In the times of the Cold War, the provision of makeshift hospitals, also called auxiliary hospitals or emergency hospitals, was part of the legally obligatory precautions of the federal states with the support of the federal government. The basis for this in Germany is § 15 of the law on civil defense of 09 August 1976, which has already been replaced by a new version of 1997. In the currently valid version of the Civil Defense Act, there are no longer any requirements for the provision of auxiliary hospitals, although the current Corona situation shows that makeshift hospitals are needed more than ever to ensure medical care for the people.
Time and again, the media report on plans to build makeshift hospitals to physically separate Corona-infected people from other patients and thus reduce the spread of the infection. The German pioneer is Berlin, where a hospital is being built in the exhibition center. According to the project manager, a construction time of 15 to 20 days is assumed (German Press Agency 2020). The current dynamic circumstances of the situation, as well as the increasing number of infected people, therefore already require an increase in treatment and, above all, intensive care capacities. Only suitable makeshift hospitals can relieve the strained situation of the healthcare system in terms of space and personnel in the near future, and planning for these must take place promptly.
But what requirements must a makeshift hospital meet in times of Corona?
Suitable premises or areas to set up tents or containers must be identified. Characteristics of these are:
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- As much space as possible
- Possibility of spatial separation of the sick
- A demarcated area for testing suspects can be considered
- Good access and exit routes for rescue vehicles
- In the case of existing test areas, access and departure for private persons must be possible
- Floors and other room equipment must be as disinfectable as possible
The necessary medical equipment should include:
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- Beds in as large a number as possible, which is based on the number of patients expected to be treated
- Ventilation capabilities and intensive care equipment to care for persons with severe disease progression (Intensive care capacity must be provided in as large a number as possible to provide medical care for the increasing number of persons with severe disease progression)
- Sufficient oxygen supplies to ensure ventilation is provided
- Stockpiling of medical gases
- Sufficient stock of infection control clothing (infection control suits, face masks, disposable gloves,…)
- Sufficient stock of medical products, which are suitable for the treatment of corona symptoms, but also previously unknown symptoms
- Sufficient stock of medicines and arrangements with pharmacies
- Medical devices for diagnostics
The necessary technical equipment:
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- Heating and ventilation system (room air independent), ideally supporting black-white separation by extracting exhaust air from treatment facilities and introducing fresh air into low-contamination areas
- Hot and cold water supply
- IT (hardware and software)
Human Resources:
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- Medical and nursing staff, as well as administrative staff, are needed
- Staff must be trained in handling infected persons
- Management positions must be defined
- Technicians and IT experts are needed to ensure and maintain the functioning of the infrastructures
Planning aspects:
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- A risk analysis and hospital alarm and response plan must be prepared on short notice regarding the specifics of Corona and the handling of infected individuals
- Arrangements must be made with neighboring facilities to obtain personnel and supplies, but also to coordinate the routing of Corona suspects
- Food supply must be ensured
Feel free to contact us if you have been tasked with setting up a makeshift hospital and need help!
An article written by Anna Müller, published on 24 March 2020
Translated by Charlotte Ley
Literature:
German Press Agency (2020): COVID-19 hospital on fairgrounds to be ready to start quickly. Ed. by Deutsches Ärzteblatt. Available online at https://www.aerzteblatt.de/nachrichten/111173/COVID-19-Krankenhaus-auf-Messegelaende-soll-schnell-startklar-sein, last updated 03/19/2020, last checked 03/23/2020.