COVID-19 Pandemic in Bergamo outbreak: a call to war. Implementation of a “COVID-Hospital” model in ASST Bergamo-Est Trust as a disaster-response strategy.

Abstract

Background: COVID-19 is a strikingly emerging disease caused by a new coronavirus (SARS-CoV-2) that has rapidly spread across all continents and affecting virtually every country. From a clinical, epidemiological, political and financial perspective, COVID-19 pandemic is now recognized as one of the worst disasters in modern era. In the North of Italy, Bergamo has been the European equal to Chinese City of Wuhan in terms of epidemiological impact of COVID-19. The first case of SARS-Cov-2 infection in Bergamo has been reported in Alzano District General Hospital (DGH), part of ASST Bergamo-Est Multi Hospitals Network. ASST Bergamo-Est comprises four Hospitals serving more than 50% of Bergamo Province and with a patient catchment of 387000 inhabitants. Methods: We retrospectively analyze the challenges and actual impact of the SARS-CoV-2 pandemic on the hospital capacity and performance. Accordingly, we report the specific operational procedures and clinical governance implementation related to the transformation of our Institutions into “COVID-hospitals”. Results: From 1st of March to 20th of April, 4919 consecutive patients were assessed in ASST Bergamo-Est Hospitals as “COVID-Hospital” referral centre, of these 1412 patients were admitted with diagnosis of moderate to severe COVID-19 respiratory insufficiency. Most of patients were high-risk individuals with a median age of 69 years. In-hospital mortality rate was 33.1%. Specific performance improvements under the “COVID-19 Hospital model” capacity-expansion strategy were analysed. Conclusions: This paper informs on the experience of ASST Bergamo-Est Trust and the disaster-response strategy during the COVID-19 pandemic. The ASST Bergamo-Est data reported corroborates the recent call for action to Governments for promoting MCI improved management with focus on COVID-19 pandemic and its possible recurrence.