MSDH reviewing ‘Crisis Standards of Care’ to keep hospitals going in case of emergency declaration

MSDH reviewing ‘Crisis Standards of Care’ to keep hospitals going in case of emergency declaration
The University of Washington released new pandemic models that show the possibility of U.S deaths topping 567,000 by April 1. (Source: CNN, Defense Department)

JACKSON, Miss. (WLBT) - Mississippi’s top doctor says the state department of health is reviewing its ’Crisis Standards of Care.’

That’s the state’s response and planning framework for medical services in the event of an emergency declaration.

In other words, if hospitals get another wave of sick patients, the state is trying to figure out how to stay afloat.

“We’re revisiting our Crisis Standards of Care,” State Health Officer Thomas Dobbs said in a press conference this week. “Let me speak plainly. It’s bad and it will get even worse.”

Mississippi has previous experience with a devastated health system. The aftermath of Hurricane Katrina in 2005 presented the problem to the Mississippi State Department of Health (MSDH), but it wasn’t until the 2015 Ebola virus disease outbreak in West Africa that leaders began to see how the Magnolia state might respond to an infectious disease outbreak.

Well, the outbreak is here.

Mississippi State Department of Health reported 2,326 new cases and 24 new deaths Thursday.

The number of presumed positive coronavirus cases in Mississippi is now at 202,651 as of December 23.

So far, 4,556 people have died from COVID-19 in Mississippi.

While specifics about staffing, beds, and resources vary per hospital, the MSDH Crisis Standard of Care (CSC) guideline says the goal is to “prepare for and respond to emergencies in resource-limited environments... and do the greatest good for the greatest number of persons.”

Before CSC is implemented, MSDH says these conditions must be met:

• Identification of critically limited resources and infrastructure

• Surge capacity fully employed within the healthcare facility

• Maximal attempts at conservation, reuse, adaptation, and substitution performed

• Regional, state, and federal resource allocation insufficient to meet demand

• Patient transfer or resource importation not possible or will occur too late to consider bridging therapies

• Request for necessary resources made to local and regional health officials

• Declared state of emergency (or in the process)

Some of these conditions have already been met including limited resources and surge capacity. University of Mississippi Medical Center announced in a recent press conference that hospital administrators are doing their best to conserve space and departments inside the hospital.

If the state does have to employ Crisis Standards of Care, MSDH says it will prioritize fairness, the duty to care, the duty to steward resources, transparency, consistency, proportionality, and accountability.

Here’s the framework:

• Develop consistent state crisis standards of care protocols

• Seek community and provider engagement

• Adhere to ethical norms during crisis standards of care (CSC)

• Provide necessary legal protections for healthcare practitioners and institutions implementing CSC

• Ensure consistency in CSC implementation

• Ensure intrastate and interstate consistency among neighboring jurisdictions Ethical features of the MSDH

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