 infected patients. This report presents an outline for a plan of action of a hospital system to deal with such an eventuality. We review the key changes that must be implemented in hospital management and activity to prevent disruption of key services due to the COVID-19 outbreak and the maintenance of high quality of care to all patients while ensuring the highest standards of staff and patient safety.