Abstract
Emergency preparedness programs have evolved over the last several decades as communities have responded to natural, intentional, and accidental disasters. This evolution has resulted in a comprehensive all-hazards approach centered around 4 fundamental phases spanning the entire disaster life cycle: mitigation, preparedness, response, and recovery. Increasing frequency of outbreaks and epidemics of emerging and reemerging infectious diseases in the last decade has emphasized the significance of healthcare emergency preparedness programs, but the coronavirus disease 2019 (COVID-19) pandemic has tested healthcare facilities' emergency plans and exposed vulnerabilities in healthcare emergency preparedness on a scale unexperienced in recent history. We review the 4 phases of emergency management and explore the lessons to be learned from recent events in enhancing health systems capabilities and capacities to mitigate, prepare for, respond to, and recover from biological threats or events, whether it be a pandemic or a single case of an unknown infectious disease. A recurring cycle of assessing, planning, training, exercising, and revising is vital to maintaining healthcare system preparedness, even in absence of an immediate, high probability threat. Healthcare epidemiologists and infection preventionists must play a pivotal role in incorporating lessons learned from the pandemic into emergency preparedness programs and building more robust preparedness plans.
Highlights
Certain disasters may be completely unanticipated, for which disaster-specific mitigation measures are either absent or of low priority
Outbreaks and encounters with new high-consequence infectious disease (HCID) are increasingly occurring[12] and numerous health systems across the US have experienced the presentation of a suspected case of Ebola virus disease (EVD), Middle East respiratory syndrome (MERS), or other HCID in their emergency department in recent years
Recent HCID outbreaks and the COVID-19 pandemic have underscored the need for hospitals to have well-developed and exercised standard operating procedures (SOPs), a trained workforce, communication plans, understanding of anticipatable needs of their vulnerable populations, clearly defined surge plans, and robust plans for supply chain management and staffing in the event of a biological threat
Summary
Over the past 2 decades, hospitals have generally evolved to function with a “just-in-time” approach to the supply chain, where few supplies are warehoused on site, but instead are delivered regularly as they are used. The vulnerabilities in that approach had national and international implications during the COVID-19 pandemic, leading to shortages of medical supplies and devices and deviation from accepted standards for respiratory protection and use of other PPE. Healthcare systems must create supply caches, regularly review stockpile levels, and rotate supplies to ensure they are ready for use. For far-reaching events that exhaust national supply stocks, healthcare systems should include supply chain management plans in their EOP for rationing, allocating, and when necessary and appropriate reusing PPE and other supplies during a shortage. The COVID-19 pandemic exposed significant gaps in all levels of supply chain management, future emergencies could affect supply chain issues that were virtually untouched during this pandemic, including waste services and gas or other fuel supply. It is important that as facilities retool their emergency plans for resource management, these elements are not overlooked
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