What are we doing in the dermatology outpatient department amidst the raging of the 2019 novel coronavirus?

Abstract

In late December 2019, several individuals with unexplained pneumonia were reported in Wuhan, China. A novel coronavirus was subsequently identified as the causative pathogen and provisionally designated 2019 novel coronavirus (2019-nCoV). 1 As of February 10, 2020, 42,638 cases of 2019-nCoV infection have been confirmed in China, with 21,675 suspected cases and 1016 deaths. There are still more than 3000 confirmed cases every day, involving people living in or visiting Wuhan, as a subsequent characteristic of human-to-human transmission. 2019-nCoV continues to spread around the world and has been reported in other countries such as the United States. 2 Hospitals in all provinces and cities across China have taken effective measures to control the spread of 2019-nCoV. On January 24, 2020, the West China Hospital of Sichuan University temporarily shut the doors of its dermatology outpatient department and dermatology surgery by postponing all of the elective operations and limiting to only emergency operations. We did not, however, completely halt the services to some patients who need to visit the dermatology outpatient department during the 2019-nCoV outbreak. At the same time, to meet the medical requirements and reduce the flow of patients to the skin clinic, we began free online and telephone consultation by providing free dermatology consultations. The dermatology outpatient department in West China Hospital was scheduled to run on January 28, 2020, mainly for critical care patients. Patients who had made an advanced appointment for obtaining medical service but chose not to visit received a full refund of registration fees. The number of dermatology outpatient clinics has been drastically reduced from 8 to 4, and only 1 accompanying person is allowed to enter the clinic. People entering the outpatient and inpatient buildings must wear masks and have their body temperature monitored by professionals wearing tight protective clothing. At the entrance of the building, anyone with a fever (body temperature ≥37.3°C), travel history to Wuhan in last 2 weeks, clear contact with residents in Wuhan in last 2 weeks, or contact with people with a fever would be directly sent to the fever clinic for screening. These individuals are considered to have been exposed and are quarantined for 2 weeks, and potential exposures are also asked to quarantine themselves for 2 weeks at home. During the skin clinic, patients are not allowed to take off their masks except on indications of facial lesions. Doctors must wear masks, surgical caps, protective suits, gloves, and goggles at work; they take off their protective equipment only after their work in a designated disposable area. In other respects, educational programs and activities of West China Hospital have come to a halt; graduate students and interns are prohibited from returning to school and work. Also, West China Hospital established special psychologic intervention counseling via a telephone and network platform to help those in need and published a psychologic protection handbook for free download. It is uncertain to predict when the 2019-nCoV will end at the time of this writing. The West China hospital is still playing a powerful role in defending against the epidemic outbreak and is a microcosm of all of the countless Chinese hospitals at this moment.