Laboratory Surge Response to the COVID-19 Pandemic: An Incident Command System Approach

Han-Ni Chuang,1,* Chien-Hung Shih,1,* Hung-Wen Tsai,2 Rong-San Jiang,1 Tzu-Hung Hsiao,2– 4 Po-Yu Liu,5 Yee-Jee Jan,6 Jiunn-Min Wang6 1Department of Medical Research, Taichung Veterans General Hospital, Taichung, 407204, Taiwan; 2Medical Administration Department, Taichung Veterans General Hospital, Taichung, 47204, Taiwan; 3Department of Public Health, Fu Jen Catholic University, New Taipei City, 24205, Taiwan; 4Institute of Genomics and Bioinformatics, National Chung Hsing University, Taichung, 40227, Taiwan; 5Division of Infection, Taichung Veterans General Hospital, Taichung, 47204, Taiwan; 6Department of Pathology & Laboratory Medicine, Taichung Veterans General Hospital, Taichung, 407, Taiwan*These authors contributed equally to this workCorrespondence: Yee-Jee Jan; Jiunn-Min Wang, Department of Pathology & Laboratory Medicine, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, 40705, Taiwan, Tel +886-4-23592525, Fax +886-4-2359-5046, Email yejan@vghtc.gov.tw; jmwang@vghtc.gov.twAbstract: The COVID-19 pandemic has reaffirmed the critical significance of effective diagnostics in outbreak response. In Taiwan, the COVID-19 wave in May 2021 led to a rapidly growing demand for SARS-CoV-2 diagnostic tests. To meet the challenge, an extensive system-wide emergency preparedness plan, hospital emergency incident command system (HEICS), was developed to deal with emergencies involving healthcare systems. During the wave of the COVID-19 outbreak, a 19.4-fold increase in SARS-CoV-2 PCR (polymerase chain reaction) diagnostic tests occurred in the hospital. The incident commander of TCVGH reviewed COVID-19 related events daily and purchased a high-throughput PCR machine for SARS-CoV-2 PCR diagnostic tests. In addition, the Department of Operations was responsible for staff scheduling and educational training. The turn-around times of SARS-CoV-2 diagnostic tests were shortened from 21.2 hours to 5.8 hours in the second week of the COVID-19 wave. Implementation of HEICS integrated resources could be helpful for expanding surge capacity during future outbreaks.Keywords: COVID-19, hospital emergency incident command system, pandemics