Telemedicine-enabled Accelerated Discharge of Patients Hospitalized with COVID-19 to Isolation in Repurposed Hotel Rooms

摘要

Healthcare facilities, especially hospitals, are facing unprecedented degrees of demand on account of large and growing numbers of patients with coronavirus disease (COVID-19) requiring hospital admission. As recently witnessed in northern Italy ( ), when patient inflows exceed outflows, hospitals will be overwhelmed; the use of resources must be optimized to avoid this tipping point. Our viewpoint is that expansion of high-dependency unit and ICU capacity is best achieved by upgrading existing lower-dependency beds rather than by building field hospitals from scratch without the integrated complex infrastructure required for hospital-based care, including oxygen. This approach identifies a sort of “reverse triage,” which has already been used in other types of catastrophic events to increase the capacity of ICUs and emergency departments ( ), and could solve several problems, including diversion of mechanical ventilators and highly trained staff away from existing hospitals that are trying to expand their capacities to meet the surge in demand.