Adapting hospital capacity to meet changing demands during the COVID-19 pandemic
- PDF / 1,220,012 Bytes
- 12 Pages / 595.276 x 790.866 pts Page_size
- 9 Downloads / 161 Views
RESEARCH ARTICLE
Open Access
Adapting hospital capacity to meet changing demands during the COVID-19 pandemic Ruth McCabe1, Nora Schmit1, Paula Christen1, Josh C. D’Aeth1, Alessandra Løchen1, Dheeya Rizmie2, Shevanthi Nayagam1, Marisa Miraldo2, Paul Aylin3,4, Alex Bottle3, Pablo N. Perez-Guzman1, Azra C. Ghani1, Neil M. Ferguson1,5, Peter J. White1,6 and Katharina Hauck1,5*
Abstract Background: To calculate hospital surge capacity, achieved via hospital provision interventions implemented for the emergency treatment of coronavirus disease 2019 (COVID-19) and other patients through March to May 2020; to evaluate the conditions for admitting patients for elective surgery under varying admission levels of COVID-19 patients. Methods: We analysed National Health Service (NHS) datasets and literature reviews to estimate hospital care capacity before the pandemic (pre-pandemic baseline) and to quantify the impact of interventions (cancellation of elective surgery, field hospitals, use of private hospitals, deployment of former medical staff and deployment of newly qualified medical staff) for treatment of adult COVID-19 patients, focusing on general and acute (G&A) and critical care (CC) beds, staff and ventilators. Results: NHS England would not have had sufficient capacity to treat all COVID-19 and other patients in March and April 2020 without the hospital provision interventions, which alleviated significant shortfalls in CC nurses, CC and G&A beds and CC junior doctors. All elective surgery can be conducted at normal pre-pandemic levels provided the other interventions are sustained, but only if the daily number of COVID-19 patients occupying CC beds is not greater than 1550 in the whole of England. If the other interventions are not maintained, then elective surgery can only be conducted if the number of COVID-19 patients occupying CC beds is not greater than 320. However, there is greater national capacity to treat G&A patients: without interventions, it takes almost 10,000 G&A COVID-19 patients before any G&A elective patients would be unable to be accommodated. Conclusions: Unless COVID-19 hospitalisations drop to low levels, there is a continued need to enhance critical care capacity in England with field hospitals, use of private hospitals or deployment of former and newly qualified medical staff to allow some or all elective surgery to take place. Keywords: Hospital capacity, Interventions, General & acute, Critical care, Elective surgery, COVID-19
* Correspondence: [email protected] 1 MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, Norfolk Place, London W2 1PG, UK 5 NIHR Health Protection Research Unit in Modelling and Health Economics, Imperial College London, London, UK Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, dis
Data Loading...
