Acute neurology during the COVID-19 pandemic
Jennifer J. Majersik, Vivek K. Reddy
Abstract
Neurologists are affected by the coronavirus disease 2019 (COVID-19) pandemic in several key ways, including reduced ability to admit and accept in transfer critically ill neurologic patients due to census overflow, personal risk of exposure to COVID-19, and potential redeployment of the acute neurologist workforce towards general medicine to assist our colleagues managing the surge of medical patients. As providers of inpatient and emergency-based acute neurologic care, we have been attempting to prepare for and manage the COVID-19 pandemic locally by focusing on 3 key areas: creating an integrated preparation plan that supports hospital measures; building an optimized, flexible, and redundant workforce; and maintaining a high level of neurologic care in our hospital and across our region despite limited transfer capabilities during the pandemic. This final concern is of key relevance in our region, where our tertiary hospital supports numerous smaller community hospitals, typically by providing an open door to patient transfers. These hospitals are often in rural or frontier regions and are also affected by COVID-19, so not only are beginning to experience their own bed and clinician shortages,1 but are concerned about what the pandemic means for the availability of traditional support systems for other non-COVID-19–related diseases.