Alternate care sites during the COVID-19 pandemic: Policy Implications for pandemic surge planning.

Alternate care sites across the US were widely underutilized during the COVID-19 outbreak, while the volume and severity of COVID-19 cases overwhelmed health systems across the United States. The challenges presented by the pandemic have shown the need to design surge capacity principles with consideration for demand that strains multiple response capabilities. We reviewed current policy and previous literature from past ACS as well as highlight challenges from the COVID-19 pandemic, to make recommendations that can inform future surge capacity planning. Our recommendations include: 1) Preparedness actions need to be continuous and flexible; 2) Staffing needs must be met as they arise with solutions that are specific to the pandemic; 3) Health equity must be a focus of ACS establishment and planning; and 4) ACS should be designed to function without compromising safe and effective care. A critical opportunity exists to identify improvements for future use of ACS in pandemics.