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

Abstract

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.

The Emergency Medicine Education and Research by Global Experts (EMERGE) Network: Challenges and Lessons Learned

“…By leveraging the EMERGE network, many more sites were recruited via referrals and direct solicitation, and all participants who were approached agreed to participate in the study. 7 This supports the notion that EDs across the globe want to participate in endeavors to generate evidence.…”

Construction of a 5G-based, three-dimensional, and efficiently connected emergency medical management system

“…The COVID-19 outbreak has reminded us of the importance of telemedicine in medical services provision, especially as a tool to reduce the risk of cross-infection caused by close contact [ 16 ]. Similar to most emergency departments, we are also facing the challenges of the pandemic [ 6 , 17 ]. Also, like the emergency departments in other hospitals, we have developed a stringent triage process to avoid nosocomial infections [ 18 , 19 ].…”

Federated data health networks hold potential for accelerating emergency research

“…The COVID pandemic further underscored the ongoing need for nimble, multi‐centered, multi‐disciplinary, collaborative approaches to understand the rapidly evolving epidemiology of the virus, and assess the impact, efficacy, and effectiveness of various operational and therapeutic interventions. Our recent work on COVID's impact on diagnostic delays across 14 EDs in Michigan 3 and a survey on the impact of COVID on provider burnout and innovation across 74 EDs in 28 countries 4 has revealed that EDs are willing to commit site resources to contribute data for research in emergency care. To overcome the shortcomings of centralized data approaches, a distributed/de‐centralized approach called federated data health networks (FDHN) has been successfully deployed in COVID research; this has opened the potential for similar approaches to emergency care network‐based research 5,6 …”