Separate Fever Clinics Prevent the Spread of COVID-19 and Offload Emergency Resources: Analysis from a large tertiary hospital in China

Jiangshan Wang; Liang Zong; Jinghong Zhang; Han Sun; Walline Harold Joseph; Pengxia Sun; Shengyong Xu; Yan Li; Chunting Wang; Jihai Liu; Fan Li; Jun Xu; Yi Li; Xuezhong Yu; Huadong Zhu

Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) broke out in Wuhan, Hubei Province at the end of 2019 [1] , and cases are now rapidly spreading worldwide [2] . Currently, controlling the spread of SARS-CoV-2 is of primary concern [3] . The main manifestations of this disease include acute fever, cough and dyspnea [4] , thus emergency departments (EDs) have become the primary facilities providing initial diagnoses and medical care for potential COVID-19 patients. Unfortunately, as the virus spreads widely, crowded patients in EDs face a high risk of cross-infection [5, 6] . In mainland China, outpatient "fever clinics" (FCs), affiliated to the ED, are designed to help separate potentially infectious from non-infectious patients [7] . FCs were started at the suggestion of National Health Commission of the People's Republic of China as early as 2003 during the SARS outbreak in China Even after the SARS event, FCs were still preserved as a location near EDs for early identification and isolation of potentially infectious patients [8] . Therefore, few suspected patients were managed in emergency department [9] . However, between SARS in 2003 and the current COVID-19 outbreak, the FC system has seen few similar stresses and few reports have emerged about this potentially key element of hospital infection-prevention infrastructure.