Should we consider a “regional” reorganization as well as a “hospital” reorganization? In the beginning of March, during the most dramatic phase of the emergency in Italy, the “hub center” system was established in Lombardy by the Regional Government. They identified few hub Centers that would address the urgent and emergent pathologies, leaving the other hospitals available for COVID-19 patients(17). Mainly established to address the shortage of beds and medical resources we experienced in the first phase, the “hub center” system might be extremely operational even later, with a different arrangement to treat elective but SARS-CoV-2 positive patients. The foundation of a SARS-CoV-2 Hub Center seems to be an option to eradicate the risk of in-hospital infection in non-COVID-19 patients, who are the most at risk, as long as the safety of health care workers is guaranteed. If we consider the peculiarity of the coronavirus-related syndrome and its pathogenetic mechanisms, a dedicated Center might offer a proper treatment before and after surgery, in terms of intensive care and pharmacological therapy: centralization and volume are pivotal to build expertise and improve quality of care, while reducing costs(18).  This setting may have some drawback: Hospital chains may be able to reorganize and distribute patients to specific centers, only if both expenses and profits can be equally shared. Moreover, this may not be sustainable with individual stand alone institutions.