June 11, 2020
August 28, 2020



This is the third of a series of Covid-19 newsletters from FDIME (Foundation for the Development of Internal Medicine in Europe). The aim of the newsletters is to present qualified answers to the public, specifically on issues in which internists have a saying.
FDIME is a non-profit organizations, which aims to improve medical care for patients in Europe and has several activities promoting medical research and medical education of young European specialists in internal medicine. FDIME supports young internists to attend the European School of Internal Medicine, participate in the European Exchange program and also provide grants for research in Internal Medicine.

You are also invited to pose additional questions, which we can try to answer in one of our next newsletters.

What are the key points to consider in facing a new outbreak in Europe

The main strategy should be based on learning from the right decisions and the mistakes made during the current pandemic. We have to be prepared to work together. These pandemics have better outcomes with effective teamwork.


The role of the politicians, as they represent the citizens of their country is to protect their health, their lives and their properties. Without this protection the economy cannot function. In this pandemic they must lead by example.

In order to fulfil their responsibilities, they need to put the interests of the community before those of political parties by understanding the main topics of Global Health and its global implications.

As pandemic is a global problem with vital issues there is an absolute need to reinforce European and international cooperation to foster common policies, research networks, sharing of information, professionals and equipment.

The government needs to possess and provide clear and truthful information about indications of a possible new outbreak of infection abroad and monitor with utmost attention the data provided by foreign and international bodies and institutions. Reliable messages to the population, including numeric data of new cases, deaths, ICU admissions and hospital discharges must be given regularly by skilled and qualified communicators. These messages must also include information about preventive measures like facemasks, social distancing, eye protection, sources of infection, details of confinement (complete or incomplete lockdown with closure of restaurants, theatres, cinemas, sport facilities etc.).

2Health care authorities:

The role of health care authorities is paramount in the case of a pandemic as they represent the most visible and credible information source able to enforce measures within the population.

To achieve their task, authorities in Europe need to create a single advisory commission at the European level in touch with the national commissions to draw up European guidelines to protect people, fight the virus, follow and support research on the disease.

Among others there is a need to identify in the quickest way possible, infected individuals (travellers from suspicious countries, asymptomatic patients) by voluntary auto-test at the entrance of countries as well as to isolate and analyse close contacts of the index-case in the previous two weeks and prescribe confinement measures. Last but not least, recognize vulnerable patients among elderly people and protect them from total isolation, where feasible.

On the communication front, give clear-cut information about available blood tests and their necessity according to the clinical situation, recommend diagnostic tests (PCR) to the health care centres or doctors’ consulting rooms where the diagnosis should be confirmed or ruled out and foster home care and telemedicine. Protect health care workers who are on the front-line and provide PPE’s at all kind of institutions not only hospitals but also for exposed personnel in highly important tasks like administration of hospitals, nursing homes, district nurses, research, ambulances, etc.

On the infrastructure level, supply blood tests and diagnostic tests (PCR) when justified, be prepared to open additional facilities with the right equipment for the admission of patients, provide or adjust the number of ICU (intensive care unit) beds as needed, Create healthcare plans for nursing homes in the preparation for pandemics.

3Physicians and other health care professionals:

The most important tasks for the health care professionals include team working, providing information, communication and coordination. Therefore, they need to keep up to date with the disease and identify the population at risk, follow the recommendations of European agencies about advances in prevention, diagnosis and treatment of the disease, forward this information in an understandable way to individuals and communities.

Utmost attention to protect people against the spread of the virus is required through early identification of symptoms and measures to detect infection risks by contacts and possibly by asymptomatic patients.

Make sure that the recommendations for protection against contracting the virus, in the case of health care workers, are followed as they are on the front of the disease.

The social dimension of communication with patients and their families at home, in hospitals and in nursing homes (fears, social and physical isolation, suffering, physical complaints) is a delicate but highly important task of the health care professionals.

To achieve successfully their goal, they need to be resilient, psychologically prepared and up to date on the most recent development of the pandemic in order to prevent fake news.


A pandemic is not a common event and there are no defined and recognized procedures to deal with it. From the declaration of the pandemic to its spread, there is a lapse of time to be informed and take the first measures. In this period an incredible amount of news flows through the communications channels and the art is to separate the wheat from the chaff. It is not an easy task. The safest and most convenient way is to source information from a qualified professional (your physician), nationally or internationally recognised scientific organisations and governmental bodies; this will avoid unnecessary and fake news. A positive behaviour and a disciplined approach with respect and attention for the community will help to withstand the pandemic.

The Foundation for the Development of Internal Medicine (FDIME),

Daniel Sereni, Ramon Pujol, Ewelina Biskup, Jan Willem Elte.

With the help of Imad Hatem, Nica Cappellini, Lorenzo Dagna, Chris Davidson, Runolfur Palsson, Stefan Lindgren, Vereny Briner, Werner Bauer (in random order).