The powder keg: Lessons learned about clinical staff preparedness during the early phase of the COVID-19 pandemic

Sainfer Aliyu, Allison A. Norful, Krista Schroeder, Michelle Odlum, Bonnie Glica, Jasmine L. Travers

Research output: Contribution to journalArticlepeer-review


Background: Little is known about clinical staff's perspectives on preparedness for a pandemic. The purpose of this study was to obtain various clinical staff perspectives about preparedness to meet the demands for care during the early phase of the SARS-CoV-2 (COVID-19) pandemic. Methods: We conducted a qualitative study using semistructured in-person interviews from March 2020 to April 2020 at a large tertiary academic urban hospital center. Interview guides were informed by the Resilience Framework for Public Health Emergency Preparedness and analyzed using a directed content analysis approach. Results: Fifty-five clinical staff participated in the study. Three themes emerged from the data (1) Risk assessment and planning: “The powder keg,” (2) Innovative evolution of roles and responsibilities, and (3) Pandemic response and capacity. In the early phases of the pandemic, participants reported varying levels of risks for dying. However, most participants adapted to practice changes and became innovative in their roles over time. Hierarchies were less relevant during care delivery, whereas team collaboration became crucial in managing workforce capacity. Discussion: As the pandemic progressed, staff preparedness evolved through a trial-and-error approach. Conclusions: The pandemic is evolving as is clinical staff preparedness to meet the demands of a pandemic. In order to get a grasp on the crisis, clinical staff relied on each other and resorted to new workarounds.

Original languageEnglish (US)
Pages (from-to)478-483
Number of pages6
JournalAmerican Journal of Infection Control
Issue number4
StatePublished - Apr 2021


  • Health care professionals
  • Health care workers
  • Hospital emergency
  • Hospital preparedness
  • SARS-CoV-2, COVID-19

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases


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