The COVID-19 (COVID) pandemic has led to unprecedented action and innovation in the US healthcare system; at the same time, it has presented extraordinary challenges and risks. Through dramatic augmentation of surge capacity, deferral of other services, and implementation of crisis standards of care, hospitals in many locations have been able to absorb the blow of the first peak of COVID cases and continue to provide lifesaving care to both COVID patients and others with life-threatening emergencies. But many communities are just beginning to experience the full force of the pandemic, and in every location, the healthcare response to COVID has come at a very dear price. Healthcare facilities have sustained huge financial losses, and healthcare workers’ health and well-being have been put at high risk. New standard operating procedures and work processes have been improvised, and many old lessons have had to be relearned.

There is an urgent near-term need to address key challenges faced now by healthcare facilities and healthcare workers in the pandemic, and this current crisis also has made painfully apparent the many vulnerabilities of our healthcare system and the longer- term structural reforms that are necessary to sustain it. This report offers answers and recommendations related to the following problems, for which there are tractable solutions:

• How can we improve infection prevention in hospitals and maintain a robust supply chain for personal protective equipment (PPE)?
• What approach should we take to restarting deferred healthcare services?
• What financial support is needed for hospitals and healthcare providers?
• How should the healthcare workforce be sustained and augmented?
• How can we provide mental health support for healthcare workers in this crisis?
• How can we provide medical care and sick leave for all people in the United States?
• How can we make telemedicine a new normal?
• How can we reduce the number of undiagnosed infectious diseases in our hospitals?
• How can we better protect emergency medical services (EMS) personnel from infectious diseases?
• How can we better coordinate the healthcare response to COVID and the next pandemic?

This is not an exhaustive compilation of all the challenges the health sector faces,
but these are among the most important. We have organized these topics and recommendations roughly in order of the urgency with which they must be addressed. There is much to be done now.