Impact of COVID-19 pandemic and lockdown on emergency room access in Northern and Central Italy


Submitted: 25 February 2021
Accepted: 6 April 2021
Published: 28 June 2021
Abstract Views: 1533
PDF: 379
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Authors

  • Fabrizio Giostra Emergency Room and Emergency Medicine, Ospedale Sant’Orsola, Bologna, Italy.
  • Maria Grazia Mirarchi Emergency Room and Emergency Medicine, Ospedale Sant’Orsola, Bologna, Italy.
  • Gabriele Farina Emergency Room and Emergency Medicine, Ospedale Sant’Orsola, Bologna, Italy.
  • Ciro Paolillo Emergency Room and Emergency Medicine, Ospedali Civili, Brescia, Italy.
  • Catello Sepe Emergency Room and Emergency Medicine, Ospedali Civili, Brescia, Italy.
  • Francesca Benedusi Emergency Room and Emergency Medicine, Ospedali Civili, Brescia, Italy.
  • Andrea Bellone Emergency Room and Emergency Medicine, Ospedale Niguarda, Milan, Italy.
  • Lorenzo Ghiadoni Emergency Room and Emergency Medicine, Azienda Ospedaliera Universitaria di Pisa, Italy.
  • Greta Barbieri Emergency Room and Emergency Medicine, Azienda Ospedaliera Universitaria di Pisa, Italy.
  • Massimo Santini Emergency Room and Emergency Medicine, Azienda Ospedaliera Universitaria di Pisa, Italy.
  • Grazia Guiddo Emergency Room and Emergency Medicine, Ospedale San Paolo, Savona, Italy.
  • Alessandro Riccardi Emergency Room and Emergency Medicine, Ospedale San Paolo, Savona, Italy.
  • Roberto Lerza Emergency Room and Emergency Medicine, Ospedale San Paolo, Savona, Italy.
  • Daniele Coen Academy of Emergency Medicine and Care (AcEMC), Milano, Italy.

In Northern Italy the coronavirus infection has spread since February 2020: the increase in admissions of COVID-19 patients corresponded to a drastic decrease in admissions of regular patients to the Emergency Room (ER). This retrospective study was conducted by Academy of Emergency Medicine and Care (AcEMC). During the lockdown period the accesses were reduced by more than 50%, and in the following months of May and June 2020, there was a recovery clearly below (70%) previous year’s numbers. We have observed a drastic reduction in white and green codes, a fair reduction in yellow codes, while red codes remained stable. The decrease in access to the ER mainly concerned patients with low priority color codes, but also the reduction in the number of accesses of yellow and red codes, insignificant at a superficial glance, is notable. If we consider that yellow and red codes during the months of the lockdown included many patients with COVIDrelated respiratory insufficiency, it is evident that there was a clear reduction in the number of serious illnesses not COVID-related. This is certainly another serious consequence of the COVID-19 pandemic.


Jeffrey MM, D’Onofrio G, Paek H, et al. Trends in emergency department visits and hospital admissions in health care systems in 5 states in the first months of the COVID-19 pandemic in the US. JAMA Int Med 2020;180:1328–33. DOI: https://doi.org/10.1001/jamainternmed.2020.3288

Rosenbaum L. The untold toll: the pandemic’s effects on patients without COVID-19. N Eng J Med 2020;382:2368-71. DOI: https://doi.org/10.1056/NEJMms2009984

Barbieri G, Spinelli S, Filippi M, et al. COVID-19 pandemic management at the Emergency Department: the changing scenario at the University Hospital of Pisa. Emerg Care Journal 2020;16:9146. DOI: https://doi.org/10.4081/ecj.2020.9146

Comelli I, Scioscioli F, Cervellin G. Impact of the COVID-19 epidemic on census, organization and activity of a large urban emergency department. Acta Biomed 2020;91:45-9.

Poggiali E, Vercelli A, Cillis MG, et al. Triage decision-making at the time of COVID-19 infection: the Piacenza strategy. Intern Emerg Med 2020;15:879-82. DOI: https://doi.org/10.1007/s11739-020-02350-y

Turcato G, Zaboli A, Pfeifer N. The COVID-19 epidemic and reorganisation of triage, an observational study. Intern Emerg Med 2020;15:1517-1524.

Decree of the President of the Council of Ministers of the Italian Government on March 9, 2020. Available from: https://www.gazzettaufficiale.it/eli/id/2020/03/09/20A01558/sg

Istituto Superiore di Sanità. Sorveglianza integrata COVID-19 in Italia. 2020. www.iss.it/documents/20126/0/Infografica_09marzo.pdf/1f62ad0a-e156-cf27-309d-26adcb1b52b4?t=1583782049035

De Filippo O, D’Ascienzo F, Angelini F. et al, Reduced rate of hospital admissions for ACS during COVID-19 outbreak in Northern Italy. N Eng J Med 2020;383:88-9. DOI: https://doi.org/10.1056/NEJMc2009166

Coen D, Paolillo C, Cavazza M, et al. Changing Emergency Department and hospital organization in response to a changing epidemic. Emerg Care J 2020;16:8969. DOI: https://doi.org/10.4081/ecj.2020.8969

Comelli I, Scioscioli F, Cervellin G. Impact of the COVID-19 epidemic on census, organization and activity of a large urban emergency department. Acta Biomed 2020;91:45-49.

Poggiali E, Vercelli A, Mazzoni S, et al. COVID-19 pandemic, piacenza calling. The survival strategy of an Italian emergency department. Acta Biomed 2020;91:1-3.

Maniscalco P, Poggiali E, Quattrini F, et al. The deep impact of novel COVID-19 infection in an Orthopedics and Traumatology Department: the experience of the Piacenza Hospital. Acta Biomed 2020;91:97-105.

Carenzo L, Costantini E, Greco M, et al. Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy. Anaesthesia 2020;75:928-34. DOI: https://doi.org/10.1111/anae.15072

Turcato G, Zaboli A, Pfeifer N. The COVID-19 epidemic and reorganisation of triage, an observational study. Intern Emerg Med 2020;15:1517-24. DOI: https://doi.org/10.1007/s11739-020-02465-2

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Giostra, F., Mirarchi, M. G., Farina, G., Paolillo, C., Sepe, C., Benedusi, F., Bellone, A., Ghiadoni, L., Barbieri, G., Santini, M., Guiddo, G., Riccardi, A., Lerza, R., & Coen, D. (2021). Impact of COVID-19 pandemic and lockdown on emergency room access in Northern and Central Italy. Emergency Care Journal, 17(2). https://doi.org/10.4081/ecj.2021.9705

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