Crisis Triage in the Era of COVID-19: Old Tools, New Approaches, and Unanswered Questions

• Type of Material: Article
• Authors: Gavin Harris, Emory University; Perren J Cobb, Keck School of Medicine of USC; Laura Evans, University of Washington
• Language: English
• Date: 2023-01-01
• Publisher: LIPPINCOTT WILLIAMS & WILKINS
• Publication Version: Final Published Version
• Copyright Statement: © 2022 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.
• Final Published Version (URL): http://dx.doi.org/10.1097/CCM.0000000000005723
• Title of Journal or Parent Work: CRITICAL CARE MEDICINE
• Volume: 51
• Issue: 1
• Start Page: 148
• End Page: 150
• Keywords: surge; Life Sciences & Biomedicine; intensive care unit preparedness; triage; COVID-19; Science & Technology; Critical Care Medicine; disaster; crisis standards of care; General & Internal Medicine
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

In mid-2001, the Johns Hopkins Center for Health Security in conjunction with the National Security Council of the United States engaged in a table-top exercise to inform debate on the threat posed by biologic agents and to simulate challenges in decision making during times of healthcare strain. Entitled Operation Dark Winter, the exercise utilized a smallpox outbreak as its framework, and the findings were presented in October 2001 to the Congressional Subcommittee on Emerging Threats and Capabilities, under the Senatorial Committee on Armed Services. Public awareness of the tragedy of September 11 was still acute, as was the lingering threat of biological attack (letters containing anthrax spores had been sent to congressional and media offices, killing five). Operation Dark Winter, uncovered, among many findings, that a major biological event was a national strategic threat. Organizational structures and capabilities of the United States were not suited to the management of a major biologic event, and, most significantly, there was “little to no surge capability” in the US healthcare system, pharmaceutical, or vaccine sectors (1).