The first point of contact is GPs or the hospital Emergency Department. A dedicated telephone helpline is available for citizens to call and obtain guidance: http://www.iss.sm/on-line/home/aggiornamenti-coronavirus/articolo49013994.html. Individuals are advised not to visit health facilities but to call the helpline first.
Patients with mild symptoms, if possible, are cured at home and patients with more severe symptoms are transferred to the hospital in the infectious disease department, and if it is necessary ICU therapy is available. The treatment protocols are based on evidence (if available) and the clinical experience of specialists in infectious disease, pneumology and intensive care.
Off label treatments, such as chloroquine, are available and they have been used in some patients after the evaluation of the Ethical Committee.
INFECTION PREVENTION AND CONTROL
A functioning infection prevention and control (IPC) program is in place in hospital/health care facilities in areas where cases are suspected, identified or transferred and there is a national IPC authority that has developed IPC guidance and/or monitors IPC at the hospital level. The national IPC authority gathers, analyzes, documents, and reports data on health care-associated infections (HAI). Droplet precautions are applied for all patients with suspected, or a confirmed high threat pathogen, and airborne precautions are applied for all patients who require aerosol-generating procedures. A procedure is in place to avoid Covid-19 patients being visited by others. Personal Protective Equipment is available for medical staff and a specific procedure is in place for its use. A protocol for environmental cleaning and disinfection exist, as does a system for the proper collection and disposal of Covid-19 contaminated medical waste.
An infection control team is responsible to follow up exposed health care workers and to decide whether a health care worker is allowed to resume his/her work. There is a strategy to deal with patients who have been exposed to a confirmed Covid-19 patient.