Benefits, open questions and challenges of the use of ultrasound in the COVID-19 pandemic era. The views of a panel of worldwide international experts

In the very last days of the year 2019a new virus of the coronavirus family, named Sars-Cov-2 was identified as responsible for the outbreak of cases of human pneumonia in Wuhan, China, a condition named Corona Virus Disease of 2019 (COVID-19). This virus displayed a rapid worldwide spread, with rates significantly higher and with much more severe clinical manifestations than those of seasonal influenza virus. From the initial source in China the virus has progressively spread also to Europe, starting to heavily impact Northern Italy, and later to other European countries and the United States, which by the end of March 2020 has become the country with the largest number of documented cases. Since the virus is new and highly infectious, all humans are potentially susceptible. Moreover, the outbreak took place unexpectedly and in a densely populated Chinese city causing a rapid exponential growth in the number of cases. This led to a huge influx of patients to medical facilities demanding investigation and support for persisting high fever and respiratory compromise. Depending on the local population reaction and the rapidity of local authorities response in combating an infectious diffusive public health threat, different modalities of this epidemic can take place (https://www.youtube.com/watch?v=gxAaO2rsdIs). Unfortunately, not only in China, but also in Northern Italy, Spain, France and America, just to name some most hit countries, authority reaction and population restrictions were not sufficiently timely to avoid the exponential growth, producing a burst of cases. This has inevitably resulted in overwhelming the capacity of the healthcare systems, in particular hospital provision, and the ability to properly allocate patients to the appropriate clinical units. This has led, particularly in North Italy and Spain, to the risk of collapse of normally comprehensive and excellent health care systems. The sheer volume of sick patients has overrun the capability of the hospitals to provide the expected healthcare, creating a sort of war scenario.