COVID-19: changing perspectives in the cathlab

In the eye of the storm: how has the outbreak of the novel Coronavirus changed life in the cathlab in Italy?

"As physicians, we are experiencing a complex era that will surely impact our future way of conceiving our profession". Luigi Biasco, interventional cardiologist in Turin, Italy, shares his personal and a professional perspective on how the outbreak of the novel Coronavirus has changed life in the cathlab.

When I was considering to review the article by Guan on Clinical Characteristics of Coronavirus Disease 2019 in China on the evening of 8 March, the lock down of a large portion of northern Italy was just announced by our government and my feeling was to live at the border of the red-zone.

On the morning of 9 March, when arriving at my hospital, I was asked for the first time to go through a thermoscan to check whether or not I could be admitted to my workplace. During the day, the first infections where laboratory confirmed and fatalities observed in my hospital. While drafting this review, the complete lock-down of the whole Italian mainland was announced by our prime minister. From a national perspective as from 9 March, 7985 positive patients and 463 deaths were certified from the ministry of health.

Only a few days ago we were counselled not to shake hands with our patients and to maintain a distance of at least 1 meter from patients/colleagues. This gives an idea of the fast changing scenario we are living in.

Life behind a mask: impacting communication between physicians and patients

As physicians, we are experiencing a complex era that will surely impact our future way of conceiving our profession. Being forced not to have physical contacts with patients and colleagues, hiding ourselves behind a mask, is rapidly changing the way communication occurs between staff and patients and their families. Verbal communication has to be implemented due to the need to abolish any other form. This has to be performed without reducing quality and quantity of information provided. On the other hand, clinical meetings with colleagues have been reduced to the least necessary, aiming to reduce the possibility of contagion. Clearly, protection of the staff is perceived as of paramount importance, due to the significant drawbacks that positivity would imply.

"As time passes by, the significance of the term "companionship" is becoming clearer to us."

Nonetheless, not all evil comes to harm. As a group, we are strengthening our team work. Every professional involved in patient management understands how his personal commitment can represent a significant contribution to team success. As time passes by, significance of the term "companionship" is becoming clearer to us.

Resource allocation: an evolving challenge

In addition, potential difficulties in medical devices supplies, as well as need to allocate resources to Covid-19 patients are rapidly changing our approach to clinical and interventional cardiology. Now more than ever before, our main criterion in deciding for admission, medical therapies and interventions is “is this absolutely necessary right now?”. Thus appropriateness in relation to the specific scenario is guiding our choices.

In summary, the sentence “looking for essentials” might easily wrap-up our experience from personal and professional standpoints. Our hope is that the challenges we are called to face now and in the next months will not represent a misfortune, but rather seen as a possibility to go deeper into the essential importance of the role that each one of us has for the whole of society.