The Lessons Learned of The Public Health Surge Capacity in the COVID -19 Pandemic Situation in Bangkok Metropolitan and perimeter Region

Abstract

The study of public health surge capacity in the COVID-19 outbreak aimed to develop policy recommendation for recurrence of the outbreak using the 4S framework for mobilization in emergencies: (1) space, (2) staff, (3) supplies, and (4) system, that assessed in 3 phases: (1) preparation period, (2) pandemic period, and (3) recovery period. Twenty key informants were selected using purposive approach. The research tool was a structured interview. Data were collected and analyzed using focus group discussion and content analysis respectively.

The results revealed the 4S framework for mobilization in emergencies: (1) preparation period: prepare space and staff by reducing non-COVID-19 services and acquiring negative pressure isolation rooms. Preparation of supplies composed of increasing the reserve period and accepting donations. Preparation of system included adopting the 2009 influenza and the Middle East Respiratory Syndrome outbreak response plans. (2) pandemic period: managing space through reduced non-COVID-19 services, established the ARI Clinic, renovated the patient units to be cohort wards, escalated negative pressure isolation rooms and make a hospitel to accommodate the green patients. Managing staff consisted of mobilizing doctors, nurses and personnel from all departments, arranging shifts and overlap working time as well as conducting infectious control training for the staff at all levels. Management of supplies composed of increasing the reserve period, accepting donations and waste disposing through biosafety principles. System management included a single command and integrated the hospital work with the EOC. (3) recovery period: set up an action plan to restore space and staff including offer usual services. Management of supply included stock inventory systems for easy preparation. System management consisted of cross-functional working and sustainable implementation of infection control measures in the hospitals.