Experts: We need to be better prepared for next crisis
Despite knowing for decades that a global pandemic was on the horizon, “we’ve done pretty much everything wrong” when it came to preparing the U. S. public health infrastructure, Yale School of Public Health Dean Sten Vermund said.
“This pandemic highlighted and emphasized that the degree of planning was not nearly enough and did not penetrate to the levels that were required,” said Dr. Dan Hanfling, an emergency room physician in Virginia who has worked with Connecticut’s Department of Public Health on past planning.
Among the improvements likely to come from the coronavirus is increased collaboration between hospitals before a crisis begins, said Dr. Ajay Kumar, Hartford HealthCare’s chief clinical officer. “It has to be a joint, concerted effort,” he said. “I would imagine the same philosophy and thinking will prevail for a long, long time to come.”
Jim Paturas, who directs Emergency Management for Yale New Haven Health, said conversations about setting up and staffing field hospitals will likely be a bigger part of future planning, as well as about “how much supplies and equipment is reasonable for an organization to stockpile,” he said.
He said health care providers outside of hospital systems, like long- term care facilities and EMS agencies, also “seem to get lost in the shuffle.”
Paturas and Kumar said allowing employees with credentials for one facility to work in other locations during the crisis will also take on a larger role in future planning.
As hospitals and states face increasing demand for health care, it’s clear that an “evidence- based support tool” to guide decisions on allocating limited resources is needed, Hanfling said. While rationing of care hasn’t happened yet, anticipating that it might has highlighted how doctors don’t have a standardized way to make decisions like who should have access to a ventilator or ICU bed if there aren’t enough.
That planning also needs to include more input from doctors, nurses, and the people making decisions at patients’ bedsides, not just those looking at theoretical situations and legal frameworks, he said.
“Let’s take things as seriously as these things should be taken, and then maybe we won’t have an event that reminds us of the Great Depression,” Vermund said, “which is going to cost us a lot more in the long run than if we had stood up the billions to support our public health infrastructure to save the trillions and the 50 percent unemployment that we’re seeing in the near future.”