Albert Einstein College of Medicine, Montefiore Health System.
Am J Bioeth. 2020 Jul;20(7):62-66. doi: 10.1080/15265161.2020.1764146. Epub 2020 May 28.
New York City hospitals expanded resources to an unprecedented extent in response to the COVID pandemic. Thousands of beds, ICU beds, staff members, and ventilators were rapidly incorporated into hospital systems. Nonetheless, this historic public health disaster still created scarcities and the need for formal crisis standards of care. These were not available to NY clinicians because of the state's failure to implement, with or without revision, long-standing guidance documents intended for just such a pandemic. The authors argue that public health plans for disasters should be well-funded and based on available research and expertise. Communities should insist that political representatives demonstrate responsible leadership by implementing and updating as needed, crisis standards of care. Finally, surge requirements should address the needs of both those expected to survive and those who will not, by expanding palliative care and other resources for the dying.
纽约市的医院为应对 COVID-19 疫情，以前所未有的规模扩充资源。数千张病床、重症监护病房床位、医护人员和呼吸机迅速纳入医院系统。尽管如此，这场历史性的公共卫生灾难仍造成了短缺，并需要制定正式的危机护理标准。由于该州未能实施长期指导文件（无论是否修订），纽约的临床医生都无法获得这些标准。作者认为，灾难公共卫生计划应该有充足的资金，并基于现有研究和专业知识。社区应该坚持要求政治代表通过实施和按需更新危机护理标准来展示负责任的领导能力。最后，扩充人员的要求应该通过扩大临终关怀和其他资源来满足预计能够存活和无法存活的患者的需求。
