This report from the Johns Hopkins Bloomberg School of Public Health’s Center for Health Security addresses key challenges facing healthcare facilities and healthcare workers

 The report notes that surge capacity augmentation, deferral of some services, and implementation of crisis standards of care have allowed hospitals to absorb case surge related to COVID-19 to this point while continuing to provide lifesaving care. However, the report also notes that some communities are only now experiencing the pandemic in full force, that healthcare facilities have sustained substantial financial losses, and that healthcare workers have risked personal health and well-being.  There are urgent near-term challenges to address the continuing response to COVID-19 and prepare for potential additional peaks in cases in the future. The challenges posed by COVID-19 have also highlighted structural vulnerabilities of the US healthcare system and the need for longer-term structural reform.

The report makes recommendations across several policy areas, including:

• PPE supply chain
• Restarting deferred healthcare services
• Financial support for healthcare facilities and providers
• Sustaining and augmenting healthcare workforce
• Providing mental health support for healthcare workers
• Providing medical care and sick leave nationally
• Making telemedicine a new normal
• Reducing the number of undiagnosed infectious diseases in hospitals
• Protecting emergency medical services personnel from infectious diseases
• Better coordinating healthcare response to COVID and future pandemics.

Regarding allocation of scarce resources, the report stresses the importance of facilities sharing resources such as ventilators and personnel both within health systems and among competing health systems facilitated by coordination efforts by mayors, governors, state hospital associations, and state boards of health. The report recommends various efforts to enhance federal involvement and situational awareness, among other improvements, and notes a compelling need for local, state, and federal governments to act to increase hospital surge capacity to respond to future unpredictable surges in case volume from epidemics or other disasters.