How Are We Facing It? Dispatches From Pathology Residents in a COVID-19 Lombardy Hospital.

Miriam Cieri,Vincenzo Belsito,Massimo Roncalli,Piergiuseppe Colombo,Camilla De Carlo,Marina Valeri,Cesare Lancellotti

doi:10.3389/fpubh.2020.00259

Abstract

At the end of February, the Italian National Health Service reported a hot spot of Coronavirus disease in the Lombardy region. COVID-19 is a highly pathogenic viral infection which poses some challenges for healthcare workers. Indeed, Pathology Departments are involved in reorganizing samples' management, from their delivery until their processing, according to National and WHO guidelines. Since Lombardy has been declared COVID-19 hot spot, due to decreasing number of surgical procedures, our Department adopted a policy to reduce personnel, allowing pathologists to work remotely during the outbreak. Lacking clear information about viral load on tissue samples, all human specimens must be considered potentially infectious, as well as patients during post-mortem examinations, and clinical information on COVID-19 status is mandatory. It is also important that Pathology staff receive an adequate training, and adherence to rules should be always accompanied by common sense.

Highlights

After the first reported case in December 2019 in Wuhan (Hubei Province, China), SARS-CoV2 is considered one of the major pathogens that primarily targets the respiratory system and in a few months has become a global health concern for humans
FFP2 masks, and disposable lab coats were available to residents, staff pathologists, and technicians
In case of tissue biobanking, FFP2 masks, surgical gloves, disposable lab coats, and protective glasses were made available to residents; at the end of the procedure, all the instruments and hoods surfaces were disinfected with hypochlorite solution

Summary

INTRODUCTION

After the first reported case in December 2019 in Wuhan (Hubei Province, China), SARS-CoV2 is considered one of the major pathogens that primarily targets the respiratory system and in a few months has become a global health concern for humans. Extraordinary measures have been adopted to minimize risk of infection among patients and healthcare workers: the hospital cafeteria was closed; the capacity of the canteen has been reduced to increase interpersonal distances (>1 meter); several check-point areas were established in order to provide surgical masks and alcoholic solutions for hand sanitizing, and to check temperature at the entrance In this scenario, a decrease in the number of planned surgery interventions was programmed by the hospital direction, limiting the activity to not-deferrable ones, such as neurovascular and oncologic procedures. We mainly performed intraoperative frozen section examination on surgical margins during prostatectomy, radical cystectomy and pancreasectomy, for malignancy assessment of lesions, and sentinel lymph node status in breast cancer In this case, FFP2 masks, and disposable lab coats were available to residents, staff pathologists, and technicians. In case of tissue biobanking, FFP2 masks, surgical gloves, disposable lab coats, and protective glasses were made available to residents; at the end of the procedure, all the instruments and hoods surfaces were disinfected with hypochlorite solution

AUTOPSY PROCEDURE

DISCUSSION

Findings

DATA AVAILABILITY STATEMENT