Disruptive Modifications to Cardiac Critical Care Delivery During the Covid-19 Pandemic: An International Perspective

Katz, Jason N.; Sinha, Shashank S.; Alviar, Carlos L.; Dudzinski, David M.; Gage, Ann; Brusca, Samuel B.; Flanagan, M. Casey; Welch, Timothy; Geller, Bram J.; Miller, P. Elliott; Leonardi, Sergio; Bohula, Erin A.; Price, Susanna; Chaudhry, Sunit-Preet; Metkus, Thomas S.; O’Brien, Connor G.; Sionis, Alessandro; Barnett, Christopher F.; Jentzer, Jacob C.; Solomon, Michael A.; Morrow, David A.; van Diepen, Sean

Abstract The COVID-19 pandemic has presented a major unanticipated stress on our workforce, organizational structure, systems of care, and critical resource supply. In order to ensure provider safety, maximize efficiency, and optimize patient outcomes, health systems need to be agile. Critical care cardiologists may be uniquely positioned to treat the numerous respiratory and cardiovascular complications of the SARS-CoV-2 virus and support clinicians without critical care training who may be suddenly asked to care for critically ill patients. This manuscript draws upon the experiences of colleagues from heavily impacted regions of the United States and Europe as well as lessons learned from military mass casualty medicine. We offer pragmatic suggestions on how to implement scalable models for critical care delivery, cultivate educational tools for team training, and embrace technologies such as telemedicine to enable effective collaboration despite social distancing imperatives.