Abstract

New York City hospitals expanded resources to an unprecedented extent in response to the COVID pandemic. Thousands of beds, ICU beds, staff members, and ventilators were rapidly incorporated into hospital systems. Nonetheless, this historic public health disaster still created scarcities and the need for formal crisis standards of care. These were not available to NY clinicians because of the state’s failure to implement, with or without revision, long-standing guidance documents intended for just such a pandemic. The authors argue that public health plans for disasters should be well-funded and based on available research and expertise. Communities should insist that political representatives demonstrate responsible leadership by implementing and updating as needed, crisis standards of care. Finally, surge requirements should address the needs of both those expected to survive and those who will not, by expanding palliative care and other resources for the dying.

摘要

为了应对COVID流行病，纽约市的医院将资源扩展到了前所未有的水平。数以千计的病床，ICU病床，工作人员和呼吸机迅速纳入了医院系统。尽管如此，这场历史性的公共卫生灾难仍然造成了人员稀缺和对正规危机护理标准的需求。纽约州的临床医生无法使用这些指南，因为该州未能执行旨在修订此类流感大流行的长期指导文件。作者认为，应对灾害的公共卫生计划应有充足的资金，并应基于现有的研究和专业知识。社区应坚持要求政治代表通过根据需要实施和更新护理危机标准来表现负责任的领导。最后，