Alternative Care Sites: An Option in Disasters.

Kenneth Iserson

doi:10.5811/westjem.2020.4.47552

Abstract

During the current COVID-19 pandemic, the limited surge capacity of the healthcare system is being quickly overwhelmed. Similar scenarios play out when an institution’s systems fail, or when local or regional disasters occur. In these situations, it becomes necessary to use one or more alternative care sites (ACS). Situated in a variety of non-healthcare structures, ACS may be used for ambulatory, acute, subacute, or chronic care. Developing alternative care facilities is the disaster-planning step that moves communities from talking to doing. This commitment pays real dividends if a disaster of any magnitude strikes. This paper discusses the basic criteria for selecting, establishing and ultimately closing an ACS, difficulties of administration, staffing, security, and providing basic supplies and equipment.

Highlights

Why Have an Alternative Care Site? During the current COVID-19 pandemic, the limited surge capacity of the healthcare system is being quickly overwhelmed
Situated in a variety of non-healthcare structures, alternative care sites (ACS) may be used for ambulatory, acute, subacute, or chronic care
As a demonstration of how poorly prepared we are, the American Medical Association sent a letter to Congressional leadership on March 19, 2020, demanding funding for frontline treatment: “Providing the funding for the capacity to care for mildly or moderately sick Covid-19 patients in an alternative care site when they cannot appropriately care for themselves at home, such as outpatient facilities or large structures in the community that are in close proximity to a hospital, will provide additional capacity for sicker Covid-19 patients that need more intensive care

Summary

Expert Commentary

During the current COVID-19 pandemic, the limited surge capacity of the healthcare system is being quickly overwhelmed. Similar scenarios play out when an institution’s systems fail, or when local or regional disasters occur. In these situations, it becomes necessary to use one or more alternative care sites (ACS). Situated in a variety of non-healthcare structures, ACS may be used for ambulatory, acute, subacute, or chronic care. Developing alternative care facilities is the disasterplanning step that moves communities from talking to doing. This commitment pays real dividends if a disaster of any magnitude strikes. Information should be considered current only at the time of publication and may evolve as the science develops

Introduction

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