Infection Prevention Considerations for a Multi-Mission Convention Center Field Hospital in Baltimore, Maryland, During the COVID-19 Pandemic

Abstract

The state of Maryland identified its first case of COVID-19 on March 5, 2020. The Baltimore Convention Center (BCCFH) quickly became a selected location to set up a 250-bed inpatient Field Hospital and Alternate Care Site. In contrast to other field hospitals throughout the United States, the BCCFH remained open throughout the pandemic and took on additional COVID-19 missions, including community SARS-CoV-2 diagnostic testing, monoclonal antibody infusions for COVID-19 outpatients, and community COVID-19 vaccinations. At the time of publication, the BCCFH had cared for 1,478 COVID-19 inpatients, performed 108,155 COVID-19 tests, infused 2,166 COVID-19 patients, and administered 115,169 doses of COVID-19 vaccine. To prevent the spread of pathogens during operations, infection prevention and control guidelines were essential to ensure the safety of staff and patients. Through multi-agency collaboration, utilization of infection prevention best practices, and answering what we describe as “PPE-ESP”, an operational framework was established to reduce infection risks for those providing or receiving care at the BCCFH during the COVID-19 pandemic.

Evaluating Efficacy of a COVID-19 Alternative Care Site Preparedness Assessment Tool for Catastrophic Healthcare Surge Capacity during Pandemic Response

“…Next, 'did not report' (DNR) coding signified the ACS case study article did not provide an explicit description for that topic when comparing it with ACS PAT V2.0 criteria. The ACS facility operations occurred in sports venues [2,29,34,52], convention facilities [30,32,[53][54][55][56][57], hotels [31,35], a defunct newspaper plant [58], and a newly constructed yet non-occupied healthcare facility [59], or other new or existing large open space venues [1,3,33,[60][61][62][63][64]. Results for each ACS case study article response compared with COVID-19 ACS PAT V2.0 by section and subtopic were summarized in Figure 4.…”

“…Therefore, comparing and contrasting the COVID-19 PAT V2.0 with peer-reviewed COVID-19 ACS was performed to establish efficacy of the tool moving forward. Twenty-three COVID-19 ACS case studies were reported in US [3,[29][30][31][32]34,52,53,[55][56][57][58][59]61] and International [1,2,33,35,54,60,[62][63][64] settings. Our discussion illuminates findings and areas for improvement.…”

“…The COVID-19 ACS PAT V2.0 tool, similar to the reported ACS case studies emphasized proper infection prevention and control (IPC) practices as a critical focus of the ACS facility conversion and healthcare operations process. However, the ACS case studies (n = 7, 30.4%) emphasized a tri-level hierarchy of infection control zones to strategically utilize PPE in contaminated areas (high risk), semi-clean areas (medium risk), and clean zones (low risk) [2,32,52,55,57,59,60]. The ACS IPC methods described functional space designations of high-risk patient care areas, medium-risk clinical staff areas including donning and doffing PPE, and low-level areas for administration and support staff where minimal PPE would be worn.…”

Racial Disparities in Hesitancy and Utilization of Monoclonal Antibody Infusion Treatment of COVID-19

“…The operational structure for BCCFH has been described. 7 All patients referred to the center from January 4 th , 2021 to May 14 th , 2021, who were eligible to receive mAb treatment based on their disease severity and risk factors, were included in the study. Patients were referred by community providers using a web-based form that automatically populated the scheduling spreadsheet.…”

Feasibility of and Experience with Telehealth Based Patient Self-referral for COVID-19 Monoclonal Antibody Therapy

“…BCCFH is a Maryland Department of Health disaster hospital two academic medical centers operate in Baltimore City. [8][9][10] In addition to inpatient care, BCCFH is Maryland's largest mass COVID testing, monoclonal infusion, and mass vaccination site. This location does not provide in-person clinic-based ambulatory care (e.g., ambulatory primary care provider or specialist services).…”