{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T03:10:23Z","timestamp":1789787423923,"version":"4.0.1"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2020,11,12]],"date-time":"2020-11-12T00:00:00Z","timestamp":1605139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,20]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>COVID-19 has challenged healthcare systems worldwide. Some countries collapsed under surge conditions, while others (such as Malta) showed resilience. Public health measures in Malta quickly reined in COVID-19 spread. This review summarizes pandemic preparedness measures in Malta and the impact on routine services.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A literature search was conducted using Google, Google Scholar and PubMed and by reviewing Maltese online newspapers. A comprehensive summary of internal operations conducted at Mater Dei Hospital (MDH) was made available.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A hospital \u2018Incident Command Group\u2019 was set up to plan an optimal COVID-19 response strategy. A \u2018rapid response team\u2019 was also created to cater for the logistics and management of supplies. A \u2018COVID-19 Emergency Operation Centre\u2019 simulated different COVID-19 scenarios. All elective services were suspended and all staff were mandatorily trained in wearing personal protective equipment. Staff were also retrained in the care of COVID-19 patients. In preparation for potential admission surges, MDH underwent rapid expansion of normal and intensive care beds. Swabbing was ramped up to one of the highest national rates worldwide. The cost for hospital COVID-19 preparedness exceeded \u20ac100 million for Malta\u2019s half a million population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Malta and its sole acute hospital coped well with the first wave with 680 cases and 9 deaths. The increased ability to deal with COVID-19 (a principally respiratory pathogen) will serve well for the anticipated combined annual influenza and the COVID-19 second wave this coming winter.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/intqhc\/mzaa138","type":"journal-article","created":{"date-parts":[[2020,10,20]],"date-time":"2020-10-20T11:19:14Z","timestamp":1603192754000},"source":"Crossref","is-referenced-by-count":6,"title":["Malta\u2019s only acute public hospital service during COVID-19: a diary of events from the first wave to transition phase"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2012-9234","authenticated-orcid":false,"given":"Sarah","family":"Cuschieri","sequence":"first","affiliation":[{"name":"Department of Anatomy, Faculty of Medicine & Surgery, University of Malta, Msida, MDS2080, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celia","family":"Falzon","sequence":"additional","affiliation":[{"name":"Administration Building, Mater Dei Hospital, Msida, MDS2090, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Janulova","sequence":"additional","affiliation":[{"name":"Administration Building, Mater Dei Hospital, Msida, MDS2090, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Aguis","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Mater Dei Hospital, Msida, MDS2090, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Busuttil","sequence":"additional","affiliation":[{"name":"Administration Building, Mater Dei Hospital, Msida, MDS2090, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel","family":"Psaila","sequence":"additional","affiliation":[{"name":"Administration Building, Mater Dei Hospital, Msida, MDS2090, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Farrugia","sequence":"additional","affiliation":[{"name":"Administration Building, Mater Dei Hospital, Msida, MDS2090, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Debono","sequence":"additional","affiliation":[{"name":"Administration Building, Mater Dei Hospital, Msida, MDS2090, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Grech","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Mater Dei Hospital, Msida, MDS2090, Malta"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,12]]},"reference":[{"key":"2021022007493132700_R1","first-page":"1","article-title":"COVID-19 panic, solidarity and equity\u2014the Malta exemplary experience","author":"Cuschieri","year":"2020","journal-title":"Z Gesundh Wiss"},{"key":"2021022007493132700_R2","first-page":"102","article-title":"May you live in interesting times: COVID-19 and Mater Dei Hospital, Malta","volume":"7","author":"Grech","year":"2020","journal-title":"Res Humanit Med Educ"},{"key":"2021022007493132700_R3","volume-title":"Health systems in transition: Malta","author":"Azzopardi-Muscat","year":"2017"},{"key":"2021022007493132700_R4","article-title":"Beating all other EU countries, Malta tops list as \u2018most trusted healthcare system\u2019","volume-title":"Lovin Malta","author":"Grech Urpani","year":"2020"},{"key":"2021022007493132700_R5","first-page":"1","article-title":"Use of incident command system for disaster preparedness: a model for an emergency department COVID-19 response","author":"Farcas","year":"2020","journal-title":"Disaster Med Public Health Prep"},{"key":"2021022007493132700_R6","volume-title":"Rapid hospital readiness checklist","author":"World Health Organization (WHO)","year":"2020"},{"key":"2021022007493132700_R7","article-title":"COVID 19 in Malta, a small Island population","volume-title":"The Synapse","author":"Grech","year":"2020"},{"key":"2021022007493132700_R8","article-title":"WHO Director-General\u2019s opening remarks at the media briefing on COVID-19 - 16 March 2020","author":"World Health Organization","year":"2020"},{"key":"2021022007493132700_R9","article-title":"Malta ranked third best worldwide for its COVID-19 testing rate","volume-title":"Lovin Malta","author":"Diacono","year":"2020"},{"key":"2021022007493132700_R10","volume-title":"Strengthening and adjusting public health measures throughout the COVID-19 transition phases. Policy considerations for the WHO European Region","author":"World Health Organization","year":"2020"}],"container-title":["International Journal for Quality in Health Care"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/intqhc\/advance-article-pdf\/doi\/10.1093\/intqhc\/mzaa138\/34896953\/mzaa138.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/intqhc\/article-pdf\/33\/1\/mzaa138\/36326208\/mzaa138.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/intqhc\/article-pdf\/33\/1\/mzaa138\/36326208\/mzaa138.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,21]],"date-time":"2021-02-21T04:00:46Z","timestamp":1613880046000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/intqhc\/article\/doi\/10.1093\/intqhc\/mzaa138\/6033548"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,12]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,2,20]]}},"URL":"https:\/\/doi.org\/10.1093\/intqhc\/mzaa138","relation":{},"ISSN":["1353-4505","1464-3677"],"issn-type":[{"value":"1353-4505","type":"print"},{"value":"1464-3677","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,1,1]]},"published":{"date-parts":[[2020,11,12]]},"article-number":"mzaa138"}}