In this study, a brief severity scoring system, administered by telephone, successfully assigned priority for hospitalization and arranged for facility isolation among patients with suspected COVID-19 in Daegu, Korea. This made a significant impact on solving an acute hospital-bed shortage in the area.
The number of infected patients with suspected COVID-19 was rapidly increasing in Daegu, Korea. This challenged the local health care system, which was able to accommodate a maximum of 741 new patients per day in the city as of February 29, 2020.
The authors of this study developed and administered (via telephone) a remote brief severity scoring system for assigning priority for hospitalization and arranging for facility isolation (“therapeutic living centers”) for patients starting on February 29, 2020.
They classified waiting COVID-19 patients into 4 categories: 1) Asymptomatic to mild patients who were asymptomatic or had common cold-like symptoms, 2) Moderate patients with a cough and fever (≥ 37.5°C); 3) Severe patients with suspected severe pneumonia (e.g., a cough and ≥ 38°C fever lasting over 3 days); and 4) Critical patients with suspected critical pneumonia if they reported shortness of breath for over 1 day and a respiratory rate of 30/min or over.
They triaged 3,033 admissions to 15 therapeutic living centers from March 3, 2020, to March 26, 2020. Only 81 cases (2.67%) were transferred to the hospital after the facility isolation. Mean and median time of transfer from therapeutic isolation centers to hospitals were 6.7 days and 4.0 days, respectively (range, 0–22 days). The main reasons of transfer to hospitals included acute exacerbation after facility isolation (49/81, 60.5%), anxiety and depressive mood (16.0%), and missed underlying medical conditions (7.4%).
The authors concluded that telephone scoring of disease severity could be very useful in overcoming the shortage of hospital-beds that occurs during outbreaks of infectious diseases.