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Effective Response to a Regional Outbreak of COVID-19: Experience of a Tertiary Emergency Center

Published online by Cambridge University Press:  31 August 2021

Sungbae Moon
Affiliation:
Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
Hyun Wook Ryoo*
Affiliation:
Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
Jae Wan Cho
Affiliation:
Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
Haewon Jung
Affiliation:
Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
*
Corresponding author: Hyun Wook Ryoo, Email: ryoo@knu.ac.kr.

Abstract

Objective:

This study evaluates the usefulness, safety, and outcomes of operating a pretriage screening clinic and an expanded preemptive quarantine area in the emergency department (ED) during a regional coronavirus disease 2019 (COVID-19) outbreak.

Methods:

A descriptive cross-sectional, retrospective study conducted in a single institution. General patient demographic data, initial vital sign, symptoms, and patient outcome was collected from January to March of 2020. Data were compared according to the implementation of a new protocol involving pretriage screening and risk stratification. Outcome was also analyzed according to quarantine areas, including conventional, negative pressured, cohort, or preemptive quarantine area.

Results:

The pretriage clinic lowered the volume of low severity patients entering emergency department. Preemptive and cohort quarantine area provided more care to febrile patients compared with conventional quarantine area with longer length of hospital stay and lower mortality. After implementing the new protocol, emergency department in the study hospital was not closed again.

Conclusions:

In a regional outbreak of an epidemic, pretriage clinic safely screened infectious patients from entering ED. Expanded preemptive quarantine area increased surge capacity on quarantine area. An infectious disease protocol implementing 2 treatment areas may contribute to preserve and maintain ED function.

Type
Original Research
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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References

