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he coronavirus disease 2019 (COVID-19) outbreak is straining U.S. hospital and health care systems. In late March 2020, the United States surpassed China as the country with the most confirmed COVID-19 cases. Experiences in New York City, an outbreak epicenter, show that there will likely be high demand for critical care resources across the United States in systems that already are strained at baseline.RAND researchers assembled a list of strategies to help U.S. hospitals create critical care surge capacity. The list was created using a review of scientific literature about past outbreaks and the current COVID-19 pandemic, a survey of frontline clinicians conducted in collaboration with the American College of Emergency Physicians, and two roundtables conducted via teleconference with leading emergency and critical care physicians and public health and preparedness experts from around the country.The strategies are organized into two tiers:• Tier 1 strategies to build contingency capacity include adaptations to medical care spaces, staffing constraints, and supply shortages without significant impact on medical care delivery. Strategies might include converting stepdown, post-anesthesia care unit (PACU) or operating room beds to intensive care unit (ICU) beds, drawing on emergency department and PACU nurses not on shift for ICU care, and KEY FINDINGSRAND researchers developed a tool to help hospitals create critical care surge capacity to respond to COVID-19.The tool allows hospitals to assess alternative strategies for creating this capacity and to identify which factors-space, staff, and equipment (such as ventilators)-are key to increasing the number of patients hospitals can treat.An illustrative analysis examined critical care capacity in each of the ten FEMA regions in the United States. In most of these regions, the number of ventilators was the key limiting factor.

This document and trademark(s) contained herein are protected by law. This representation of RAND intellectual property is provided for noncommercial use only. Unauthorized posting of this publication online is prohibited. Permission is given to duplicate this document for personal use only, as long as it is unaltered and complete. Permission is required from RAND to reproduce, or reuse in another form, any of its research documents for commercial use. For information on reprint and linking permissions, please visit www.rand.org/pubs/permissions.The RAND Corporation is a research organization that develops solutions to public policy challenges to help make communities throughout the world safer and more secure, healthier and more prosperous. RAND is nonprofit, nonpartisan, and committed to the public interest. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.Support RAND Make a tax-deductible charitable contribution at www.rand.org/giving/contribute www.rand.org For more information on this publication, visit www.rand.org/t/TLA164-1

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is home to three research centers that focus the efforts of collaborative groups of researchers on defined areas of inquiry to accelerate progress toward the development of new treatments and vaccines to prevent and cure autoimmune conditions, cancer, and infectious disease. Together, we will create a framework for researchers to reanalyze existing data with sex as a biological variable, to work together to spark new projects, to hire new faculty to build key research areas, to communicate via the WHAM Report, and to establish an ignition point for new leadership in the scientific field. WHAM's LEAD PARTNERSPlease find additional infographics and social media toolkits on www.thewhamreport.org.The technical specifications for the models are publicly available. Please visit www.thewhamreport.org/report/brain to learn more about using these data and citing this report.