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From an Italian Doc: [exerpts]

Lessons Learned from the Front Line of the COVID-19 Outbreak in Northern Italy: An Emergency Physician’s Perspective:

• Prepare to initially receive patients with upper airway symptoms, followed in the next days by patients with persistent fever, and finally, patients with interstitial pneumonia. The proportion of patients needing admission increases day by day. As of March 10, 2020, up to 60%-70% of patients presenting to the ED with suspected COVID-19 infection needed to be admitted, primarily for hypoxia.
• Be...
• In the first days, the critically ill patients will be mostly older than 65 with comorbidities, followed by younger patients in the days/weeks after. Do not exhaust all of your resources with the first patients. Patients will need to stay in the ICU for weeks.
• Patients come in waves, usually in late afternoon. For every 100 patients coming to the ED, expect to have 5 with severe ARDS, 10-20 with mild/moderate ARDS, and 40 patients needing oxygen to treat hypoxia.
• Do...
• Prepare in advance to have 10% of staff becoming ill. Personal protection is hard to maintain during long shifts in a busy ED, but it is feasible, and constant vigilance is mandatory.
• Most...
• In large health systems...
• Lung ultrasound...
• Tell all the...
• Prepare psychological support for the staff early. You will need it.