COVID-19: A Letter from Austria

Gert Mayer Gert Mayer is head of the Department of Internal Medicine IV (Nephrology and Hypertension), Innsbruck, Austria, and is a member of the Kidney News Editorial Board.

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The COVID-19 situation in Austria is still developing. Looking at the numbers from Northern Italy, it replicates the pace there (increase in confirmed cases of 1.5 times each day). Tyrol is a “red zone”; everyone with typical symptoms is a suspected case. The government has taken rigorous actions, closing down borders and public life. People not needed for public service (like medical personnel) or other basic aspects of life (supermarket employees, etc.) are not allowed to leave home, with the exception of buying food.

Nephrology is a sensitive specialty because people with kidney diseases are very vulnerable. We have reduced outpatient clinic work, and we have closed our renal transplant program and all elective surgery.

From an organizational point of view, the current critical aspects, especially for the care of people on dialysis, are the following:

  1. Organize dialysis: We try to set up “clean” units and concentrate patients with symptoms and those who have tested positive in special wards. Because this is not possible everywhere, several other ways to separate patients who test positive from the others within a unit are discussed (currently we prefer specials shifts in dedicated rooms rather than dedicated rooms only). Patients absolutely stay in their shift and we are making individual plans for patients who need dialysis more frequentlv (e.g., postoperative trauma individuals).

  2. Secure the supply of materials and make conscious decisions on using them to obtain maximum benefit.

  3. Keep our staff healthy: This is a special concern. Next to the regular prophylaxis measures, we form teams (nurses and doctors) who work together over a period of time to avoid one individual’s positive test leading to isolation of everyone. We reduce face-to-face meetings and use video conference whenever possible to secure communication. Colleagues not needed for patient care are sent home and we are starting to train students and doctors to handle dialysis machines.

Some final pieces of advice:

  • ■ Prepare as soon as possible. The clearer the instructions are from the leading authorities from the very beginning, the more comfortable everybody is.

  • ■ Communicate and coordinate with colleagues from other hospitals; smart solutions can also come up through others.

  • ■ Uncertainty and fear exist already and should not be increased further by conflicting orders.

Austrian nephrology will do whatever it takes to protect our patients.

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