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OBJECTIVE This paper describes how a large academic medical center solved the challenges of war preparedness and subsequently adapted them for the COVID-19 pandemic. SETTING A 1,000-bed academic medical center in Northern Israel has faced two extreme challenges since 2006: operating under missile attack during the 2006 Second Lebanon War, and rapid establishment of a scalable infrastructure for COVID-19 patients. The first challenge led to construction of a dual-use facility: a parking lot during peacetime, and a fully functioning fortified underground emergency hospital (FUEH) in times of emergency. Several drills have confirmed readiness for various scenarios including conventional and unconventional warfare, and treating isolated patients during the Ebola and SARS threats. RESULTS The hospital achieved preparedness for patient care during the COVID-19 pandemic, including all facilities and personnel, including infrastructure, laboratories, and innovations, to maintain standard patient care and separate COVID-19 treatment facilities. The hospital\'s second challenge represented by the COVID-19 pandemic led to adaptation of the FUEH as a key strategic facility in Northern Israel for treating hundreds of COVID-19 patients. Each solution was supported by innovations targeted for specific purposes and needs. CONCLUSIONS The function and unique mechanisms used to leverage use of a dual facility was proven viable for several emergency conditions, including the COVID-19 pandemic. Infrastructure and technological flexibility is essential when planning for handling different emergencies situations.
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The Vancouver Convention Health Centre (VCHC) was rapidly set up as a part of the COVID-19 response in Brit-ish Columbia in order to create surge hospital capacity bed space. Multiple field hospitals were set up across the country in preparation for a possible surge and the VCHC utilized a non-traditional health care space and overlaid it with medical infrastructure. Maximum flexibility was required in planning for multiple patient populations and a novel four-box concept to plan for the requirements of the respective possible populations was developed. Key difficulties that needed to be overcome in planning COVID-19 medical care delivery in a non-traditional space included oxygen delivery, unknown future patient populations, and staffing. A clear recommendation can also now be made that healthcare provision should be considered during the design and build of new recreational or convention facilities in all communities.
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American_journal_of_disaster_medicine
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Israeli underground hospital conversion for treating COVID-19 patients.
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Vancouver Convention Health Centre (COVID-19 Response): Planning, implementation, and four lessons learned.
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