One such step reflects the finding that hospitals might be “the main” source of Covid-19 transmission, the Bergamo doctors warned. The related coronavirus illness MERS also has high transmission rates within hospitals, as did SARS during its 2003 epidemic.
Major hospitals such as Bergamo’s “are themselves becoming sources of [coronavirus] infection,” Cereda said, with Covid-19 patients indirectly transmitting infections to non-Covid-19 patients. Ambulances and infected personnel, especially those without symptoms, carry the contagion both to other patients and back into the community.
“All my friends in Italy tell me the same thing,” Cereda said. “[Covid-19] patients started arriving and the rate of infection in other patients soared. That is one thing that probably led to the current disaster.”
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For patients who need more intensive care, dedicated Covid-19 medical centers, akin to the “fever hospitals” that London set aside for smallpox, cholera, and typhus patients 200 years ago, would be a safer way to deliver care than the current system, Cereda said.
Another needed move from patient- to community-centered care: Assume everyone who develops a fever and other symptoms has the coronavirus, Cereda said. (A positive identification usually isn’t necessary and doesn’t change treatment, since there is no known Covid-19-specific therapy yet.) Then, at least until the U.S. has adequate testing capacity, reserve those tests for nursing homes, schools, and other possible hot spots in the community in order to identify people who are infected with virus but who do not have symptoms.
From the article:
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Here is the paper.