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Weekly Epidemiological Record ; 97(7):41-48, 2022.
Article in English, French | GIM | ID: covidwho-1848679


Background: Italy was one of the first European countries to report COVID-19 cases, at the end of January 2020.1 In mid-February, the country reported community-based transmission, especially in the northern regions of Lombardia, Piemonte and Emilia-Romagna.2 The COVID-19 pandemic overstretched the structural capacity of health care facilities, and several hospitals in Emilia-Romagna undertook emergency measures to renovate, expand and reconstruct existing facilities. The Italian Ministry of Health required that emergency rooms be reorganized and restructured to separate the flow of human traffic and create permanent isolated areas for patients waiting for the results of tests for COVID-19.3 Emilia-Romagna, with WHO headquarters and the WHO regional and country offices, then launched the "hospital of tomorrow" project to set new standards to be applied to health-care facilities after COVID-19. Below, we present the preliminary results of the initial steps, covering 3 months of project (Figure 1). The case study will last one year (October 2020-November 2021) and further results will be discussed at the end of the project. Setting: St Orsola-Malpighi polyclinic, the facility selected for this pilot project, is an internationally acclaimed institution that dates back more than 4 centuries. It represents the European architectural heritage, with a mix of old and new pavilions, integrated into a city context. It is organized into 7 departments with 91 operative units. Before the COVID-19 pandemic, it was equipped with 1758 beds and had more than 5000 staff, with annual outpatient and inpatient turnovers of 400 000 and 72 000 patients, respectively. On any given day, approximately 20 000 staff, students, university lecturers and researchers, patients, visitors and suppliers are present on the hospital grounds.4 Process and outcomes: The hospital directors in collaboration with the WHO team defined the key macro areas for the intervention to enhance the facility's strengths and reduce its weaknesses in the health-care standards required to prevent the spread of SARS-CoV-2 and other infections and to improve the well-being of patients and staff and the quality of services. Working groups were established for each macro area, with representatives and group members selected by the hospital's Board of Directors. Representatives of the groups met weekly to coordinate activities and to serve as contact persons for group activities and liaison among the groups. The groups formed initially addressed staff spaces, high-tech logistics, "wayfinding", patient and visitor spaces, operational system support, user reception and access and telemedicine.

G Ital Med Lav Ergon ; 42(2):73-81, 2020.
Article in Italian | WHO COVID | ID: covidwho-628850


During COVID-19 pandemic crisis, Italian Government has approved Law Decree no. 18 of 17 march 2020, in which art. 15 allows enterprises to produce, import and commercialize surgical masks notwithstanding the current rules of product certification. It is just required that the interested enterprises send to the Italian National Institute of Health a selfcertification in which they declare the technical characteristics of the masks and that masks are produced according to the safety requirements. In this context, a technical-scientific unit was established at the University of Napoli Federico II to provide interested enterprises with state-of-the-art consultancy, testing and measurement services, adhering to rigorous scientific protocols. Characterization tests were carried out on 163 surgical masks and/or materials for their construction and they have enabled the identification of pre-screening criteria to simplify the procedure for evaluating surgical masks using methods for assessing the filtration efficiency of particles and aerosols. Based on experimental results, it has been observed that a filtration efficiency for particles with sizes larger that 650 nm (PFE>650) exceeding 35% might guarantees a bacterial filtration efficiency (BFE) higher than 95% while BFE values higher than 98% are obtained when the PFE>650 is larger than 40%. PFE measurement is extremely simpler with respect to BFE, the latter being time-consuming and requiring specific equipment and methods for its realization. Many tested materials have shown the capability to assure high filtration efficiencies but Spundonded-Meltblown-Spunbonded (SMS), that are layers of non-woven fabric with different weights of Meltblown, can simultaneously guarantee high particle filtration efficiencies with pressure drop values (breathability) in the limits to classify the surgical masks as Type II/IIR. In fact, the fabric products analyzed so far have not been able to simultaneously guarantee adequate BFE and breathability values. On the contrary, Spunbonds of adequate weights can virtually verify both requirements and accredit themselves as possible materials for the production of surgical masks, at least of Type I. Further studies are needed to verify the possibility of producing low-cost, reusable surgical masks that could meet the criteria of circular economy.