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Adapting hospital capacity to meet changing demands during the COVID-19 pandemic.
McCabe, Ruth; Schmit, Nora; Christen, Paula; D'Aeth, Josh C; Løchen, Alessandra; Rizmie, Dheeya; Nayagam, Shevanthi; Miraldo, Marisa; Aylin, Paul; Bottle, Alex; Perez-Guzman, Pablo N; Ghani, Azra C; Ferguson, Neil M; White, Peter J; Hauck, Katharina.
  • McCabe R; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, Norfolk Place, London, W2 1PG, UK.
  • Schmit N; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, Norfolk Place, London, W2 1PG, UK.
  • Christen P; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, Norfolk Place, London, W2 1PG, UK.
  • D'Aeth JC; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, Norfolk Place, London, W2 1PG, UK.
  • Løchen A; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, Norfolk Place, London, W2 1PG, UK.
  • Rizmie D; Centre for Health Economics & Policy Innovation, Department of Economics & Public Policy, Imperial College Business School, Imperial College London, London, UK.
  • Nayagam S; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, Norfolk Place, London, W2 1PG, UK.
  • Miraldo M; Centre for Health Economics & Policy Innovation, Department of Economics & Public Policy, Imperial College Business School, Imperial College London, London, UK.
  • Aylin P; Dr Foster Unit, Department of Primary Care and Public Health, Imperial College London, London, UK.
  • Bottle A; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London, London, UK.
  • Perez-Guzman PN; Dr Foster Unit, Department of Primary Care and Public Health, Imperial College London, London, UK.
  • Ghani AC; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, Norfolk Place, London, W2 1PG, UK.
  • Ferguson NM; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, Norfolk Place, London, W2 1PG, UK.
  • White PJ; MRC Centre for Global Infectious Disease Analysis and Abdul Latif Jameel Institute for Disease and Emergency Analytics, Imperial College London, Norfolk Place, London, W2 1PG, UK.
  • Hauck K; NIHR Health Protection Research Unit in Modelling and Health Economics, Imperial College London, London, UK.
BMC Med ; 18(1): 329, 2020 10 16.
Article in English | MEDLINE | ID: covidwho-873986
ABSTRACT

BACKGROUND:

To calculate hospital surge capacity, achieved via hospital provision interventions implemented for the emergency treatment of coronavirus disease 2019 (COVID-19) and other patients through March to May 2020; to evaluate the conditions for admitting patients for elective surgery under varying admission levels of COVID-19 patients.

METHODS:

We analysed National Health Service (NHS) datasets and literature reviews to estimate hospital care capacity before the pandemic (pre-pandemic baseline) and to quantify the impact of interventions (cancellation of elective surgery, field hospitals, use of private hospitals, deployment of former medical staff and deployment of newly qualified medical staff) for treatment of adult COVID-19 patients, focusing on general and acute (G&A) and critical care (CC) beds, staff and ventilators.

RESULTS:

NHS England would not have had sufficient capacity to treat all COVID-19 and other patients in March and April 2020 without the hospital provision interventions, which alleviated significant shortfalls in CC nurses, CC and G&A beds and CC junior doctors. All elective surgery can be conducted at normal pre-pandemic levels provided the other interventions are sustained, but only if the daily number of COVID-19 patients occupying CC beds is not greater than 1550 in the whole of England. If the other interventions are not maintained, then elective surgery can only be conducted if the number of COVID-19 patients occupying CC beds is not greater than 320. However, there is greater national capacity to treat G&A patients without interventions, it takes almost 10,000 G&A COVID-19 patients before any G&A elective patients would be unable to be accommodated.

CONCLUSIONS:

Unless COVID-19 hospitalisations drop to low levels, there is a continued need to enhance critical care capacity in England with field hospitals, use of private hospitals or deployment of former and newly qualified medical staff to allow some or all elective surgery to take place.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Surge Capacity / Hospitalization Type of study: Experimental Studies / Observational study / Reviews Limits: Adult / Humans Country/Region as subject: Europa Language: English Journal: BMC Med Journal subject: Medicine Year: 2020 Document Type: Article Affiliation country: S12916-020-01781-w

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Coronavirus Infections / Surge Capacity / Hospitalization Type of study: Experimental Studies / Observational study / Reviews Limits: Adult / Humans Country/Region as subject: Europa Language: English Journal: BMC Med Journal subject: Medicine Year: 2020 Document Type: Article Affiliation country: S12916-020-01781-w