Fangcang hospital (Chinese: 方舱医院; pinyin: fāngcāng yīyuàn; lit. 'square-cabin hospital')[1] refers to a kind of makeshift/mobile field hospitals notably used during the COVID-19 pandemic in Wuhan, Hubei, China.
History and usage
Such hospitals were intended for large-scale medical isolation and instituted either by establishing rapidly constructed modular/portable buildings, or through the acquisition of indoor space within existing venues and even temporarily renovated gyms and dorms in colleges and universities with enclosed cubicles to assist social distancing.
Chinese literature has mentioned the concept of "medical Fangcang" as early as 1989.[2] China has constructed fangcang hospitals during the 2008 Sichuan earthquake and 2010 Yushu earthquake.[3][4]
Health Policywww.thelancet.com Published online April 2, 2020 https://doi.org/10.1016/S0140-6736(20)30744-3 1
Fangcang shelter hospitals: a novel concept for responding
to public health emergencies
Simiao Chen*, Zongjiu Zhang*, Juntao Yang, Jian Wang, Xiaohui Zhai, Till Bärnighausen†, Chen Wang†
Fangcang shelter hospitals are a novel public health concept. They were implemented for the first time in China in February, 2020, to tackle the coronavirus disease 2019 (COVID-19) outbreak. The Fangcang shelter hospitals in China were large-scale, temporary hospitals, rapidly built by converting existing public venues, such as stadiums and exhibition centres, into health-care facilities. They served to isolate patients with mild to moderate COVID-19 from their families and communities, while providing medical care, disease monitoring, food, shelter, and social activities.
We document the development of Fangcang shelter hospitals during the COVID-19 outbreak in China and explain their three key characteristics (rapid construction, massive scale, and low cost) and five essential functions (isolation, triage, basic medical care, frequent monitoring and rapid referral, and essential living and social engagement). Fangcang shelter hospitals could be powerful components of national responses to the COVID-19 pandemic, as well as future epidemics and public health emergencies.
COVID-19 pandemic
In Wuhan, at the onset of the COVID-19 pandemic in January 2020, general medical institutions and the newly expanded pneumonia specialist hospital were overwhelmed by the sudden surge in hospital bed demands by suspected COVID-19 cases.[5] Many patients with existing conditions were also turned away, leading to deaths which were otherwise preventable.[6][7] Authorities were criticized by experts and citizens alike.[6] Meanwhile, the large number of low-severity cases — almost all are individuals with suspected or mild symptoms — still needed at least a fortnight of isolation (due to the incubation period of SARS-CoV-2).
Officials decided against home isolation for mild to moderate cases, as home isolation is not always properly complied with and it was difficult to organize medical care and monitoring for those in isolation. Furthermore, home isolation could be psychologically taxing on the patients as the patients know that they are putting their family members at risk of infection.[8] On the other hand, in-hospital isolation will hold up medical resources and increase the risk of nosocomialexposure. Under such circumstances, the principle of centralized low-level care management of non-critical patients was adopted. The Government of the People's Republic of China established 16 fangcang hospitals in Wuhan, providing a total of more than 20,000 beds.[9][10][11]
As of March 10, 2020, all patients admitted to the square cabin hospital of Wuhan Wushan Hongshan Stadium were discharged. Thus, all 16 fangcang hospitals in Wuhan completed their missions and their cabins were shut down.[12]
IntroductionFangcang shelter hospitals were developed and used for the first time in China to tackle the coronavirus disease 2019 (COVID-19) outbreak.1 The term Fangcang, which sounds similar to Noah’s Ark in Chinese, was borrowed from military field hospitals,2,3 but it refers to a novel concept: large, temporary hospitals built by converting public venues, such as stadiums and exhibition centres, into health-care facilities to isolate patients with mild to moderate symptoms of an infectious disease from their familes and communities, while providing medical care, disease monitoring, food, shelter, and social activities.
Etymology
Fangcang (simplified Chinese: 方舱; traditional Chinese: 方艙; pinyin: fāngcāng), literally meaning "square cabin", is a Chinese term referring to a portable modular building structure formed using a combination of various solid materials, most notably cargotectures. The concept of "Fangcang" was borrowed from military field hospitals,[13] which was initially introduced by the United States military, who has been making makeshift structures since the 1950s.[14]
Outside of the context of the outbreak, makeshift or Fangcang structures can refer to many kinds of modular structures.[14]
...Hospital isolation of the growing numbers of COVID-19 patients in Wuhan was not feasible, and home isolation was not desirable. China thus needed a novel approach to control the COVID-19 out break in Wuhan. In response, Chinese officials and experts developed the Fangcang shelter hospital: large health-care facilities that were built overnight and provided isolation, triage, medical care, monitoring and referral, shelter, and social engagement.
The hospitals were built in existing public venues by installing beds, sheltered space, and the three zones and two passages (san qu liang tong dao) of hospital isolation wards.23–28 Figure 2 shows one of the Fangcang shelter hospitals in Wuhan with three zones—a contaminated zone where patients live, a semi-clean zone where health workers put on and take off their protective suits, and a clean zone where supplies are received—and two passages, one for patients and the other for health workers. Although Fangcang shelter hospitals have some historic precedents, such as makeshift hospitals, emergency field hospitals, emergency shelters, and hospital isolation wards,30–32 they have three distinct characteristics and five functions that set them apart from facilities that have previously been used for the control of public health emergencie