Guidelines for Creating Alternate Care Sites to Manage COVID-19

When beds are full – but patients continue to need care – what happens next?

To relieve pressure on hospitals and healthcare systems, jurisdictions are establishing alternate care sites (ACSs): Places where COVID-19 patients can receive general and acute care as they isolate from family, friends and their community. These sites are being established quickly – within two or three weeks – in non-traditional environments.

Also called “pop-up healthcare” or “temporary hospitals,” alternate care sites are cropping up across the country – and the world. (View current projects and their progress here.) Deploying safe, comfortable ACSs is a vital piece of saving lives and helping people recover from COVID-19.

(An interesting side note about alternate care sites: Although this may be the first time you’re hearing about them, ACSs have been deployed before. For example, during the 2009 presidential inauguration, alternate care sites were set up on a small scale in Washington, DC, to prevent local emergency departments from becoming overwhelmed by visits.)

Where Are Alternate Care Sites Popping Up?

Several types of facilities are being temporarily transformed into patient care sites:

• Convention centers
• Decommissioned hospitals
• Dorms
• Hotels
• Sports arenas

Other types of facilities are also being utilized on occasion, including vacant grocery stores and parking garages.

With shelter-in-place orders, isolation ordinances and higher-education institutions transitioning to distance learning, many of these facilities now have room to house hospital beds and medical equipment while also ensuring safe distancing between patients and providing dedicated places for staff to put on and remove PPE.

As of April 14, the U.S. Army Corps of Engineers has more than 15,000 beds in alternate care facilities contracted or pending final approval (with more on the way).

Who Plays a Role in Setting Up Alternate Care Sites?

Several federal government agencies come together to establish alternate care sites: the Federal Emergency Management Agency (FEMA), the U.S. Department of Health and Human Services (HHS) and either the U.S. Army Corps of Engineers (USACE) or the state’s National Guard. Local county or city governments also typically play a role, depending on where the sites are established.

The process follows specific phases of operation:

1. “Plan” phase, which starts with the state or municipality establishing a medical plan, pinpointing possible locations for ACSs and requesting a site assessment.
   
   
2. “Build” phase, which involves the state or municipality, general contractors and the U.S. Army Corps of Engineers to convert the space quickly
   
   
3. “Supply” phase, which involves the procurement and installation of medical equipment with the help of FEMA and HHS
   
   
4. “Staff and operate” phase, which turns the site back over to the state or municipality to get things up and running

To bring an orderly and systematic approach to federal assistance for state and local governments as they provide aid to community members, a Stafford Act emergency and major disaster declarations have been made by the President. In addition to permitting state and local governments to receive funding for eligible measures taken to address the pandemic, it also emphasizes preferences for local business contracts.

Communication Design Guidelines from the U.S. Army Corps of Engineers

Here’s where general contractors and low-voltage installers enter the picture: In order to transform these facilities quickly, your help is needed.

The U.S. Army Corps of Engineers has created three documents that outline layouts, equipment and engineering requirements for turning each facility type into an alternate care site. These guidelines include references to CSI MasterFormat Division 27 (communications design).

1. Hotel to Hospital Concept (H2HC): guidelines for transforming dorm or hotel rooms into alternate care sites. The U.S. Army Corps of Engineers maps out the following recommendations for cabling and connectivity in these environments:

• Utilize existing broadband capabilities to support VPN and access to electronic health records, etc.
  
• OSP cabling (12f fiber optic, upgradeable to at least 1 Gb/s)
  
• Cabling and connectivity to support wired/wireless camera infrastructure that displays real-time footage at nurses’ stations
  
• Cabling and connectivity for nurse call systems that integrate with the nurses’ station for patient-clinician communication

2. Arena to Hospital Concept (A2HC): guidelines for transforming sports arenas or convention centers into alternate care sites. The U.S. Army Corps of Engineers maps out the following recommendations for cabling and connectivity in these environments:

• Utilize existing broadband capabilities to support VPN and access to electronic health records, etc.
  
• OSP cabling (12f fiber optic, upgradeable to at least 1 Gb/s)
  
• Cabling and connectivity to support wired/wireless camera infrastructure that displays real-time footage at nurses’ stations
  
• Enhanced wired/wireless communications in newly established clinical spaces
  
• Cabling and connectivity for nurse call systems that integrate with the nurses’ station for patient-clinician communication
  
• VoIP phones at each workstation
  
• Category 6A RJ45 4-port telecommunications outlet at each workstation and adjacent to each patient bed

3. Closed Hospital to Hospital Concept (CH2HC): guidelines for transforming decommissioned hospitals back into functioning facilities. The U.S. Army Corps of Engineers maps out the following recommendations for cabling and connectivity in these environments:

• Utilize existing site systems (building automation, nurse call, etc.) to the greatest extent possible
  
• Utilize existing broadband capabilities to support VPN and access to electronic health records, etc.
  
• Cabling and connectivity to support wired/wireless camera infrastructure that displays real-time footage at nurses’ stations

Tips on Getting Involved

As alternate care sites arrive in your area, it’s best to be prepared. Here are a few quick tips to make sure you’re ready to help when opportunity knocks:

• Get listed on the Disaster Response Registry, which is a list of contractors willing to provide services in emergency situations
  
• Search contract opportunities (a good place to start is with the U.S. Army Corps of Engineers’ list of active projects)
  
• Search the online SBA Subcontracting Network for subcontracting opportunities
  
• Search U.S. Army Corps of Engineers’ Contract Awards (contact the awarded general contractor for subcontract opportunities)
  
• Keep on top of local opportunities to support this initiative; network and stay connected

Belden Stands Ready to Help in the Fight Against COVID-19

Our innovative, reliable and high-performance solutions include indoor and outdoor copper and fiber cable and connectivity, as well as racks and cabinets and cable management. Our systems are designed to support applications such as wired and wireless networks, data centers, distributed antenna systems, smart buildings and 5G.

Belden is working side by side with low-voltage installers and general contractors on local opportunities and ensuring that Belden products are in stock. We have cabling and connectivity inventory dedicated specifically to supporting alternate care sites and the fight against COVID-19.