The Society of Critical Care Medicine (SCCM) has updated its statistics on critical care resources available in the United States in light of the onset of COVID-19 and the strong possibility of large percentages of the U.S. population being admitted to the hospital and intensive care unit (ICU).
The outbreak of COVID-19 has generated concern that critically ill patients may overwhelm existing ICU bed availability. SCCM suggests that with the stoppage of elective procedures, ICU beds normally used to provide perioperative support would become available to provide COVID-19 care, as would operating rooms (with ventilators) and post-anesthesia care unit beds. Like China did, rapidly constructed hospitals solely for COVID-19 patients could be done in the United States. Local governments can also consider regionalizing or cohorting their critically ill COVID-19 patients into designated high-acuity large medical centers. Opening previously shuttered hospital facilities or medical wards and updating their supportive utilities (eg, power, data, air, oxygen, and suction) should be considered. SCCM suggests that priority should focus not only on increasing the numbers of mechanical ventilators, but on growing the number of trained professionals, for both the near and long term, who will be needed to both mechanically ventilate patients with COVID-19 and to care for other critically ill patients who will require ICU care. SCCM encourages hospitals to adopt a tiered staffing strategy in pandemic situations such as COVID-19. Hospitals with telemedicine capacity may also use the technology to connect with expert resources at other locations. Hospitals and their critical care organizations must include in their pandemic resource planning an ethical and legal approach to triage and resource allocation that would be activated only if the pandemic is perceived to be overwhelming the hospital’s surge capacity strategies.