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In a pandemic response such as that experienced during COVID-19, government health authorities may reach capacity at the existing healthcare facilities and must enact emergency surge plans. Surge capacity is crucial to prevent health care worker infection and hospital collapse during an outbreak. Field or surge hospitals, so-called because they are designed to treat a surge in the number of patients needing care, are deployed in a wide range of scenarios including natural disasters and epidemic outbreaks and operation in these conditions requires adaptation to disaster medicine principles, while maintaining acceptable standards of care.
For healthcare authorities across the globe, including in the Middle East and North Africa (MENA) region, coming to terms with the enormity of the COVID-19 outbreak meant coming face to face with alarming hospitalisation rates and mortality rates. For examples, the Centres for Diseases Control and Prevention revealed that the overall cumulative COVID-19 hospitalisation rate in the United States was 98.4 per 100,000, with the highest rates in people aged 65 years and older (297.6 per 100,000) and 50-64 years (148.6 per 100,000). Meanwhile, data collected from 20 regions in Italy indicated that the average interregional case fatality rate was 7.5%, and the average ICU admission rate was 21.4%.
According to the World Health Organisation, what these experiences in the COVID-19 outbreak indicate is that ‘business-as-usual service delivery approaches’ are not sufficient to respond once a cluster of cases or widespread community transmission is registered and surge capacity will be needed. Creating surge capacity for acute and intensive care by repurposing or requisitioning of structures beyond the hospital setting to provide for excess patient numbers is vital to strengthening the health systems response to COVID-19 while maintaining essential hospital services.
Therefore, health authorities and healthcare organisations must understand what surge hospitals are and how they can plan for and establish them, including whom they should work with to do so. What steps need to be taken to safely and rapidly enact surge capacity? And who should be involved in planning, establishing, and operating surge hospitals?