Division of Risk Assessment & International Cooperation. The first imported case of the novel coronavirus (2019-nCoV) in Korea. Press Release. http://www.kdca.go.kr/board/board.es?mid=a30402000000&bid=0030&act=view&list_no=365797&tag=&nPage=2. Korean Center for Disease Control. Published 2020. Accessed April 13, 2020.Google Scholar
Kim, JY, Choe, PG, Oh, Y, et al. The first case of 2019 novel coronavirus pneumonia imported into Korea from Wuhan, China: implication for infection prevention and control measures. J Korean Med Sci. 2020;35(5):e61.Google ScholarPubMed
Korean Society of Infectious Diseases; Korean Society of Pediatric Infectious Diseases; Korean Society of Epidemiology; Korean Society for Antimicrobial Therapy; Korean Society for Healthcare-associated Infection Control and Prevention; Korea Centers for Disease Control and Prevention. Report on the epidemiological features of coronavirus disease 2019 (COVID-19) outbreak in the Republic of Korea from January 19 to March 2, 2020. J Korean Med Sci. 2020;35(10):e112.CrossRefGoogle Scholar
Division of Risk Assessment & International Cooperation. The updates on COVID-19 in Korea as of 20 March. Press Release. http://www.kdca.go.kr/board/board.es?mid=a30402000000&bid=0030&act=view&list_no=366687&tag=&nPage=12. Korean Center for Disease Control. 2020. Published 2020. Accessed April 13, 2020.Google Scholar
Liu, J, Xie, W, Wang, J, et al. A comparative overview of COVID-19, MERS and SARS: review article. Int J Surg. 2020;81:1-8.CrossRefGoogle ScholarPubMed
Kim, GU, Kim, MJ, Ra, SH, et al. Clinical characteristics of asymptomatic and symptomatic patients with mild COVID-19. Clin Microbiol Infect. 2020;26(7):948.e1-948.e3.CrossRefGoogle ScholarPubMed
Ministry of Health and Welfare (Korea). Receiving necessary hospital treatment locally. http://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=351474. Published 2019. Accessed April 22, 2020.Google Scholar
Ministry of Health and Welfare (Korea). Frequently asked questions, about COVID-19. http://ncov.mohw.go.kr/en/faqBoardList.do?brdId=13&brdGubun=131&dataGubun=&ncvContSeq=&contSeq=&board_id=&gubun=. Published 2020. Accessed April 26, 2020.Google Scholar
Ministry of Health and Welfare (Korea). Guidelines for the operation of COVID-19 screening clinics. http://ncov.mohw.go.kr/en/guidelineView.do?brdId=18&brdGubun=181&dataGubun=&ncvContSeq=7&contSeq=2937&board_id=&gubun=. Published 2020. Accessed September 9, 2020.Google Scholar
World Health Organization. Coronavirus disease (COVID-19) Q&A. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-covid-19. Published 2020. Accessed September 9, 2020.Google Scholar
Park, J, Lim, T. Korean Triage and Acuity Scale (KTAS). J Korean Soc Emerg Med. 2017;28(6):547-551.Google Scholar
Kwon, H, Kim, YJ, Jo, YH, et al. The Korean Triage and Acuity Scale: associations with admission, disposition, mortality and length of stay in the emergency department. Int J Qual Health Care. 2019;31(6):449-455.Google Scholar
Scarfone, RJ, Coffin, S, Fieldston, ES, et al. Hospital-based pandemic influenza preparedness and response: strategies to increase surge capacity. Pediatr Emerg Care. 2011;27(6):565-572.Google ScholarPubMed
Varughese, S, Read, JG, Al-Khal, A, et al. Effectiveness of the Middle East respiratory syndrome-coronavirus protocol in enhancing the function of an emergency department in Qatar. Eur J Emerg Med. 2015;22(5):316-320.CrossRefGoogle ScholarPubMed
Li, H, Zhang, Z, Li, P, et al. Challenges and responses: a tertiary hospital in 2019-nCoV epidemic. Disaster Med Public Health Prep. 2020;14(6):808-811.CrossRefGoogle ScholarPubMed
Wee, LE, Fua, TP, Chua, YY, et al. Containing COVID-19 in the emergency department: the role of improved case detection and segregation of suspect cases. Acad Emerg Med. 2020;27(5):379-387.CrossRefGoogle ScholarPubMed
Carenzo, L, Costantini, E, Greco, M, et al. Hospital surge capacity in a tertiary emergency referral centre during the COVID-19 outbreak in Italy. Anaesthesia. 2020;75(7):928-934.CrossRefGoogle Scholar
Guan, WJ, Ni, ZY, Liang, WH, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-1720.Google ScholarPubMed
Korea Biomedical Review. Closures of emergency rooms could hit critical patients hard. http://www.koreabiomed.com/news/articleView.html?idxno=7476. Accessed April 25, 2020.Google Scholar
Doctor’s News (Korea). Suspected Novel Coronavirus patients should avoid visiting emergency department. https://www.doctorsnews.co.kr/news/articleView.html?idxno=133101. Accessed April 27, 2020.Google Scholar
Chosun Ilbo. Where to visit in cold symptoms or acute pneumonia. https://www.chosun.com/site/data/html_dir/2020/02/21/2020022102894.html. Accessed April 25, 2020.Google Scholar
Kwon, KT, Ko, JH, Shin, H, et al. Drive-through screening center for COVID-19: a safe and efficient screening system against massive community outbreak. J Korean Med Sci. 2020;35(11):e123.CrossRefGoogle ScholarPubMed
Choi, S, Han, C, Lee, J, et al. Innovative screening tests for COVID-19 in South Korea. Clin Exp Emerg Med. 2020;7(2):73-77.Google ScholarPubMed
Kim, JY, Hong, DY, Kim, SY, et al. Reliability of Korean Triage and Acuity Scale-based triage system as a severity index in emergency patients. J Korean Soc Emerg Med. 2017;28(6):552-556.Google Scholar
The Joint Commission. Surge hospitals: providing safe care in emergencies. 2020. https://www.jointcommission.org/-/media/tjc/documents/covid19/surge-hospitals.pdf. Published 2020. Accessed July 25, 2020.Google Scholar
Chang, YT, Lin, CY, Tsai, MJ, et al. Infection control measures of a Taiwanese hospital to confront the COVID-19 pandemic. Kaohsiung J Med Sci. 2020;36(5):296-304.CrossRefGoogle ScholarPubMed
Institute of Medicine. Hospital-Based Emergency Care: At the Breaking Point. Washington, DC: The National Academies Press; 2007:259-285.Google Scholar
Davis, Z, Zobel, CW, Khansa, L, et al. Emergency department resilience to disaster-level overcrowding: a component resilience framework for analysis and predictive modeling. J Operations Manag. 2020;66(1-2):54-66.Google Scholar
Steele, L, Orefuwa, E, Dickmann, P, et al. Drivers of earlier infectious disease outbreak detection: a systematic literature review. Int J Infect Dis. 2016 Dec;53:15-20.CrossRefGoogle Scholar