Mobilization and Preparation of a Large Urban Academic Center during the COVID-19 Pandemic

Coronavirus disease 2019 (COVID-19) is a global pandemic that has affected 188 countries as of the time of this writing. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative virus of this disease, has the potential of causing a fatal severe respiratory distress syndrome. The initial reports from hot spots such as China and Italy indicate that about 15% of affected patients will develop severe pneumonia requiring hospitalization and that 5–6% will require intensive care (1). The exponential spread of this virus in major metropolitan areas has led to escalating health care use, thereby placing a massive burden on acute care resources, including hospital beds, personal protective equipment (PPE), and ventilators (2). An equally distressing problem is a shortage of trained medical personnel who are capable of treating the surge of patients requiring intensive care, especially as more healthcare workers become infected, quarantined, or hospitalized. Containment has been difficult in the United States, and the magnitude of community spread is unknown. Restrictions on travel and everyday life have been imposed in an attempt to curb the infection rate, but the number of patients requiring hospitalization and intensive care is predicted to be high. In anticipation of a surge in hospitalizations, it is paramount for every medical center in the United States to rapidly establish contingency plans to accommodate increased demand. Concurrently, hospitals need protocols as well as training to minimize healthcare worker exposure and ensure proper active and reserve staffing. Logistical deficiencies can stress a healthcare system, but with adequate preparation, we hope to reduce COVID-19 mortality by ensuring that the standard of care is preserved despite the increase in healthcare use. Meanwhile, efforts to reduce the possible spread of COVID-19 to patients, visitors, and essential healthcare providers through early detection, isolation, and triaging need to be emphasized. In the perspective article, we report our institution’s plan for addressing these challenges.