Institutional Readiness for Critical Care in Viral Hemorrhagic Fever Patients Post-COVID-19

Strategic Insights -

Researchers at NYC Health + Hospitals have conducted a follow-up survey to assess the readiness of Special Pathogen Treatment Centers (SPTCs) to provide critical care interventions to confirmed and suspected viral hemorrhagic fever (VHF) patients after the COVID-19 pandemic. The survey, conducted in April 2023, revealed that most SPTCs were prepared to provide basic critical care interventions, such as intubation and pharmacologic cardioversion. However, fewer institutions had policies governing code status, extracorporeal membranous oxygenation (ECMO), and cricothyrotomy. The study highlights the challenges faced by healthcare institutions in preparing for special pathogen outbreaks, including staff turnover and reduced support for training and equipment maintenance.

Key Takeaways:

  • 14 out of 74 US SPTCs completed the survey, representing 19% of the participating institutions.
  • Most respondents (79%) reported being prepared to provide intubation/mechanical ventilation, pharmacologic cardioversion, renal replacement therapy, and defibrillation to suspected and confirmed VHF patients.
  • Fewer institutions were ready to provide cricothyrotomy (36%), ECMO (29%), or code status (14%).
  • Factors impacting institutions' ability to provide critical care to a VHF patient included staff safety (71%) and clinical futility (50%).
  • Less than half (36%) of respondents reported that the COVID-19 pandemic positively affected their facility's ability to care for VHF patients, while 21% indicated that the pandemic prompted their facility to be better prepared to care for a VHF patient.
  • The study highlights the need for governments and healthcare institutions to institute measures to recruit, support, and retain staff to ensure critical care readiness for special pathogen patients.

Statistics:

  • 19% of participating institutions completed the survey (14 out of 74 US SPTCs)
  • 79% of respondents reported being prepared to provide intubation/mechanical ventilation
  • 71% of respondents reported being prepared to provide pharmacologic cardioversion, renal replacement therapy, and defibrillation
  • 36% of respondents reported being prepared to provide cricothyrotomy
  • 29% of respondents reported being prepared to provide ECMO
  • 14% of respondents reported being prepared to provide code status

Sources:

  • "Institutional readiness to provide critical care to patients with viral hemorrhagic fever (VHF) in the United States after the COVID-19 pandemic." Antimicrobial Stewardship & Healthcare Epidemiology, 2025,5.
  • NYC Health + Hospitals. (2023). Institutional readiness to provide critical care to patients with viral hemorrhagic fever (VHF) in the United States after the COVID-19 pandemic. DOI: 10.1017/ash.2025.10167.