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States Respond to COVID-19: Calif. Prepares for Concurrent Emergencies

As California enters peak wildfire season, Gov. Gavin Newsom (D) prepares for concurrent emergencies during the COVID-19 public health emergency.

In addition to ensuring adequate personal protective equipment and hiring 858 more firefighters, the state implemented new shelter guidance in the event that Californians must evacuate their homes. New sheltering protocols require:

  • health screening on entry;
  • dedicated cleaning staff at all sites;
  • prepackaged meals; and
  • medical and mental health professionals on site.

Further, in the event of an evacuation, the state is prepared to secure hotel rooms, college dormitories, fairgrounds, and campgrounds to allow individuals to shelter in individual settings.

Mich., Texas Using Regional Medical Operations Coordination Cells

In recent guidance on transferring patients to relief health care facilities when responding to community transmission of COVID-19, the Centers for Disease Control and Prevention (CDC) highlighted two state approaches to using medical operations coordination cells (MOCCs) and relief hospitals.

An MOCC, as described by CDC, is a group of medical operations experts within emergency operations centers at the substate, statewide, and regional levels that can assist in the transferring patients between health care facilities. Relief hospitals are licensed health care facilities that will accept transferred patients or share resources to care for as many people as possible during a crisis.

Texas had a strong public health and disaster response infrastructure in place before COVID-19. The state was able to strengthen their framework and response efforts by linking their current disaster response plans to MOCCs, allowing the state to structure cooperation across the state, support communications, and deliver actionable data. This initiative helped Texas to:

  • coordinate health care delivery in hot spots;
  • manage drive-through testing for COVID-19;
  • integrate acute health care, public health, and disaster management; and
  • ensure safe and high-quality patient care by transferring within the system where care was optimal.

When Michigan began to experience serious surges in COVID-19, the Michigan Healthcare Preparedness Program developed a strategy to optimize available health care resources. To do this, the state used relief hospitals to transfer patients to ensure care for as many people as possible. Between April 1 and April 20, nearly 1,000 patients were transferred between hospitals. About 85 percent of these patients were transferred through direct interhospital contact, and about 30 percent were transferred within health care systems.

We encourage all members to visit the America’s Essential Hospitals coronavirus resource page for more information about the outbreak.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Abigail Painchaud is a policy associate at America's Essential Hospitals.

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