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COVID-19 Intelligence Report: Healthcare Facilities and Systems

June 15, 2020

Updates on Systems of Care

May 18, 2020

Title: COVID-19: Healthcare System Operations Strategies and Experiences

Publisher: HHS ASPR TRACIE

Publication Date: May 11, 2020

URL: https://files.asprtracie.hhs.gov/documents/covid-19-healthcare-system-operations-webinar-ppt-final.pdf

Key Takeaway:  HHS ASPR’s Technical Resources, Assistance Center, and Information Exchange (TRACIE), in collaboration with the HHS/FEMA Healthcare Resilience Task Force, hosted a webinar on May 11, 2020 on COVID-19: Healthcare System Operations Strategies and Experiences. Presenters from a few of the hardest hit hospitals in New York, Louisiana, and Arizona shared their hospital operations experiences and logistics (space, staff, and stuff) strategies with the current COVID-19 response.

 

May 11, 2020

Title: Can N95 Respirators be Reused after Disinfection?  How Many Times?

Publication: ACS Nano

Publication Date: 05 May 2020

URL:  https://pubs.acs.org/doi/pdf/10.1021/acsnano.0c03597

Key Takeaways:  Heating to 185 deg F at 30% humidity was found to be the most promising, nondestructive methods for various N95 masks, including respirators and those made from “meltblown” fabric.   UV was determined to be the next best option.  Steam, alcohol, bleach, and were also assessed and found to be more destructive to the masks.  UV was shown in a separate article, however, to potentially miss spots of both viruses and bacteria on masks intentionally contaminated in the laboratory setting and subsequently decontaminated.

 

Title: Facial Protection for Healthcare Workers During Pandemics: a Scoping Review

Publication: BMJ

Publication Date: 23 April 2020

URL:  https://gh.bmj.com/content/bmjgh/5/5/e002553.full.pdf

Key Takeaways:  This review of over 5000 articles determined that compared with surgical masks, N95 respirators perform better in laboratory testing, may provide superior protection in inpatient settings and are equivalent in outpatient settings; conservation strategies result in inferior protection but include extended use, reuse, decontamination of medical-grade masks or the use of improvised cloth masks, both of which may be combined with a face shield.  There is not much evidence on conservation strategies that could help conserve personal protective equipment during emergency shortages

 

Title: Critical Care Surge Capacity in U.S. Hospitals

Publication: RAND Corporation

Publication Date: May 2020

URL:  https://www.rand.org/pubs/research_briefs/RBA164-1.html

Key Takeaways:  RAND researchers established a list of strategies to help the U.S. create ICU surge capacity.  For hospitals and communities to effectively respond to the anticipated surge in the critical care needs for COVID-19 patients, the balance between space, staff, and stuff (i.e., resources) needs to be maximized and bottlenecks and shortages identified and mitigated.  The article includes recommendations and suggested assessment and planning tools for hospital administrators as well as government planning officials. 

 

Title: National Action Plan for Expanding and Adapting the Healthcare System for the Duration of the COVID Pandemic

Publisher: Johns Hopkins Bloomberg School of Public Health: Center for Health Security

Publication Date: 5 May 2020

URL: https://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2020/200505-healthcare-report.pdf

Key Takeaways:  This report offers recommendations related to several key current challenges being faced at healthcare facilities, such as: PPE supply chain, telehealth and resuming traditional healthcare in the future, managing surge staffing, challenges in prehospital care (EMS), ensuring readiness for the next chapters in the COVID story and further emerging infectious disease outbreaks.

 

Title: Ten Ways Healthcare Systems Can Operate Effectively during the COVID-19 Pandemic

Publisher: CDC

Publication Date: May 1, 2020

URL: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ways-operate-effectively.html

Key Takeaways:  This new document from CDC shares practical approaches that healthcare administrators can use based on the developing best practices from the healthcare community.

April 27, 2020

Title:  CDC COVID-19 Surge Calculator 

Publisher: US Centers for Disease Control and Prevention 

Publication: April 21, 2020

URL: https://www.cdc.gov/coronavirus/2019-ncov/hcp/COVIDsurge.html

Key Takeaway: 

  • A spreadsheet-based tool that hospital administrators and public health officials can use to estimate the surge in demand for hospital-based services during COVID-19 pandemic. 
  • Users enter the population in the hospital catchment area number of cases to date, the available hospital resources (non-ICU beds, ICU beds, and mechanical ventilators), and up to three community mitigation strategies.

 

Title:  COVID-19 Hospital Resource Package

Publisher: US DHHS ASPR TRACIE 

Publication: April 24, 2020 (continuously updated)

URL: https://files.asprtracie.hhs.gov/documents/covid-19-hospital-resource-packagedocument.pdf

Key Takeaway: 

  • Resources for hospital administrators compiled by DHHS ASPR Technical Resources, Assistance Center, and Information Exchange (TRACIE). Sections include Hospital

Surge, Crisis Standards of Care, Staffing Surge and Resilience, Workforce Protection,

HHS and CMS Regulatory Relief, Equipment Supply Surge, and Telemedicine. Though these resources may be individually listed in prior Intelligence Reports, this brings those together.

 

Title:  N95 MASK RE-USE STRATEGIES

Publisher: Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) 

Publication: April 17, 2020

URL: https://www.sages.org/n-95-re-use-instructions/

Key Takeaway: 

  • The CDC and NIOSH do not formally recommend decontamination and re-use of N95 masks, but acknowledge that in times of scarcity such strategies can be used based on individual clinical judgment and the institutional resources available.
  • Because coronaviruses lose their viability significantly after 72 hours, organizations have promoted a rotation and re-use strategy. Assuming no soiling and minimal to no viral contamination to the mask, this guidance suggests a strategy for reusing N95 masks.  

April 9, 2020

Title: American Association of Medical Colleges – Covid-19 Clinical Guidance Repository

Web address: www.aamc.org/covid19guidance 

Key Takeaway: The AAMC COVID-19 Clinical Guidance Repository includes COVID-19 treatment and management guidance from academic medical centers (AMCs) to serve as a resource for hospitals and clinicians.

March 31, 2020

Health System Capacity Calculator                                                   

  • https://www.medrxiv.org/content/10.1101/2020.03.25.20043711v1
  • Estimating the maximum daily number of incident COVID-19 cases manageable by a healthcare system 
  • Note from submitter: The COVID-19 Acute and Intense Resource Tool (CAIC-RT) is an interactive online tool capable of estimating the maximum daily number of incident COVID- 19 cases that a healthcare system could manage given age-based case distribution and severity. 

PPE Burn Rate Calculator                                                     

Society of Clinical Care Medicine: Surviving Sepsis Recommendations

 Clinical Decision Support Tool: Covid-19 Patient Severity Scoring Tool

  • https://surgisphere.com/research-tools/severity.php 
  • Note from submitter: This is a clinical decision support tool developed by a commercial global health care collaborative based on patient data on over 20,000 COVID patients from the >1,000 hospitals world-wide (85% US/Europe). Our (GW’s) evaluation of this tool is that the accuracy numbers sound quite good, although their validation sample was small so it’s not clear that this was fully validated. While the predictors intuitively make sense, not sure about the classification.

CDC Guidance

Journal Articles

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