Planning of surgical activity in the COVID-19 era: A proposal for a step toward a possible healthcare organization

Health-care systems worldwide are experiencing a decline in elective surgical activity during the current COVID-19 pandemics. The progression of morbid conditions—especially of cancer—and the uncontained increase of waiting list for scheduled interventions are the major drawbacks. We propose a possible organization of a COVID-19 free hospital or hub, that include both patients’ and workforce’s preparation before entering the facility. The addition of a planned pathway for the whole workforce (physicians, nurses, cleaning and transporting crews, etc.) represents the basis of the program, and involves COVID-19 testing and subsequent self-isolation before entering the hospital, avoidance of work in non-COVID free areas, a strategic fractioning with a multilayer coverage system of care, periodic re-testing. Based on these suggestions, the realization of a COVID-19 free hospital could be achieved, allowing the continuation of a safe surgical activity in view of a possible restoration of non-urgent activity.