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Severe Acute Respiratory Syndrome Coronavirus 2 and Medical Evacuation in Lombardy: Lessons Learned from an Unprecedented Pandemic

Published online by Cambridge University Press:  05 September 2023

Riccardo Stucchi
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Alba Ripoll-Gallardo*
SSD AAT Milano, Agenzia Regionale Emergenza Urgenza (AREU), Dipartimento di Emergenza e Accettazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
Giuseppe Maria Sechi
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Eric S. Weinstein
CRIMEDIM—Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
Guido Francesco Villa
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Cristina Frigerio
Dipartimento di Anestesia e Rianimazione, ASST Melegnano Martesana, Cernusco sul Naviglio, Italy
Federico Federighi
UOC Maxiemergenze e Grandi Eventi, ARES 118 Lazio, Italy
Giacomo Grasselli
Department of Anesthesia and Intensive Care, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy Department of Pathophysiology and Transplantation, University of Milan, Milano, Italy
Alberto Zoli
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Rodolfo Bonora
Agenzia Regionale Emergenza Urgenza (AREU), Milan, Italy
Roberto Fumagalli
Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy Dipartimento di Anestesia e Rianimazione, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
Corresponding author: Alba Ripoll Gallardo; Email:


The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerging infectious disease pandemic developed in Lombardy (northern Italy) during the last week of February 2020 with a progressive increase of patients presenting with serious clinical findings. Despite the efforts of the Central Italian Government, regional resources were rapidly at capacity. The solution was to plan the medical evacuation (MEDEVAC) of 119 critically ill patients (median age 61 years) to in-patient intensive care units in other Italian regions (77) and Germany (42). Once surviving patients were deemed suitable, the repatriation process concluded the assignment. The aim of this report is to underline the importance of a rapid organization and coordination process between different nodes of an effective national and international network during an emerging infectious disease outbreak and draw lessons learned from similar published reports.

Concepts in Disaster Medicine
© The Author(s), 2023. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health

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AREU Crisis Unit: Enzo Albergoni RN3, Paolo Baldini RN10, Giuseppe Brambilla RN3, Gianluca Chiodini EMT3, Lucia Colombi RN3, Giovanni De Luca RN1, Roberto Di Silvestre MD3, Claudio Mare MD3, Maurizio Migliori MD3, Michele Pirovano RN3 and Fabrizio Polverini RN3


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