Shortfalls to the Healthcare System and Recommendations During the COVID-19 Crisis

Critical Shortages in the Healthcare System

The COVID-19 pandemic has pushed healthcare systems Commentary

around the world into unprecedented times. Healthcare systems have struggled with increased patient levels requiring intensive care; reports have shown hospitals in need of life-saving equipment and manpower. Medical Association of Critical Care physicians claimed that the COVID-19 pandemic would strain the 29,000 intensive-care- trained physicians. New York hospitals have gone as far as mandating dermatologists and other specialty physicians in helping fight COVID-19 [5].

Recommendations: Recognizing this unparalleled situation, governments and institutions have moved to inhibit non-essential travel across borders and canceling many conferences and events to slow down the spread of infection and ease the stress on healthcare systems [6]. Due to the strain on healthcare systems, states such as New York and New Jersey have moved to increase their healthcare workforce by suspending red-tape requirements and making it easier for foreign medical graduates to join the struggle. Connecticut has requested retired healthcare workers return to the workforce while medical schools in New York have expedited graduation for fourth year students. With increasingly worrying trends of medical workers falling ill, these measures are to ensure an adequate workforce.

Healthcare Systems at a Maximum Capacity

Due to the current number of patients admitted to the ICU, linear and exponential models have calculated the number of patients needing ICU beds will exceed total ICU capacity [7]. Many hospitals worldwide are already facing shortages. It would be a great challenge for healthcare providers to deliver the best care to the patients when there is a clear shortage of ICU facilities, beds, and personal protective equipment (PPE). Along with ventilators and ICU beds, there is an extreme shortage of PPE for frontline healthcare workers that include masks, face shields, gloves, gowns, hand sanitizers, and respirators [8].

Recommendations: In order to contain the anticipated shortages faced by the healthcare system due to the COVID-19 virus, the federal government has moved to provide mobile health units in New York. Such field hospitals are located at the Javits Center and in Central Park; the former was built in a matter of days and accounts for an additional 4,000 beds [9, 10]. Furthermore, providing a centralized emergency task force has ameliorated an already saturated health care system. Hospitals have been able to quell a pandemic of insurmountable portions through the use of established criteria. During this time, the CDC advised the government to put in place every measure, such as reinforcing public health measures of quarantine and self-isolation, to contain the virus [6]. Increasing laboratories testing along with the use of PPE early on could avert unintentional cross-contamination within the population. Additional resources include a cohesive collaborative effort of multinational emergency forces that would be vital in combating this pandemic.

Support the Healthcare Workforce in Delivering High-Quality Care

Some of the logistic problems confronted by healthcare workers in care deliverance include proper wearing of PPE and lack of healthcare equipment. The highest priority for all healthcare workers exposed to patients with respiratory symptoms is PPE. Barrier precautions are considered one of the most important preventive measures. Due to the limited availability of resources, such as N95 masks, it is important to highlight that protection is similarly achievable with regular surgical or medical masks applied to both the healthcare worker and patient. The CDC recommends that strict prioritization of the use of PPE be implemented to help ensure an adequate quantity remains for the treatment of high-risk patients [11]. In instances where face masks are not readily available, CDC recommends the use of face shields without masks, removing clinicians at high-risk of COVID-19 from their clinical service temporarily, and the use of handmade masks made from bandanas and scarves.

The members of the healthcare workforce in the battle against COVID-19 have been under immense emotional pressure. Performing work duties with full protective gear can be tiresome and can result in injury and bruising if worn for long periods of time. This, along with the stress of higher risk of disease contraction and caring for co-workers who are infected can result in tremendous distress to healthcare workers. In Singapore, the Prime Minister has been playing an active role in boosting morale and showing their support to frontline workers by listening and personally addressing any concerns or challenges they may be facing to ensure that any difficulties are addressed immediately [12].

Ethical Approval

Not applicable as no live participants or samples were involved while producing this manuscript.