• Santiago Núñez-Velasco, Rodrigo Mercado-Pimentel, Miguel Ochoa-Plascencia, Regina Rodríguez-Arias, Gerardo Lopez-Espinoza, Maria Elena González-González, Carlos Estrella-Sánchez, and Carlos Ramírez-Huerta.
• Department of Neurosurgery, Fray Antonio Alcalde Civil Hospital of Guadalajara, Guadalajara, Jalisco, Mexico. Electronic address: snunez@hcg.gob.mx.
• World Neurosurg. 2020 Oct 1; 142: 506512506-512.

BackgroundMexico declared the first case of novel coronavirus disease (COVID-19) in February 2020. At the time we write this article, our country is facing a community spread phase, expecting a rapid increase in the number of cases and fatalities. The Fray Antonio Alcalde Civil Hospital of Guadalajara has been declared a non-COVID-19 hospital with the mission of providing care to patients already registered and also those transferred from neurosurgical departments of neighboring centers, which have been converted into COVID-19 only hospitals.MethodsAn organized response regarding personnel, surgical case selection, operating room behavior, and facility reorganization were designed to prevent an internal coronavirus outbreak in the neurosurgery department at the Fray Antonio Alcalde Civil Hospital of Guadalajara.ResultsDistancing actions by the staff and residents, including ward case discussions, neurosurgery rounds, and classes, will be carried out virtually. We classified neurosurgical patients into 4 groups depending on whether their condition demands care in 0-6 hours, 6-48 hours, 48 hours to 14 days, and >14 days. Subsequently, a questionnaire with epidemiologic, radiologic, clinical, and serologic criteria will be applied to determine the risk of COVID-19 infection to define to which area they are going to be transferred according to the different risk zones in our facility.ConclusionsDespite not being a COVID-19 center, we consider all patients at the neurosurgical ward and staff members as asymptomatic carriers or infected in the preclinical period. Specific measures must be taken to ensure the safety and care of neurosurgical patients and medical staff during the community spread phase.© 2020 Elsevier Inc. All rights reserved.

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