In this issue of Acute and Critical Care, Wang et al. [2] reported a roadmap for hospitals and health systems to prepare for a surge in critical care capacity. In this study, they explained the efforts to prepare for the COVID-19 pandemic, for which their hospital expanded their hospital intensive care unit (ICU) for the management of critically ill patients. In conclusion, they suggested flexible bed management initiatives, teamwork across multiple disciplines, and development and implementation of guidelines to manage a surge of critically ill COVID-19 patients.

In our hospital, a regional center for the respiratory center has been placed into the dedicated center for COVID-19 including 17 ICU beds since December 30, 2020. Also, other tertiary hospitals within Busan Metropolitan City prepare ICU beds for critically ill COVID-19 patients. In order to provide immediate care for critically ill COVID-19 patients, the workers of the Busan Civil Facilitation Division assess total and available ICU beds of tertiary care hospitals within our city. In the event of an acute critically ill COVID-19 patient, these workers help the patient be admitted to a tertiary hospital using various messenger programs among hospitals.

In many countries, there are specialized wards within some tertiary hospitals or specialized hospitals for the management of COVID-19 patients. These institutions prepare separate ICUs and medical resources including mechanical ventilators and various equipment to manage patients requiring ICU admission. However, critical care resources, facilities of tertiary care hospitals, and shortage of critical care personnel are serious issues [3]. Moreover, available strategies to manage critically ill patients caused by non-COVID-19 origins are essential. Therefore, an understanding of the number of patients, capacity, and resource utilization is essential for public health policymakers to adequately address resource allocation. In addition, rapid communications among institutions within a province or city should be necessary to overcome shortage of ICU resources and to inform important decisions about allocation of scarce resources [3,4].