The Coronavirus Disease 2019 (COVID-19) pandemic began in Late 2019 in Wuhan, China. The outbreak is due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection . Italy had precious little time to prepare any response to the COVID-19 pandemic. This response is led by the Italian national government in coordination and synchrony with local (or regional) governments and hospitals.
The major hot spot of COVID-19 patients have thus far been in the north of Italy, especially in the region of Lombardy. To date, the total of infections in Italy is > 215,000, of which 80,723 are in Lombardy . Over 10 million people live in Lombardy region, forming more than one-sixth of Italy’s population, .
Within Lombardy, Milano’s metropolitan area is the largest in Italy, and the third most populated functional urban area in the entire European Union .
As it is now well known from the clinical course of COVID-19 available in the guidelines and the literature, the most severe cases develop acute respiratory conditions that require intensive care unit (ICU) admission. Although only a few of those infected require ICU, the need for ICU beds increases exponentially during the upward trajectory of the pandemic outbreak curve. In this scenario, the demand for critical care in the northern region of Italy exceeded supply, raising significant practical and ethical concerns in the process. To overcome this important issue, within 2 weeks from concept to opening, a new hospital was arranged. This is not a camp hospital or acute triage “fever clinic,” but a real “brick and mortar” hospital focused on intensive care and intensive triage of the critically ill cases. Two pavilions, located on two floors, of an exhibition area were made eligible to host all the equipment and staged care triage settings of the IC ward. All the services (laboratories, radiology, etc.) necessary to an independent functioning of over dedicated IC 200 beds were allocated in the same building with a strategic position. This location minimized cross-contamination and interactions with non-COVID-19 activities and staff. Procedural and staff sequestration that mimics the geographic sequestration of such an effort is requisite to successful nosocomial containment of pandemic COVID-19. Radiology is one of the frontline specialities in the clinical service, because of its role in diagnosis and follow-up of patients. A multidisciplinary symphony of coordinated policies, infrastructure, communications, flow, and staff awareness were harmonized to enable a successful mission to fight COVID-19. The present article describes the logistical setting, strategy, and organization for radiology services in a new dedicated Covid-19 critical care and critical triage hospital.