Abstract
During any pandemic, it has long been known that local jurisdictions would need to be self-sufficient with little or no outside assistance, particularly from the federal government. While all eyes have been on California, New York, and Massachusetts, the capacities of health systems in other states have yet to be put to the test. If there are subsequent waves of COVID-19 and other jurisdictions see significant increases in disease spread, the systems used to respond will become critical.Using a review and synthesis approach, this article explores our collective experience and knowledge as it pertains to use of alternate care sites for dealing with the patient surge created by a disease outbreak. Probing the concept of alternate care site (ACS) systems reveals various types of alternate care sites that may be employed during an outbreak. The historical value of ACS models used during outbreak response are discussed. This culminates in the development of a notional response model and list of actions that should be taken by all jurisdictions as we prepare for additional waves of disease.
Highlights
As the COVID-19 outbreak accelerates across the globe, increased attention is being focused on preserving the healthcare infrastructure while meeting excess demands created by the disease
There are at least two reasons that emergency planners and health system leaders should not lower their guard: first, the epidemic curves for each region and community will be different; while New York plateaus, other areas may still be closer to the beginning (Today, 2020)
On March 2, 2020, nearly 500 public health professionals and 14 organizations signed an open letter to Vice President Mike Pence and other officials outlining principles and practices underpinning a fair and effective response to the COVID-19 pandemic (Gonsalves et al, 2020)
Summary
As the COVID-19 outbreak accelerates across the globe, increased attention is being focused on preserving the healthcare infrastructure while meeting excess demands created by the disease. The purpose of developing this surge capacity is to preserve medical resources for the duration of the outbreak while continuing to deal with causes of morbidity and mortality unrelated to the SARS-CoV-2 virus (Altevogt et al, 2010; Watson, Rudge, & Coker, 2013). During this period it is likely that mortality from all causes will climb; having more than doubled during previous outbreaks (Madhave et al, 2017). The distinction is important - surges produced by outbreaks are qualitatively different, are prolonged, and are confounded by other factors
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