Critical Care Surge Response Strategies for the 2020 COVID-19 Outbreak in the United States¶
Abir, M., Nelson, C., Chan, E., Al-Ibrahim, H., Cutter, C., Patel, K., & Bogart, A. (2020). Critical Care Surge Response Strategies for the 2020 COVID-19 Outbreak in the United States.
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Primes¶
- Vulnerability Decomposition
- The identical procedure transfers to a hospital assessing its vulnerability to a respiratory pathogen: exposure is staff-and-patient density and ward layout, sensitivity is the immunocompromised-patient share, adaptive capacity is PPE stock plus surge beds plus reserve staffing — and which term binds is contested rather than settled, since a national review of COVID-19 crisis standards of care found the constraint to be staffing rather than physical beds while a modelling study of United States critical-care surge found ventilators the limiting factor in most estimates and explicitly not nurses, respiratory therapists, or beds; the factorisation says where to look for the constraint, not which factor will turn out to bind.
This sourceCONTRADICTS the staffing-as-binding-term reading: "In the majority of estimates for the United States, ventilators are the limiting factor … in no case is the number of nurses, respiratory therapists, or beds the limiting factor." Ventilators are not among the adaptive-capacity items this entry lists, so the disagreement is partly about how the factors are populated.
- The identical procedure transfers to a hospital assessing its vulnerability to a respiratory pathogen: exposure is staff-and-patient density and ward layout, sensitivity is the immunocompromised-patient share, adaptive capacity is PPE stock plus surge beds plus reserve staffing — and which term binds is contested rather than settled, since a national review of COVID-19 crisis standards of care found the constraint to be staffing rather than physical beds while a modelling study of United States critical-care surge found ventilators the limiting factor in most estimates and explicitly not nurses, respiratory therapists, or beds; the factorisation says where to look for the constraint, not which factor will turn out to bind.
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