Israeli underground hospital conversion for treating COVID-19 patients

Authors

  • Michal Halberthal, MD, MHA
  • Gidon Berger, MD
  • Khetam Hussein, MD
  • Shimon Reisner, MD, MHA
  • Michal Mekel, MD
  • Netanel A. Horowitz, MD
  • Yael Shachor-Meyouhas, MD
  • Yuval Geffen, PhD
  • Gila Hyams, RN
  • Rafael Beyar, MD, DSc

DOI:

https://doi.org/10.5055/ajdm.2020.0371

Keywords:

COVID-19, emergency drills, fortified underground hospital

Abstract

Objective: This paper describes how a large academic medical center solved the challenges of war preparedness and subsequently adapted them for the COVID-19 pandemic.

Setting: A 1,000-bed academic medical center in Northern Israel has faced two extreme challenges since 2006: operating under missile attack during the 2006 Second Lebanon War, and rapid establishment of a scalable infrastructure for COVID-19 patients. The first challenge led to construction of a dual-use facility: a parking lot during peacetime, and a fully functioning fortified underground emergency hospital (FUEH) in times of emergency. Several drills have confirmed readiness for various scenarios including conventional and unconventional warfare, and treating isolated patients during the Ebola and SARS threats.

Results: The hospital achieved preparedness for patient care during the COVID-19 pandemic, including all facilities and personnel, including infrastructure, laboratories, and innovations, to maintain standard patient care and separate COVID-19 treatment facilities. The hospital’s second challenge represented by the COVID-19 pandemic led to adaptation of the FUEH as a key strategic facility in Northern Israel for treating hundreds of COVID-19 patients. Each solution was supported by innovations targeted for specific purposes and needs.

Conclusions: The function and unique mechanisms used to leverage use of a dual facility was proven viable for several emergency conditions, including the COVID-19 pandemic. Infrastructure and technological flexibility is essential when planning for handling different emergencies situations.

Author Biographies

Michal Halberthal, MD, MHA

Hospital Management, Rambam Health Care Campus, Haifa, Israel; The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

Gidon Berger, MD

Hospital Management, Rambam Health Care Campus, Haifa, Israel; The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Department of Internal Medicine "B," Rambam Health Care Campus, Haifa, Israel

Khetam Hussein, MD

The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Infection Control Unit, Rambam Health Care Campus, Haifa, Israel

Shimon Reisner, MD, MHA

MIDGAM-Israel National Biobank for Research, Weizmann Institute for Science, Rehovot, Israel

Michal Mekel, MD

Hospital Management, Rambam Health Care Campus, Haifa, Israel

Netanel A. Horowitz, MD

Hospital Management, Rambam Health Care Campus, Haifa, Israel; The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel

Yael Shachor-Meyouhas, MD

Hospital Management, Rambam Health Care Campus, Haifa, Israel; The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Pediatric Infectious Disease Unit, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa, Israel

Yuval Geffen, PhD

Hospital Management, Rambam Health Care Campus, Haifa, Israel; Division of Clinical Laboratories, Rambam Health Care Campus, Haifa, Israel

Gila Hyams, RN

Nursing Management, Rambam Health Care Campus, Haifa, Israel

Rafael Beyar, MD, DSc

Hospital Management, Rambam Health Care Campus, Haifa, Israel; The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

References

Bar-El Y, Michaelson M, Hyams G, Skorecki K, Reisner SA, Beyar R: An academic medical center under prolonged rocket attack—organizational, medical, and financial considerations. Acad Med. 2009; 84(9): 1203–1210. DOI: 10.1097/ACM.0b013e3181b18bd6.

Bar-El Y, Reisner S, Beyar R: Moral dilemmas faced by hospitals in time of war: The Rambam Medical Center during the second Lebanon war. Med Health Care Philos. 2014; 17(1): 155–160. DOI: 10.1007/s11019-013-9517-x.

Haverkort JJ, de Jong MB, Foco M, et al.: Dedicated mass-casualty incident hospitals: An overview. Injury. 2017; 48(2): 322–326. DOI: 10.1016/j.injury.2016.11.025.

Hick JL, Penn P, Hanfling D, et al.: Establishing and training health care facility decontamination teams. Ann Emerg Med. 2003; 42(3): 381–390. DOI: 10.1016/s0196-0644(03)00442-6.

Ong SWX, Tan YK, Chia PY, et al.: Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient. JAMA. 2020; 323(16): 1610-1612. DOI: 10.1001/jama.2020.3227.

Yung CF, Kam KQ, Wong MSY, et al.: Environment and personal protective equipment tests for SARS-CoV-2 in the isolation room of an infant with infection. Ann Intern Med. 2020; 173: 240–242. DOI: 10.7326/M20-0942.

He X, Lau EHY, Wu P, et al. Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. 2020; 26: 672–675. DOI: 10.1038/s41591-020-0869-5.

Zhuang Z, Zhao S, Lin Q, et al.: Preliminary estimates of the reproduction number of the coronavirus disease (COVID-19) outbreak in Republic of Korea and Italy by 5 March 2020. Int J Infect Dis. 2020; 95: 308-310. DOI: 10.1016/j.ijid.2020.04.044.

Guan WJ, Ni ZY, Hu Y, et al.: Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020; 382: 1708–1720. DOI: 10.1056/NEJMoa2002032.

Grasselli G, Pesenti A, Cecconi M: Critical care utilization for the COVID-19 outbreak in Lombardy, Italy: Early experience and forecast during an emergency response. JAMA. 2020; 323: 1545–1546. DOI: 10.1001/jama.2020.4031.

World Health Organization: Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). Available at https://www.who.int/docs/default-source/coronaviruse/who-chinajoint-mission-on-covid-19-final-report.pdf. Accessed May 13, 2020.

Feldman O, Meir M, Shavit D, et al.: Exposure to a surrogate measure of contamination from simulated patients by emergency department personnel wearing personal protective equipment. JAMA. 2020; 323(20): 2091–2093. DOI: 10.1001/jama.2020.6633.

Yelin I, Aharony N, Shaer Tamar E, et al.: Evaluation of COVID- 19 RT-qPCR test in multi-sample pools. Clin Infect Dis. 2020; DOI: 10.1093/cid/ciaa531. [Epub ahead of print]

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Published

10/01/2020

How to Cite

Halberthal, MD, MHA, M., G. Berger, MD, K. Hussein, MD, S. Reisner, MD, MHA, M. Mekel, MD, N. A. Horowitz, MD, Y. Shachor-Meyouhas, MD, Y. Geffen, PhD, G. Hyams, RN, and R. Beyar, MD, DSc. “Israeli Underground Hospital Conversion for Treating COVID-19 Patients”. American Journal of Disaster Medicine, vol. 15, no. 3, Oct. 2020, pp. 159-67, doi:10.5055/ajdm.2020.0371.

Issue

Vol. 15 No. 3 (2020): Summer

Section

Articles

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