The coronavirus disease 2019 (COVID-19) virus is creating unprecedented stresses on hospital and critical care systems. Hospitals, health care systems, states, and regions urgently need to assess their resources, identify potential bottlenecks, and create strategies for increasing critical care surge capacity, which refers to the resources needed to care for the sickest patients with the novel coronavirus.

In this report, the authors present a list of strategies for creating critical care surge capacity and estimate the number of patients accommodated, given the number of available critical care doctors and nurses, respiratory therapists, ventilators, and hospital beds. They also document the development of a user-friendly, Microsoft Excel–based tool that allows decisionmakers at all levels — hospitals, health care systems, states, regions — to estimate current critical care capacity and rapidly explore strategies for increasing it.

The strategies are organized into two tiers. Tier 1 includes contingency capacity strategies: adaptations to medical care spaces, staffing constraints, and supply shortages in a way that can increase capacities without significant impact on medical care delivery. Tier 2 includes crisis capacity strategies: changes that likely will have significant impact on routine care delivery and operations.