Some makeshift hospitals to be kept as precautionary measures

Preparations being made for future flare-ups of virus, other emergencies

Building more makeshift hospitals in advance and reserving some as permanent fixtures are intended as a precautionary measure to fight against potential COVID-19 resurgences and other health emergencies, according to officials and experts.

They said early preparedness will involve designing layouts to prevent cross infection, training healthcare workers to adapt to such a medical setting quickly and stocking sufficient medical equipment.

Makeshift hospitals have been retrofitted mostly from public venues such as exhibition centers or stadiums to isolate and treat mild COVID-19 patients. They were first built during the initial wave of the domestic outbreak centered in Hubei province in early 2020 and were later adopted by many cities hit by the virus.

During the process of coping with a protracted battle against the virus since March, Ma Xiaowei, minister of the National Health Commission, said that permanent makeshift hospitals should be prepared to make sure that they can be activated swiftly in case of a health emergency.

Data released by the commission showed that as of April 25 there were nearly 400 makeshift hospitals with 560,000 beds, up from 33 with 35,000 beds as of March 22.

"Building makeshift hospitals is definitely not a signal of a worsening epidemic," said Guo Yanhong, an official with the commission's bureau of medical administration. "Rather, it targets the high infectiousness of Omicron and aims at arresting its spread with prompter action to put all infected cases in isolation."

Such facilities can also play an important role in tackling other major public health events, while maintaining their operation for other purposes in normal times, she said during a news conference.

Zhao Hongjia, Party chief of Fujian Provincial People's Hospital, said that given the recent development of the COVID-19 pandemic, it is necessary and important for makeshift hospitals to exist in the long term.

"The planning of makeshift hospitals should be more comprehensive and meticulous in the future," said Zhao, who was also one of the leaders of the medical aid team sent from Fujian to Shanghai.

A significant consideration is preventing the risk of cross infections.

"Once they are put into use, the risk of cross infections should be taken into consideration in a number of aspects, from the design of passageways for patients and medical workers, transport routes for medical waste, as well as waste water disposal channels," she said.

Chen Erzhen, vice-president of Ruijin Hospital affiliated to Shanghai Jiaotong University's School of Medicine, and head of the city's medical treatment teams at quarantine facilities, said that early planning of makeshift hospitals is essential based on past experiences.

"Previous makeshift hospitals began operation as soon as they were available, thus a series of problems had surfaced at the beginning," he said. "As a result, we should make early preparations in advance, such as drawing a layout based on existing public infrastructure to save time when an emergency case arises."

Chen also suggested local urban planners incorporate emergency preparations into the planning of large construction projects, as part of efforts to tackle not only viral outbreaks, but also other possible disasters.

Even though makeshift hospitals are designed to only receive asymptomatic or mild patients, Zhao, from Fujian province, said healthcare staff working there should receive targeted training.

"Training should be strengthened in terms of managing and operating makeshift hospitals, and caring for patients in such a setting," she said. "If the environment and operation of such a facility can be upgraded and make patients feel reassured, they will recover more quickly."

Public records have shown that an increasing number of cities in Henan, Shandong, Jiangxi and Jilin provinces have begun constructing dedicated makeshift hospitals.

Wang Shuiping, head of the Jiangxi Provincial Health Commission, said during a news conference in mid-May, that the province will step up efforts to build permanent makeshift hospitals, while encouraging the establishment of makeshift hospitals that are flexible or affiliated to other healthcare institutions.

In Jilin city, Jilin province, one of a few makeshift hospitals built during a recent wave of COVID-19 that hit the city is being made permanent, according to an article released on the official website of the city government in late April.

The hospital, covering 3.5 hectares, was refurbished from a driving school and has over 2,100 beds, according to the article.

Chen Ye, general manager of Yinhong Modular House, a company that has participated in building makeshift hospitals throughout the COVID-19 epidemic, said he had recently received a call from Henan province inquiring about permanent makeshift hospitals.

"Such hospitals should in theory be constructed by masonry, but that would be more costly and take longer to build, so modular homes are still the first choice," he said.

Chen said he has recently seen a trend of integrating makeshift hospitals with budget hotels.

"For instance, a makeshift hospital project underway in Nanjing, Jiangsu province was called off because the local outbreak was contained quickly," he said. "Later on, it was decided that the project would be made into a four-star hotel that can also be quickly turned into a hospital in case of a health emergency."