A stratified approach to hospital surge capacity during the COVID-19 pandemic in Tokyo

Background

Surge capacity preparedness is critical for maintaining adequate healthcare delivery during pandemics and disasters. Urbanization and aging populations have heightened the need for innovative capacity strategies. Temporary hospitals provide a flexible solution, enabling adaptive responses through adjustable bed counts, tailored patient criteria, and strategic activation.

Methods

Nine temporary hospitals with 842 beds were established across Tokyo to manage COVID-19 surges, focusing on elderly patients with comorbidities, such as dementia, cardiovascular conditions, and chronic respiratory disorders. Admission criteria included age, absence of ventilator dependency, specific comorbidities, and an expected hospital stay of up to 10 days.

Results

Over 2 years, the temporary hospitals admitted more than 10,000 patients, providing surge capacity for outbreaks and reducing the strain on permanent hospitals. Elderly patients requiring prolonged bedside care benefited from comprehensive medical management and rehabilitation, improving their functional outcomes.

Conclusion

Temporary hospitals designed for stratified patient populations offer a viable model for managing surge capacity in disaster medicine. This approach underscores the importance of adaptive strategies to address healthcare demands during public health emergencies.