Introduction: A worldwide pandemic currently grips much of the global healthcare system. This pandemic is rivaled in the past 150 years only by the 1918 flu pandemic.

Planning and preparedness efforts have been ongoing for disasters specifically affect significant numbers of patients with burn injuries. As such, much effort has included a focus on the three critical elements consistent with an all-hazards approach: staff, space, and supplies. While COVID19 is not a Burn Mass Casualty Incident (BMCI) per se, it has profoundly impacted the profession and our ability to care for patients.

Only later, when we can look back to this period, will we know at what stage we are in regarding the magnitude of the disaster. Furthermore, the impact has been inconsistent, with some locations being overwhelmed while leaving others prepared for a surge that never came (at least at this point).

This report will briefly examine the first 12 weeks of data collected around North America regarding the impact COVID19 had on burn care.

Methods: A (short) six question survey was distributed to leaders from each burn center in the ABA each week for 12 consecutive weeks starting mid-March 2020. The survey primarily focused on staff, space, and supplies as it related to the burn center with a final question focusing on the healthcare system. Results: We received replies from approximately 50 burn centers each week during the survey. The respondents represented each of the regions of the US and Canada. 

Results: We received replies from approximately 50 burn centers each week during the survey.

The respondents represented each of the regions of the US and Canada.

Respondents who reported: a “mild problem, not impacting care.”
Staff range from 24% (week 12) to 39% (week 5).
Supply range from 0% (week 12) to 63% (week 1).
Space range from 26% (week 1) to 25% (weeks 3 and 4)

Respondents who reported: a “moderate problem threatening care”
Staff range from 7% (week 12) to 19% (week 3).
Supply range from 0% (week 12) to 30% (week 1).
Space range from 6% (week 7) to 19% (week 3).

The third section focused on general surge capacity at the healthcare system where the burn center is located. Surge capacity added to augment space needs for the healthcare system ranged from: a low of 16% week 12 to 47% week 3.

Conclusions: While this disaster had little to do with burn-injured patients, it substantially reduced capacity to provide care for all disciplines as many systems diverted resources to confront the crisis. The costs are yet to be fully measured, but our efforts to focus on investing in disaster preparedness are essential for long term continuity of care. Early into the disaster, supply was the most critical deficit. As the supply chain was rebuilt, and space was acquired, a variety of solutions were employed to solve the staffing shortage. Long term, the staff component of this disaster will pose the greatest concern.

Applicability to Practice: This disaster reminds us of the value to consider all hazards that also limit our ability to care for patients with burn injuries.

References and Resources

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