What about a medical oncology unit during the Covid19 pandemic Activity maintained thanks to timely decisions?: Sondrio's experience

ABSTRACT

Background: On February 21, 2020 the first Italian Covid19 patient was diagnosed. From that day the pandemic begins, which spreads with an impressive growth. The Oncology Unit Director has responsibilities, which obliged him to execute orders dropped by the Hospital Management in a top-down manner. Above all, he has direct responsibilities towards his collaborators and patients. It's not allowed to entrench behind the sentence I've no provisions. For this reason, it is necessary to deal with the emergency with clinical intelligence, notwithstanding specific provisions. Method: Since March 9, the Sondrio's Medical Oncology team received specific provisions from its Director, more restrictive than that developed by the hospital summarized in-obligation to measure body temperature (BT) before leaving home-light protection during work surgical mask, gloves, cap.-complete protection in case of suspect Covid19 patient-placement of active treatments on at least 2 distinct time slots to avoid gatherings.-sanitization of the chairs after each patient-from 3 April 2020 obligation for all staff to use KN95 masks, purchased directly.-obligation for each patient o to stay at home if BT > 37.5 ° C. o to monitor BT at home before going out. o to detect BT before entering in day hospital. o it's always forbidden to have accompanying persons. o at least surgical mask o to disinfect hands using gloves Results: With the provisions, no one became infected during work in the last 3 months. Only 1 nurse was Covid+, due to her husband. By contrast, 44 patients were Covid+ and 21/44 have died. 3/44 were diagnosed as Covid19 + as hospitalized patients. These data testifies our daily risk. No patient produced written complaints to the hospital management for our new rules. Discussion: In Sondrio's Province there've been 1,480 infections. Almost 400/1,480 were health employers, a doctor has died. The most serious pandemic of the last 50 years was managed initially with a lack of tampons, delay in the use of serology, ostracism towards the use of personal protective equipment. The provisions of Oncology Unit Director ensured-protection of staff-guaranteed treatment for all patients At 31 May 2020, the out-inpatients hospitalization activity was comparable to 2019. We used our knowledge for them without deserting. On 9 April and 9 May, 2020 all staff underwent rapid qualitative serological tests purchased directly by our decision. All were negative.