A Global Survey of Emergency Department Responses to the COVID-19 Pandemic

• DOI: 10.5811/westjem.2021.3.50358
• Publication Date: 2021-09-13T23:33:31Z
• Authors: Prashant Mahajan; Chong Shu-Ling; Camilo Gutierrez; Emily White; Benjamin Cher; Elizabeth Freiheit; Apoorva Belle; Johanna Kaartinen; Vijaya Arun Kumar; Paul Middleton; Chip Jin Ng; Daniel Osei-Kwame; Dominik Roth; Tej Prakash Sinha; Sagar Galwankar; Michele Nypaver; Nathan Kuppermann; Ulf Ekelund
• Keywords: SURGE; Pandemic; RC86-88.9; SARS-CoV-2; Global Pandemic Preparedness; Surgery, anesthesiology, intensive care, radiology; R; COVID-19; Medical emergencies. Critical care. Intensive care. First aid; Global Health; 3. Good health; 03 medical and health sciences; Cross-Sectional Studies; 0302 clinical medicine; Emergency Medicine; Medicine; Humans; Endemic Infections; Triage; Emergency Service, Hospital; COVID 19; Pandemics

Introduction: Emergency departments (ED) globally are addressing the coronavirus disease 2019 (COVID-19) pandemic with varying degrees of success. We leveraged the 17-country, Emergency Medicine Education & Research by Global Experts (EMERGE) network and non-EMERGE ED contacts to understand ED emergency preparedness and practices globally when combating the COVID-19 pandemic.

Methods: We electronically surveyed EMERGE and non-EMERGE EDs from April 3–June 1, 2020 on ED capacity, pandemic preparedness plans, triage methods, staffing, supplies, and communication practices. The survey was available in English, Mandarin Chinese, and Spanish to optimize participation. We analyzed survey responses using descriptive statistics.

Results: 74/129 (57%) EDs from 28 countries in all six World Health Organization global regions responded. Most EDs were in Asia (49%), followed by North America (28%), and Europe (14%). Nearly all EDs (97%) developed and implemented protocols for screening, testing, and treating patients with suspected COVID-19 infections. Sixty percent responded that provider staffing/back-up plans were ineffective. Many sites (47/74, 64%) reported staff missing work due to possible illness with the highest provider proportion of COVID-19 exposures and infections among nurses.

Conclusion: Despite having disaster plans in place, ED pandemic preparedness and response continue to be a challenge. Global emergency research networks are vital for generating and disseminating large-scale event data, which is particularly important during a pandemic.