I Lived Through China’s Coronavirus Crisis. Here’s What Western Hospitals Should Know.
As coronavirus cases rose in countries around the world, China was on its way to recovery. In this post, a medical planner who lives in Shanghai offers three ideas for healthcare systems in other parts of the world to consider based on China's learnings. This piece was written by Huifang Hu.
On a global scale, we are witnessing three critical shortages during the coronavirus pandemic: beds, staff and personal protective equipment (PPE). Yet as cases rise in countries around the world—from Spain to the US—China is on its way to recovery. As a medical planner who lives in Shanghai, here are three ideas to consider for healthcare systems in other parts of the world based on what we’ve learned here.
Add more patient beds rapidly via temporary hospitals for milder cases
With countries like the US just now establishing temporary hospitals to fight the coronavirus, China deployed this method on a rapid scale. Officials asked permanent hospitals to focus on the 20% most critical patients and temporary hospitals to care for the remaining 80% of patients with milder illness. In addition, healthcare experts established a series of building design and medical best practices. To meet the surge of patients, the Chinese government built temporary hospitals across the country, including two major facilities in Wuhan: Huoshenshan Hospital and Leishenshan Hospital with 2,500 beds. They also sent 40,000 top doctors and nurses to operate them and support the city.
Medical team leaders shared their experience about infection control in Wuhan and developed guidelines [Mandarin at the top, English below] that address site selection, architectural requirements, detailed workflows and even how to recycle some PPE like protection goggles in a worst-case scenario. The temporary hospitals—some which are now closed as coronavirus cases have declined in the country—are based off of mobile military medical systems and organized around three types of distinct areas: clean, semi-clean and contaminated spaces. They also feature separate circulation for medical staff and patients. In addition, China officials also converted hotels, dorms, stadiums and exhibition centers into temporary hospitals as well, as other countries are now doing to meet this critical need.
Use multi-bed units on hospital floors to save resources
While isolating coronavirus patients in separate rooms may be ideal depending on a healthcare system’s unique needs and real estate portfolio, many hospitals are increasingly short on crucial resources, like space. Grouping individuals diagnosed with the coronavirus together in multi-bed units on a hospital floor—or in other buildings entirely—can maximize space, with the ability to fit more beds into an area. A multi-bed unit can also help medical staff efficiently monitor patients’ conditions at one time and potentially reduce nursing staff, giving healthcare workers better sightlines to patients. This strategy may also save equipment, as healthcare staff don’t have to change their PPE as often if they are working only with coronavirus patients in a designated area—unlike isolation rooms distributed on different levels of a hospital that require medical staff to put on and take off their PPE when entering and exiting single patient rooms.
Separate suspected and diagnosed coronavirus patients for efficient treatment
While temporary sheltered screening areas outside of hospitals, such as triage tents, are the new norm across healthcare facilities, many hospitals in Asia also benefit from designated “fever clinics” that were recently repurposed for coronavirus testing. This is a permanent space that allows medical staff to screen people with fever-causing illnesses like the flu—and divert them without entering the emergency department. These types of facilities could be considered and implemented in other countries for future pandemics and more typical cases like the flu, not only as part of new hospital projects, but also as additions to existing ones. In Shanghai, positive cases are then funneled to the Shanghai Public Health Clinic Center, a specialty infectious disease hospital outside the city.
While the outcome of the coronavirus is uncertain, it is different than other viruses we’ve faced in the past, such as SARS and MERS. As countries around the world respond to the coronavirus pandemic—with peaks in many countries including the US predicted for April—we hope these takeaways help our peers across the world conquer this great challenge.