Disaster Planning During a COVID-19 Outbreak

This document will be regularly updated and will change with progression of the outbreak. We will highlight information and advice specific to our members alongside ongoing work with the Royal College of Anaesthetists, the Faculty of Intensive Care Medicine and the ICS towards joint coordinated information.

Last updated Thursday 2 April 2020. 

Given the situation in China and the escalating situation in Italy where intensive care resources have been rapidly overwhelmed there is a need for having adaptable frameworks for the staged escalation of the ICU foot print across the hospital and a framework for shared decision making for institutions for the best use of resources including triage for organ support and the discontinuation of life sustaining therapy as chances of survival for a patient falls.

Surge planning

Anaesthesia departments are anticipated to be vital in the surge response and should begin immediate planning to expand and assist in the management of patients outside of the footprint of critical care.

The NHS England has advised to:

“Review your critical care and high dependency capacity and consider how you could increase capacity and the impact of doing so.” 

Many intensive care units will have surge planning frameworks which were last tested during the H1N1 outbreak.

Attention to enabling expansion of the level 2 and 3 footprint of the ICU at short notice. This may involve utilization of members of available skilled ICU staff supervising cohorts of less experienced staff. Utilisation of transfer ventilators and theatre anaesthetic rooms and theatres suites.

Stock levels

Although drug and equipment shortages might be anticipated with an escalating outbreak, stock levels should be proportionate for short term demand needs and stockpiling is not acceptable as this transfers strain to the supply chain and to the rest of the NHS.

Consideration of remanufacture/reuse of essential equipment may be necessary in the future if supply chains become critically compromised.