Increasing ICU capacity to accommodate higher demand during the COVID-19 pandemic

Area of Science:

• Critical Care Medicine
• Health Services Research
• Pandemic Preparedness

Background:

• The COVID-19 pandemic placed unprecedented demand on healthcare systems globally.
• Intensive care units (ICUs) are critical for managing severe cases, necessitating surge capacity planning.

Purpose of the Study:

• To assess the short-term capacity of Australian intensive care units (ICUs) to expand services during the COVID-19 pandemic.
• To identify limitations in ICU bed availability, equipment, and staffing for surge scenarios.

Main Methods:

• A national survey of all 194 Australian public and private ICUs was conducted.
• Data on available and potential ICU beds, equipment, and staffing were collected from ICU directors.
• Australian and New Zealand Intensive Care Society (ANZICS) registry data supplemented the survey findings.

Main Results:

• The total number of staffed ICU beds decreased by 8.2% compared to 2020, with greater declines in rural/regional and private ICUs.
• Sufficient ventilators were available, exceeding the maximum number of ICU beds.
• Available nursing staff could support the opening of only 47% of potential additional physical ICU beds.

Conclusions:

• Australian ICUs have experienced a reduction in staffed bed numbers compared to the previous year.
• While equipment availability is adequate, the expansion of ICU capacity is primarily limited by the availability of appropriately trained staff.
• Fewer than half of the potential additional ICU beds could be operationalized under pre-pandemic care models due to staffing constraints.