Italian doctors call for protecting healthcare workers and boosting community surveillance during covid-19 outbreak

Beyond the personal risks that doctors and healthcare workers are facing directly—highlighted by the death of general practitioner and national delegate for continuous medical education Roberto Stella in Varese—hospitals and medical personnel are a potential vehicle for spread of covid-19.2 The New England Journal of Medicine has reported on the huge proportion of infected people who remain asymptomatic and their role in spreading the epidemic.2 At the same time, as pointed out by Tedros Ghebreyesus, director general of the World Health Organization, about 41% of covid-19 cases confirmed in Wuhan resulted from hospital related transmission.3 A hospital-centric model has been shown to be inadequate in coping with the coronavirus outbreak. Protecting healthcare workers is a crucial factor both for control of the outbreak and for continuing to provide necessary care to people with covid-19 and to all the other patients who need treatment at home or in hospital.4 Along with adequate urgent supplies of respiratory protective devices and disposable gowns, which are unacceptably still lacking in the middle of the outbreaks, we propose providing at least all symptomatic healthcare workers with validated rapid response tests, registered at the Italian Ministry of Health, which have 100% specificity (ability to detect negative cases) and produce a result in 15 to 45 minutes, depending on the different products. [...]healthcare services would be sure that personnel with negative results could start working in hospitals, ambulances, or home based and long term care facilities for elderly people and critically ill patients.