BACKGROUND: Planning for extreme surges in demand for hospital care of patients requiring urgent life-saving treatment for coronavirus disease 2019 (COVID-19), while retaining capacity for other emergency conditions, is one of the most challenging tasks faced by health care providers and policymakers during the pandemic. Health systems must be well-prepared to cope with large and sudden changes in demand by implementing interventions to ensure adequate access to care. We developed the first planning tool for the COVID-19 pandemic to account for how hospital provision interventions (such as cancelling elective surgery, setting up field hospitals, or hiring retired staff) will affect the capacity of hospitals to provide life-saving care.
METHODS: We conducted a review of interventions implemented or considered in 12 European countries in March to April 2020, an evaluation of their impact on capacity, and a review of key parameters in the care of COVID-19 patients. This information was used to develop a planner capable of estimating the impact of specific interventions on doctors, nurses, beds, and respiratory support equipment. We applied this to a scenario-based case study of 1 intervention, the set-up of field hospitals in England, under varying levels of COVID-19 patients. RESULTS: The Abdul Latif Jameel Institute for Disease and Emergency Analytics pandemic planner is a hospital planning tool that allows hospital administrators, policymakers, and other decision-makers to calculate the amount of capacity in terms of beds, staff, and crucial medical equipment obtained by implementing the interventions. Flexible assumptions on baseline capacity, the number of hospitalizations, staff-to-beds ratios, and staff absences due to COVID-19 make the planner adaptable to multiple settings. The results of the case study show that while field hospitals alleviate the burden on the number of beds available, this intervention is futile unless the deficit of critical care nurses is addressed first.
DISCUSSION: The tool supports decision-makers in delivering a fast and effective response to the pandemic. The unique contribution of the planner is that it allows users to compare the impact of interventions that change some or all inputs.
Bibliographical noteFunding Information:
P.C., J.C.D., A.L., R.M., N.S., S.N., P.N.P.-G., A.C.G., N.M.F., P.J.W., and K.H. acknowledge the MRC Centre for Global Infectious Disease Analysis
(reference MR/R015600/1), jointly funded by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth and Development Office
(FCDO), under the MRC/FCDO Concordat agreement and is also part of the EDCTP2 program supported by the European Union (EU). P.C., R.M., M.M., P.N.
P.-G., N.M.F., and K.H. also acknowledge the Abdul Latif Jameel Institute for Disease and Emergency Analytics, funded by the Abdul Latif Jameel Foundation.
N.M.F. and K.H. were also supported by the National Institute for Health Research (NIHR) HPRU in Modelling and Health Economics, a partnership between
Public Health England (PHE), Imperial College London and LSHTM (grant code NIHR200908). J.C.D. also acknowledges funding from the Wellcome Trust
(215193/Z/19/Z). N.S. also acknowledges funding from the Imperial College MRC Doctoral Training Partnership. P.A. is partially funded through a research
grant from Dr Foster Intelligence (a wholly owned subsidiary of Telstra Health) and through the NIHR PSTRC. P.A. also acknowledges support from the NIHR
under the Applied Health Research (ARC) program for North West London, and the Imperial NIHR Biomedical Research Centre. A.C.G. and N.M.F.
acknowledge additional COVID-19 funding from the Wellcome Trust and FCDO. D.R. acknowledges funding from Imperial College Business School. S.N. is
also partially supported by NIHR Imperial Biomedical Research Centre funding.
The views expressed are those of the authors and not necessarily those of the United Kingdom Department of Health and Social Care, EU, FCDO, MRC, National
Health Service, NIHR, or PHE. The funding bodies had no role in the design of the study, analysis and interpretation of data and in writing the manuscript.
Open Access: This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Publisher Copyright: Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.
Citation: Christen, Paula MSc; D’Aeth, Josh C. MRes; Løchen, Alessandra MSc; McCabe, Ruth MSc; Rizmie, Dheeya MRes; Schmit, Nora MSc; Nayagam, Shevanthi PhD; Miraldo, Marisa PhD; Aylin, Paul MBChB; Bottle, Alex PhD; Perez-Guzman, Pablo N. MD; Donnelly, Christl A. ScD; Ghani, Azra C. PhD; Ferguson, Neil M. DPhil; White, Peter J. PhD; Hauck, Katharina PhD. The J-IDEA Pandemic Planner, Medical Care: May 2021 - Volume 59 - Issue 5 - p 371-378
- adult critical care
- critical care
- health systems capacity
- hospital capacity
- hospital provision interventions
- pandemic response