Mass Hospital Evacuation During COVID-19 Pandemic: Experience of Hospital Cluster Infection in Taiwan

Abstract

Introduction:A mass hospital evacuation occurred in Taiwan in 2021 due to the clustered COVID-19 infection in Hospitals. To maintain essential services with limited manpower, 74 patients are triaged and evacuated to 12 hospitals in 6 cities in 16 hrs for further treatment.Method:All patients were evaluated by physicians for discharge. The patients who still needed hospitalization were classified into three groups according to the risk of infection1. The high-risk group of patients were cared for by infected staff directly; the moderate-risk group were patients admitted to the same ward but didn’t receive care from infected staff. The low-risk group were patients avoiding infection outbreak. Only the low-risk group patients were transferred, excluding patients with unstable vital signs, hospice, and prison. Command Center of HICS of TGH set up a transfer execution team to handle this task.Results:There were 74 patients transferred, including 56 from internal medicine and 18 from the surgery ward. Most of the transfers are concentrated within 16 hours. These patients were transferred to 12 emergency hospitals in 6 cities. The average transport time was 1.5 hours and the longest was about 3 hours due to the distance and traffic.The 17 private ambulances and 11 Fire Department ambulances were dispatched and transferred 60 patients. In addition, there were 14 patients evacuated by small buses. No mortality or COVID-19 infection had been reported within 3 days after this mass evacuation, only one patient had been intubated after one hour of arrival to hospital due to condition deterioration.Conclusion:A hospital evacuation is a complicated process, especially during a pandemic. All infection control measures create difficulties in the patient transfer process. Well-prepared evacuation plans, regular drills, well-trained personnel, an organized command system, and regional cooperation are the keys to mass evacuation in a disaster.