Resuming work gradually in the context of COVID-19: Experience from a tertiary dermatology department in China.

Dear Editor,

A novel coronavirus spread throughout the world, leading to over 3 million confirmed cases until 30 April 2020. Currently, China steps toward the end of the epidemic and adopts an orderly and active approach to resume work. Herein, we report the experiences of resuming work in a tertiary dermatology department in China.

Our hospital took active measures to reduce the spread of coronavirus disease (COVID‐19) infection, including curtailing large gatherings, suspending routinely outpatient services, and implementing telemedicine consults. On 10 February 2020, dermatologic clinics began to run on, with only two outpatient units per day. Two types of patients were allowed in dermatologic clinics after triage: patients diagnosed with severe or urgent diseases, such as drug eruption, severe psoriasis, and acute urticaria; patients who need follow‐up with long‐term use of immunosuppressant or biologics. At the entrance of outpatient buildings, people must have their temperature measured by professionals, and those with fever must be directly referred to the fever clinic.

On 23 March, our hospital adjusted strategies to push on work resumption. According to guidelines released by the Beijing Health Commission, the migrant population in Beijing should make an advanced appointment and quarantine themselves for at least 14 days at home before visiting the clinics. To reduce the aerosolized spear of an afebrile carrier of the virus, only the patients with green health OR code (without travel history to epidemic areas and contact to confirmed patients) are allowed for hospital visits. Only the elderly patients and children could be accompanied by another person entering the dermatologic clinics. Temperature measurement is kept while wearing a mask in outpatient settings is not mandatory unless patients have a fever (body temperature ≥ 37.3°C). The examination table, doorknobs, and so on, should be wiped down with 70% alcohol. Patients in the elevator and waiting room are directed by professional personnel in social distancing. We also staggered patient appointment times to avoid their congregating. The number of dermatology outpatient unit was gradually increased. Limitation on disease types in outpatient treatment was canceled. Dermatology surgery, mycological assessment, and several services provided by STD and laser clinic were also gradually restored. From 25 April 2020, we received an average of 350 daily visits with 15 outpatient units. A variety of diseases were treated in our dermatological clinics, ranging from common diseases (as acne, eczema, psoriasis, vitiligo, etc.) to rare immune diseases (lupus erythematosus, pemphigus, dermatomyositis, etc.). A total of 618 free dermatologic teleconsultations were implemented last week. Some clinical treatments, such as CO2 laser, phototherapy, and photodynamic therapy, are still halted.

For inpatient settings, we also developed a proposal for work resumption, and increased inpatients' admissions orderly, with strict limits on the total number of patients and newly admitted patients. Newly diagnosed patients are still not allowed to be admitted, and one separate room is reserved for emergencies. We also continued to train healthcare workers in delivering telemedicine consultations. Of note, medical staff should wear personal protective equipment accordingly in specific areas. Surgical masks, disposable medical caps, and medical clothing are warranted in general wards and outpatient clinics.

However, in moderate‐risk and high‐risk regions, medical staff should remain highly vigilant of the epidemic situation and take measures accordingly. Dermatologists returning to work might also face a drastic surge of patients with healthcare needs and should pay more attention to avoid the risk of infection. We hope that our experience of work resumption can provide a reference for dermatologists in the context of COVID‐19.

CONFLICT OF INTEREST

The authors declare no conflict of interest.