In the early months of 2020, Europe was confronted by a pandemic that originated in China, which initially affected its territories in different ways. Parts of northern Italy were among the regions most affected. At the same time, Ticino, a small canton of Switzerland geographically wedged into Italian territory, had an incidence rate comparable to that of hard-hit Lombardy. Home to 350,000 inhabitants and separated from the rest of Switzerland by the Alps, Ticino had to face the first part of the pandemic with little available knowledge. The cantonal authorities decided to transform two active hospitals into COVID centres, concentrating all coronavirus patients there. Since the virus was new and there were no clear guidelines for managing it, the nutritional team on site had to reorganise to provide patient care, adapting their strategy to accommodate the evolution of the pandemic and growing medical knowledge. This paper explains how one of these teams developed a model to deal with the first wave of COVID, maintaining it during the second and current third wave of the pandemic.