It reached a peak of 542 COVID patients hospitalized at the same time, 186 of whom were in critical and semi-critical care beds.
A large-scale reorganization of tasks was designed, creating new teams capable of responding to the extremely high demand.
On February 25, 2020, Barcelona’s Hospital Clínic diagnosed the first case of COVID-19 in Catalonia and the Iberian Peninsula. At that time, it was still believed that the spread of the disease could be contained, but this was not the case. Bellvitge Hospital admitted its first case on March 1, 2020, and within weeks, the number of hospitalized patients had already surpassed one hundred. On March 15, a nationwide lockdown was declared in Spain, lasting more than three months.
By April, at the peak of the first wave of the pandemic, Bellvitge Hospital was already dedicating 85% of all its resources to COVID-19. It reached a peak of 542 COVID patients hospitalized at the same time, 186 of whom were in critical and semi-critical care beds. Mortality rates among patients were extremely high.
In record time, the hospital underwent a drastic transformation to respond to the new situation. All scheduled surgical and non-surgical procedures were suspended; all professionals on leave returned—many retired staff even volunteered to reinforce care services—and a large-scale reorganization of tasks was designed, creating new teams to meet the overwhelming demand for COVID patient care.
Family and visitor access was completely prohibited, replaced by a new telephone support system. Strict safety measures were implemented, including mandatory masks and personal protective equipment (PPE), and patient flow circuits were reorganized to separate different areas. Dozens of new protocols were written and published on the hospital’s intranet, new technological advancements were developed, and a psychological support service was launched for both patients and healthcare professionals. Additionally, a micro-donation campaign was initiated to manage the numerous offers of financial and material assistance.
The Microbiology Department increased testing capacity by eight times, conducting more than 24,000 tests between February 22 and May 6. The critical care area expanded from 68 to 139 beds, the respiratory semi-critical unit from 4 to 70 beds, and the hospitalization area added 60 beds in former operating rooms and repurposed other decommissioned spaces. Another 53 beds were set up in the lobby of the Outpatient Consultation area, though they were ultimately not needed. Additionally, Bellvitge professionals managed the operational logistics of the Hospital Fira Salut at Fira de Barcelona, which treated recovering patients from the entire surrounding area.
A multidisciplinary crisis committee met daily for months to continuously adapt to the rapidly changing situation. “We always tried to stay ahead of the disease, but it was extremely difficult given that we were facing an unprecedented scenario,” recalls Dr. Cristina Capdevila, who was the hospital’s director at the time and is now its general manager.
Generosity, Flexibility, and Public Support
According to Dr. Capdevila, “For all professionals, it was an incredibly tough ordeal, both in terms of workload and emotional strain. Many of us became infected. But every single staff member, both clinical and non-clinical, worked together and demonstrated extraordinary generosity and flexibility to meet society’s needs.”
She also highlights “the immense support from the public—from applause on balconies to the hundreds of emails and messages of encouragement we received daily, which helped us keep going.”
During the first and most severe wave of the pandemic, Bellvitge University Hospital became one of the leading centres in Europe for implementing ECMO (extracorporeal membrane oxygenation) to support COVID patients with severe respiratory and cardiac failure.
After the first wave subsided, the hospital gradually returned to normal operations and ended the year having ensured that all oncology, cardiac, and other essential surgeries were performed within the guaranteed timeframes. However, the emergence of new coronavirus variants and subsequent waves of infections continued to require extraordinary efforts from the hospital for a long time.
At the beginning of 2021, under the initiative of the Catalan Health Service, Bellvitge Hospital inaugurated a new healthcare building dedicated exclusively to COVID-19. This building has since been repurposed to house hospitalization areas for neurological diseases and other healthcare services. Additionally, the pandemic opened up a wide range of new scientific questions, sparking multiple research initiatives across departments such as Emergency Medicine, Intensive Care, Pulmonology, Infectious Diseases, and Microbiology. These research efforts have focused on topics such as long COVID, clinical outcome prediction, and the application of artificial intelligence in critical care.
As Dr. Capdevila concludes, “We suffered greatly, but we also learned a lot. The pandemic forced us to change the way we did things, to take on tasks we had never done before, and to see our profession with a new mindset. Many of the new skills and approaches we developed during that time have remained and have made us a stronger team—for the benefit of our patients.”