Critical Care And Emergency Department Response At The Epicenter Of The COVID-19 Pandemic

Abstract

New York City has emerged as the global epicenter for the coronavirus disease 2019 (COVID-19) pandemic. The city's public health system, New York City Health + Hospitals, has been key to the city's response because its vulnerable patient population is disproportionately affected by the disease. As the number of cases rose in the city, NYC Health + Hospitals carried out plans to greatly expand critical care capacity. Primary intensive care unit (ICU) spaces were identified and upgraded as needed, and new ICU spaces were created in emergency departments, procedural areas, and other inpatient units. Patients were transferred between hospitals to reduce strain. Critical care staffing was supplemented by temporary recruits, volunteers, and Department of Defense medical personnel. Supplies needed to deliver critical care were monitored closely and replenished to prevent interruptions. An emergency department action team was formed to ensure that the experience of front-line providers was informing network-level decisions. The steps taken by NYC Health + Hospitals greatly expanded its capacity to provide critical care during an unprecedented surge of COVID-19 cases in NYC. These steps, along with lessons learned, could inform preparations for other health systems during a primary or secondary surge of cases.

Performance analysis of portable HEPA filters and temporary plastic anterooms on the spread of surrogate coronavirus

“…The Centers for Disease Control and Prevention (CDC) recommends that hospitalized persons be placed in a single person room with the door kept closed, and that an airborne infection isolation room (AIIR), also known as a negative pressure room, be used for such patients who may require an aerosol generating procedure in an effort to contain potentially infectious aerosols from patients known or suspected of an active infection due to SARS-CoV-2 [ 6 ]. However, as was seen in Italy [ 7 ], the US [ 8 ]and in other countries [ 9 ], the first wave of the SARS-CoV-2 pandemic often quickly saturated the capacity of hospitals to provide an AIIR for all patients known to have or suspected of COVID-19.…”

Impact of public and private sector COVID-19 diagnostics and treatments on US healthcare resource utilization

“…The dramatic increase in need for health care resources by patients with severe manifestations that require more intensive treatment risks overwhelming hospital systems, in terms of both staff and space to treat patients [5]. For example, the New York Public Health System had a pre-pandemic capacity of 300 ICU beds, yet at the peak of the COVID-19 surge were caring for 1,000 ICU patients [7]. This burden is further compounded by the longer lengths of stay (LOS) required by COVID-19 patients requiring respiratory support, with estimates of ICU ventilator use ranging from 18-23 days vs. approximately 3-8 days during non-pandemic times [8][9][10].…”

Association of COVID-19-imposed lockdowns and online searches for toothache in Iran

“…1 Providing the best possible therapeutic clinical care could be mentioned as a critical duty for the healthcare systems in each country or region in the era of COVID-19. [2][3][4] Setting urgent medical centres to provide necessary medical services for patients during the outbreak is a practised experience for many countries. 3,5,6 Given that more hassles (e.g.…”