Pediatric urological surgery readiness condition (PedsUROCON)

To the editor, As of March 11th, 2020 the World Health Organization declared Coronavirus disease 2019 (COVID-19) a pandemic and urged countries to implement protocols to contain the virus spread [1]. It was soon realized that the world was ill prepared and too few lessons had been learned from previous infectious outbreaks in 2003 and 2009. [2] As a result, preparation and planning were insufficient to deal with the impact of this strain on the healthcare system. To deliver the optimal care despite this pervasive and fast-evolving event, healthcare managers must address and adjust 4 main domains in order to reach optimal surge capacity: maximize use of hospital structure, increase staff capacity, prioritize use of equipment and supplies, and develop an efficient communication system between hospitals [3,4]. Another key factor in pandemic preparedness is the rapid acquisition of information on pathogen epidemiology. All of this knowledge is essential to make adjustments, which can increase the reliability of the current protocol in addition to clarifying existing hospital vulnerabilities. More importantly, it can assist in predicting which further measures might be necessary to accommodate the influx of patients. [3,4]. It is important to recognize that patient flow plays a primary role in organization of hospital resources [4]. Critically analyzing the needs and requirements of each healthcare component, by identifying a hierarchy of their services, can lead to hospital planning being more efficient, resulting in quicker establishment and mobilization of rapid-response groups. [3,4]. However, accuracy of communication is a major challenge identified when creating a mass protocol as inconsistent terminology or triggers can generate confusion [4]. For this reason, assuring optimal communication and networking between local and regional hospitals aids hospital management by allowing patient tracking, information sharing, and appropriate distribution of patients and supplies [3-5]. Defense readiness condition (DEFCON) is a system created by the United States military to standardize the level of reaction required for a threat level perceived by the military [6]. DEFCON is graded from 1 to 5, where 5 represents normal peacetime readiness and 1 represents maximum readiness – nuclear war is imminent [6]. Each level is detailed with the expected actions and clearly states the trigger to activate the next level. This system establishes a clear and well-defined app