ASST Papa Giovanni XXIII, Bergamo: a new organizational Microbiology and Virology Laboratory structure to face the health emergency from the Sars-Cov-2 outbreak.

Abstract

On January 12, 2020, the World Health Organization (WHO) declared Covid-19 an emergency of international interest. The first documented case in the "Pope John XXIII" Hospital in Bergamo was identified on Friday, February 21, 2020. The ASST Pope John XXIII of Bergamo was among the very first Hospital Companies to implement a series of organizational remodelling to quickly face the health emergency from the Sars-Cov-2 outbreak. In this context, we will describe the role and organizational changes adopted by the Complex Operating Unit (UOC) Microbiology and Virology. Laboratory diagnostics can effectively help counteract this and other (future) viral outbreaks. Molecular diagnostics is the only method currently recommended for the identification of infectious cases. The gold-standard method for identifying the virus is Real-time PCR (RT-PCR) according to both the protocol of the Charitè University Hospital in Berlin and the American CDC (Center for Disease Control and Prevention). Biological samples of the lower respiratory tract (sputum, endotracheal aspirate, or broncho-alveolar washing) or alternatively upper respiratory tract samples are preferred for the execution of a swab for each nostril and a swab for each side of the oropharyngeal cavity. The need to adopt a new organizational structure also concerned the UOC Microbiology and Virology, which was quickly called upon to cope with the health emergency by making its contribution through molecular research of the Sars-Cov-2 virus. We will illustrate the salient phases of the reorganization that led to the execution of over 1000 molecular swabs per day and the implementation of a service in H24. Properly managing human resources in the 24 hours was essential for the proper functioning of the laboratory itself and to deal with the ongoing health emergency. In this even evolving and uncertain context, it was difficult to adopt predefined strategies, but the right involvement, the self-denial of the staff and the strong team spirit have made it possible to achieve excellent performance and quality results.