Limitations
We have been adapting to a rapidly changing environment. These strategies proved to be practical and feasible. Having a well thought plan helps to provide for the most robust response possible. However, this strategy has several important limitations. First, we have not yet been able to study the effectiveness of our proposed strategies. Second, our contingency plan is a temporary emergency plan that could not resist long-scale outbreak. This plan was rapidly developed and continues to be modified and updated at “Spedali Civili” Hospital in Brescia. Finally, the isolation OR workflow and clinical care guidelines are institution- and department-specific; hence, our recommendations may not be applicable to all healthcare facilities. Nonetheless, we thought that it would be useful to share our early experience to help other institutions conducting and adapting such strategies more quickly.