Three months of COVID-19 in a pediatric setting in the center of Milan.

Agostoni, Carlo; Bertolozzi, Giuseppe; Cantoni, Barbara; Colombo, Carla; Montini, Giovanni; Marchisio, Paola

The second epicenter of the global COVID-19 epidemic following Wuhan, and the first in the Western world, occurred unexpectedly in the Lombardy region of Italy, whose capital city is Milan. The aggressive nature of the outbreak in the region was dramatic, leading to a 2-month period of lockdown. Within the Policlinico, the historic hospital in the center of Milan, many units were rapidly converted into intensive care units or semi-intensive units for adult patients. During lockdown, the pediatric inpatient units had to face daily reorganization caused by the necessary logistic and structural transformations, thus restricting routine care pathways for chronic patients, while the Pediatric Emergency Unit had to develop a system able to effectively separate the children and caregivers infected with COVID-19 from those who were not affected. These 2 months enhanced resilience among both doctors and nurses, and facilitated the transversal transmission of data aimed at helping colleagues and patients in any way possible, in spite of the restrictive measures limiting the rate of activity in pediatric care. The reorganization of the current phase of decreasing epidemic activity still leaves us with unanswered questions regarding the further possible changes to implement in the event of a potential reoccurrence of epidemic peaks. Fig. 1 Duomo Square and the "Milano Brera fashion district," March 30, 2020, 3 p.m. Fig. 2 Number of accesses to the Pediatric Emergency Unit, IRCCS Policlinico, Milan, for the years 2018 (blue bar) and 2019 (red bar). Fig. 3 Total number of accesses (blue bars) to the PEU for the period March 1 to May 4 for 2019 and 2020, according to priority codes at triage: white, green, yellow, and red, as percentages of total accesses.