Rapidly Organize Redeployed Medical Staff in Coronavirus Disease 2019 Pandemic: What We Should Do

The coronavirus disease 2019 (COVID-19) pandemic has emerged as a global health crisis, necessitating urgent and effective responses from healthcare systems worldwide. Healthcare workers are at the forefront of this battle, yet the rapid spread of the virus has led to severe shortages of medical personnel during peak periods. To manage infected patients and prevent further transmission, adequate staffing is essential. This article outlines the strategies employed in Wuhan, China, which can serve as a model for organizing and redeploying medical staff during such emergencies.

Central and Local Government’s Role in Immediate Response

The Chinese government played a pivotal role in the immediate response to the COVID-19 outbreak. The centralized coordination of the medical system enabled a swift and effective reaction to the public health emergency. A massive redeployment of healthcare professionals from across the country was orchestrated to support Wuhan, the epicenter of the outbreak. By March 4, 2020, approximately 43,000 medical staff from various regions had been assigned to hospitals in Hubei province, the hardest-hit area.

The mobilization and transfer of medical staff were entirely government-led. A general anti-epidemic headquarters was established in Wuhan to oversee the operation. This headquarters determined the number of medical workers to be mobilized, the quantity of medical equipment required, and the types of hospitals to be utilized. Medical staff from other provinces took over the management of patients in local hospitals in Wuhan and Hubei province. For instance, on New Year’s Eve, the first batch of Shanghai experts was dispatched to Wuhan Jinyintan Hospital within four hours of receiving their assignment. They arrived in Wuhan at midnight, received training on infection prevention and control the next day, and set up a new intensive care unit ward for COVID-19 patients on the third day.

Interim medical teams, often comprising more than 100 members, were rapidly organized within one or two days. This process included determining the personnel list, preparing medical materials, and gathering the staff to depart for Wuhan. Such high-efficiency organization significantly saved time and was instrumental in managing the surge of patients during the peak of the outbreak.

Importance of Personal Protective Equipment (PPE)

Healthcare workers are at significant risk of infection during highly virulent outbreaks. Ensuring that medical staff have sufficient personal protective equipment (PPE) is crucial for their safety and for preventing the spread of the virus. Governments and hospitals took responsibility for supplying PPE to medical teams, ensuring that all personnel managing COVID-19 patients were well-protected.

The goal of hospital infection prevention and control was to achieve “zero infection” among medical staff. Several measures were implemented to this end. First, comprehensive training was provided to medical staff, particularly since many were from different professional departments and lacked experience in infectious disease prevention and control. Special training sessions were organized on how to properly don and doff protective clothing. Second, the supply of frontline medical materials, including PPE, was prioritized. Despite the initial shortage of medical protection supplies, governments and hospitals made concerted efforts to meet the demand. Third, continuous supervision of infection prevention measures was maintained. Hospital prevention and control personnel supervised medical processes, and medical staff reminded each other during the donning and doffing of PPE.

These efforts paid off, as all medical staff supporting Wuhan were evacuated safely in April, with nucleic acid and antibody tests confirming the achievement of the “zero infection” goal.

Medical Teams: Size and Resiliency

Each redeployed medical team typically consisted of 130 to 140 members, enabling them to independently manage a single department in Wuhan hospitals. The Chinese authorities assigned an administrative leader to each team, responsible for supplies, daily life, and the safety of team members. Senior physicians oversaw medical care, while hospital infection experts supervised personal protection.

Most medical teams were temporarily established, with members coming from different hospitals and departments, often as strangers to one another. Effective teamwork required excellent leadership and coordination from team leaders, who had rich management experience. Leaders quickly assessed the expertise of their members and assigned them to appropriate roles. Additionally, there was collaboration between different medical teams, including mutual support of protective materials, case discussions, and the exchange of treatment experiences.

Communication: A Key Element for Team Effectiveness

Frontline medical staff in Wuhan faced numerous challenges, including missing their families, worrying about infection, and potential shortages of protective equipment. Psychological support was crucial during this highly stressful period. A survey of 450 medical staff revealed that while over 90% were willing to participate in the fight against the epidemic, more than 80% were worried about being infected, and 30% experienced sleep disorders.

To address these concerns, medical teams regularly held meetings, and psychological experts provided counseling. Special books were printed, and psychological service hotlines were established to help alleviate the pressure on medical staff.

Minimizing Shift Length

Extended periods of wearing PPE can lead to excessive fatigue. To mitigate this, each nurse’s shift was limited to 4 to 6 hours, with 4 hours being encouraged. Special logistics teams were deployed to assist with the daily needs of medical staff. Shortening continuous working hours helped protect the health of medical staff, ensured work efficiency, and improved the quality of medical care.

Acknowledging the Efforts of Medical Staff

The hard work of medical staff on the frontlines was widely reported by the media, which expressed appreciation and admiration for their efforts. Local governments and hospitals also showed their support by providing bonuses and taking care of the families of frontline workers. After completing their assignments in Wuhan, medical staff were given vacation time to rest and recover.

Conclusion

The coordinated response of the Chinese medical system to the COVID-19 pandemic highlights the importance of scientific deployment of medical staff in managing public health emergencies. The strategies employed in Wuhan, including rapid organization of medical teams, ensuring sufficient PPE, effective communication, psychological support, and minimizing shift lengths, provide valuable lessons for other regions facing similar challenges. Future research should focus on resolving shortages and properly redeploying medical staff during pandemics.

doi.org/10.1097/CM9.0000000000001033

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