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  • Establishing a COVID-19 treatment centre in Israel at the initial stage of the outbreak: challenges, responses and lessons learned

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Report from the front
Establishing a COVID-19 treatment centre in Israel at the initial stage of the outbreak: challenges, responses and lessons learned
  1. Elhanan Bar-On1,2,
  2. Gad Segal2,3,
  3. Gili Regev-Yochay2,4,
  4. Galia Barkai2,5,
  5. Asaf Biber2,6,
  6. Avinoah Irony2,7,
  7. Assaf Luttinger1,
  8. Hindy Englard7,
  9. Amir Grinberg8,
  10. Eldad Katorza2,9,
  11. Galia Rahav2,4,
  12. Arnon Afek2,8,
  13. Yitshak Kreiss2,8
  1. 1 The Israel Center for Disaster Medicine and Humanitarian Response, Sheba Medical Center, Tel Hashomer, Israel
  2. 2 Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
  3. 3 Internal Medicine K, Internal Medicine T, Sheba Medical Center, Tel Hashomer, Israel
  4. 4 Infection Prevention and Control Unit, Sheba Medical Center, Tel Hashomer, Israel
  5. 5 Paediatric Infectious Disease Unit, Sheba Medical Center, Tel Hashomer, Israel
  6. 6 Infectious Disease Unit, The Center for Geographic Medicine and Tropical Diseases, Sheba Medical Center, Tel Hashomer, Israel
  7. 7 Emergency Medicine, Sheba Medical Center, Tel Hashomer, Israel
  8. 8 Medical Management, Sheba Medical Center, Tel Hashomer, Israel
  9. 9 Medical Management, Department of Obstetrics and Gynaecology, Sheba Medical Center, Tel Hashomer, Israel
  1. Correspondence to Professor Elhanan Bar-On, The Israel Center for Disaster Medicine and Humanitarian Response, Sheba Medical Center, Tel Hashomer 52621, Israel; belhanan{at}gmail.com

Abstract

Anticipating the need for a COVID-19 treatment centre in Israel, a designated facility was established at Sheba Medical Center—a quaternary referral centre. The goals were diagnosis and treatment of patients with COVID-19 while protecting patients and staff from infection and ensuring operational continuity and treatment of patients with non-COVID. Options considered included adaptation of existing wards, building a tented facility and converting a non-medical structure. The option chosen was a non-medical structure converted to a hospitalisation facility suited for COVID-19 with appropriate logistic and organisational adaptations. Operational principles included patient isolation, unidirectional workflow from clean to contaminated zones and minimising direct contact between patients and caregivers using personal protection equipment (PPE) and a multimodal telemedicine system. The ED was modified to enable triage and treatment of patients with COVID-19 while maintaining a COVID-19-free environment in the main campus. This system enabled treatment of patients with COVID-19 while maintaining staff safety and conserving the operational continuity and the ability to continue delivery of treatment to patients with non-COVID-19.

  • disaster planning and response
  • global health
  • infectious diseases
  • viral
  • major incident
  • planning

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/emermed-2020-209639

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    Footnotes

    • Handling editor Ellen J Weber

    • Contributors All authors contributed to writing and reviewing the manuscript. EB-O planned, wrote and submitted this study and is responsible for its overall content as guarantor. GR-Y, GS, GB, AB, AI, HE, AG, EK, GR and AA are contributed to writing and reviewing.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; internally peer reviewed.