With doctors wearing hazmat suits that have been reinforced in case patients attack them, an Israeli hospital has opened what it says is the word’s first psychiatric coronavirus ward.

After coronavirus spread through a psychiatric ward in South Korea, infecting 100 people, staff at Sheba Medical Center in Ramat Gan decided that Israel urgently needed a plan for when coronavirus made inroads among the country’s 3,500 psychiatric in-patents.

“The situation we have worked to prevent isn’t science fiction, it happened in South Korea and also in China,” Mark Weiser, head of the Sheba’s psychiatric division, told The Times of Israel. “We’ve seen how quickly the virus can spread in a psychiatric ward, and while patients aren’t typically old, they are at risk because of various conditions and because many are taking anti-psychotics.”

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There are already four patients in the ward, which opened on Thursday, and it is has a capacity of 16.

Entering uncharted territory, staff have needed to think through every possible scenario — a task so hard that they hired actors to play out different possible situations. “We took actors and simulated things that could happen, and had our staff deal with the actors and learn from it,” Weiser said. “For example, we had a protective clothing and found it was too easily torn when an actor became violent.”

He said that trying to isolate psychiatric patients with coronavirus in the hospital’s regular wards could prove disastrous, as many fail to follow social distancing rules. “Our wards are crowded and people have psychosis, mania, impaired judgement,” said Weiser. “You can ask them to stay away from one another and not to touch but often this doesn’t happen; they don’t observe social distancing.”

But placing psychiatric patients in regular coronavirus wards can also be risky, especially if they become aggressive. ”Some patients can have behave in disturbed manner and be violent,” Weiser said, explaining that every detail of the new ward had to be designed in the context of this worry.

Referring to the lesson learned from the actors about gowns, he said: “There’s a fear protective clothing could be torn, so we have adapted clothing by adding another layer — often a tear-proof gown — over the suit, and added googles underneath the protective face mask.”

Much of the time, doctors sit in a control room, talking to patients via a video chat facility. This technology also allows patients to take therapy, and enables assessments that are legally required if patients are forcibly hospitalized to take place from a distance.

Weiser said: “The bottom line is that what we’re doing is giving optimal medical care while protecting ourselves from being infected and taking in to account legal and human rights.”