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Review
. 2021 Aug;34(4):280-288.
doi: 10.37201/req/041.2021. Epub 2021 Mar 22.

Temporary hospitals in times of the COVID pandemic. An example and a practical view

F J Candel  1 , J Canora, A Zapatero, R Barba, J González Del Castillo, G García-Casasola, J San-Román #, R Gil-Prieto, P Barreiro, M Fragiel, F Prados, P Busca, J Vázquez-Castro, J Marco
Affiliations
Review

Temporary hospitals in times of the COVID pandemic. An example and a practical view

F J Candel et al. Rev Esp Quimioter. 2021 Aug.

Abstract
in English, Spanish

We describe the most widely used temporary hospital in Europe during the first pandemic wave, its structure, function, and achievements. Other models of care developed during the pandemic around the world were reviewed including their capacity, total bed/ICU bed ratio and time of use. We particularly analyzed the common and differential characteristics of this type of facilities. IFEMA Exhibition Center was transformed into a temporary 1,300-bed hospital, which was in continuous operation for 42 days. A total of 3,817 people were treated, generally patients with mild to moderate COVID-19, 91% of whom had pneumonia. The average length of stay was 5 to 36 days. The most frequent comorbidities were hypertension (16.5%), diabetes mellitus (9.1%), COPD (6%), asthma (4.6%), obesity (2.9%) and dementia (1.6%). A total of 113 patients (3%) were transferred to another centers for aggravation, 19 (0.5%) were admitted to ICU and 16 patients (0.4%) died. An element of great help to reducing the overload of care in large hospitals during peaks of health emergencies could be these flexible structures capable of absorbing the excess of patients. These must be safe, breaking domestic transmission and guarantee social and emotional needs of patients. The success of these structures depends on delimitation in admission criteria taking into account the proportion of patients who may require, during admission, assistance in the critical care area.

Describimos el hospital temporal más utilizado en Europa durante la primera ola de la pandemia, su estructura, función y resultados, así como otros modelos de atención desarrollados durante la pandemia en todo el mundo. Se revisa su capacidad, ratio de camas totales/UCI y tiempo de uso. También se describen las características comunes y diferenciales de este tipo de instalaciones. El recinto ferial de IFEMA se convirtió en un hospital temporal de 1.300 camas, que estuvo en funcionamiento continuo durante 42 días. Se atendió a un total de 3.817 personas, en general pacientes con COVID-19 leve a moderada, de los cuales el 91% tenía neumonía. La duración media de la estancia fue de 5 a 36 días. Las comorbilidades más frecuentes fueron la hipertensión (16,5%), la diabetes mellitus (9,1%), la EPOC (6%), el asma (4,6%), la obesidad (2,9%) y la demencia (1,6%). Un total de 113 pacientes (3%) fueron trasladados a otros centros por agravamiento, 19 (0,5%) fueron ingresados en la UCI y 16 pacientes (0,4%) fallecieron. 1200 camas totales con un 8% de camas críticas podría ser una proporción óptima, pero delimitando los criterios de ingreso. La clave para reducir la sobrecarga asistencial en los grandes hospitales durante los picos de emergencias sanitarias reside en estas estructuras flexibles capaces de absorber el exceso de pacientes. Estas deben ser seguras, romper la transmisión doméstica y garantizar las necesidades de atención social y emocional de los pacientes. El éxito de estas estructuras depende de la delimitación en los criterios de admisión teniendo en cuenta la proporción de pacientes que pueden requerir, durante el ingreso, asistencia en el área de cuidados críticos..

Keywords: COVID-19; ICU beds; admission criteria; emergence facilities; emporary hospital; hospital design.

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Conflict of interest statement

All authors declare they have no conflicts of interest.

Figures

Figure 1:
Figure 1:
Planting plane of assistant distribution controls in Hall 9. A: standard hospitalization modules (UE). B: Intensive care unit (ICU) module. C: Work and office rooms for physicians and nurses. D: Palliative care rooms. E: Access to Hall 7 and Radiology (Rx, CT scan).
Figure 2
Figure 2
A: Distribution of beds in ward 5 at the beginning (first week). B: Transition to ward 9 with army in the assembly of panels and the structure. C: A total of twenty-seven kilometers circuit of soldered copper tube were connected to external oxygen towers. D: Final Aspect of Hall 9, ready to admittance. E: hoverboard devices connected to wheelchairs for transporting patients and pharmaceuticals. F: Portable CT scan. G: Intensive care bed. H: Continuous training sessions updating protocols of action.
Figure 3
Figure 3
Activity of the Covid-19 IFEMA Field Hospital during the first wave. A: Proportion of Admittances and Discharges from march to April 2020. B: Proportion of Admittances in IFEMA (orange bars) compared with those on the rest of Madrid Hospitals. C: Schedule of IFEMA daily time admittances.
See this image and copyright information in PMC

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