Disaster plan implemented in the Covid-19 pandemic - actions, results and lessons learned

• Grant number: 20/12143-4
• Support Opportunities: Research Grants - Research in Public Policies
• Start date: March 01, 2021
• End date: February 28, 2023
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Agreement: CNPq - PPSUS
• Principal Investigator: Eloisa Silva Dutra de Oliveira Bonfá
• Grantee: Eloisa Silva Dutra de Oliveira Bonfá
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil
• Associated researchers: Amanda Cardoso Montal ; Anna Miethke Morais ; Edivaldo Massazo Utiyama ; Fabiane Yumi Ogihara Kawano ; Fernanda Harumi Misumi Castanheira ; Izabel Oliva Marcilio de Souza ; Leila Suemi Harima Letaif ; Luciana Bertocco de Paiva Haddad ; Maria Amélia de Jesus Nogueira ; Maria Beatriz de Moliterno Perondi ; Paulo Francisco Ramos Margarido ; Rossana Pulcineli Vieira Francisco ; Solange Regina Giglioli Fusco ; Suze Maurem Jacon

Abstract

The rapid expansion of the COVID-19 pandemic in the world caused the need to adopt new strategies for the organization of health systems and services. In a scenario where the demand quickly exceeded the usual capacity of health services, especially in relation to beds in intensive care units (ICU), there was an urgent need to increase this structure and offer it to the network. In this context, on January 29, 2020, the Hospital das Clínicas of the Faculty of Medicine of the University of São Paulo (HCFMUSP) activated its Disaster Plan to face the pandemic. With the progressive increase in the number of cases in São Paulo, the Crisis Committee of HCFMUSP decided to isolate its Central Institute (ICHC) to serve these patients. Thus, 300 exclusive ICU beds were mobilized for cases of COVID-19, which corresponds to 10% of the total ICU beds for this purpose in the public health network in the city of São Paulo. From March 30 (date that marked the beginning of this movement) until July 31, 2020, more than 3,900 suspected cases of COVID-19 were treated at the ICHC. It is possible and desirable to make a thorough review of the disaster response that has been implemented. Although the primordial role of the strategy adopted by the HCFMUSP Crisis Committee in the response and containment of the epidemic by COVID-19 in the state is notorious, it is essential that this strategy is documented and evaluated in a systematic way. This review after the most critical months of the epidemic in São Paulo will allow the effectiveness of the strategies adopted to be considered, as well as the limitation of others, identifying those that should be incorporated into the Disaster Plan for future confrontations. Thus, this project aims to analyze the Disaster Plan implemented at HCFMUSP in the context of the COVID-19 epidemic, the results obtained from different perspectives (activation, service management in the context of capacity expansion, quality of care, comparative analysis with Plans tertiary university hospitals) and the limitations faced. The study is the report of the implementation of the HCFMUSP Disaster Plan, based on the review of meeting minutes, reports and documents produced, as well as the experience of the proponents - members of the HCFMUSP Crisis Committee, in addition to the quantitative analysis of epidemiological data and assistance. The epidemiological description of suspected cases of COVID-19 will be made based on information from the epidemiological surveillance center and the institutional database - COVID-19 from HCFMUSP. All suspected cases of COVID-19 admitted to the ICHC between March 30 and July 31, 2020 will be included in the study. The analysis of the impact of the Disaster Plan on the health network of the State of São Paulo will be made based on the analysis of CROSS System regulation data. The study will enable a systematic and detailed description of all stages of planning and implementing the Disaster Plan in response to the COVID-19 pandemic in a university hospital in the state of São Paulo. From the results found, a technical document will be produced incorporating the prevention and mitigation strategies found to support the activation of the Disaster Plan at future times. In addition, the comparison of the different response strategies implemented by different university hospitals will allow the proposal of a model for structuring large hospitals for pandemics based on the best results obtained. (AU)