COVID-19 and Healthcare Security: Challenges and Opportunities for Building Enduring Systems of Safety


For many healthcare organizations, alternate care sites proliferated quickly and remained a fixture during the pandemic. Alternate locations included fairgrounds, empty college dorms, closed prisons, convention centers and empty department stores (U.S. Office of Inspector General, 2020). These sites played a crucial role in providers’ ability to more safely administer timely care. Workers at home or other alternate locations encounter some of the same physical threats as those working in traditional healthcare settings, as well unique challenges (American Hospital Association [AHA], n.d.). Access control, alarm and surveillance systems can be challenging for a structure that is not designed to be permanent (e.g., large tent or trailer) (Warren, 2021). Nevertheless, these tools can greatly improve a site’s safety, especially when it has at least minimal security staffing. Workers can protect each other by knowing the surrounding environment and the average response times for first responders. The law enforcement annual report usually includes this information. Even if a clinic is near a hospital, it may have significantly different security challenges. Each clinic should conduct its own security vulnerability assessment to identify its unique set of needs (Reilly, 2019). However, even a thorough assessment can and probably will evolve as the facility takes shape. Security teams should expect the configuration of the space to change multiple times. Remaining adaptable to these changes will help ensure the security of patients and staff.

To overcome these obstacles, several recommendations should be considered. Those charged with setting up the site should clearly define perimeters to securely manage access into and egress from the site while meeting the clinical and infection-control requirements of the facility (AIPC & UFI, 2020). These and other security considerations should be embedded into every stage of a temporary site, from initial set-up to dismantling (AIPC & UFI, 2020). The COVID-19 pandemic forced organizations to become more flexible and collaborative. Because of the fluid nature of pandemics, maintaining regularly scheduled staff meetings is critical to ensuring both security and clinical operations. These meetings should include any staff who are off-site (AIPC & UFI, 2020).

Embracing some key principles will promote a safe environment for patients and staff. While it is not realistic to run regular drills in a state of emergency, developing and drilling emergency egress plans can save lives in case of a fire, flood, active shooter or other unexpected events. The physical environment should complement these procedures. Site designers should choose a layout for the facility that supports the ability to promptly evacuate, lock down, and shelter in place as needed (Warren, 2021). While patient care and infection control may supersede security concerns during a pandemic, this only makes it more vital for security teams to work with other site leaders from the beginning. Security heads should not hesitate to voice their needs, as others may overlook them amidst the fast-paced conditions.

Active sites such as convention centers require a slightly different set of considerations. If an external security team is brought in, it should work together with any existing security teams as these personnel are most familiar with the building. Additionally, the project design would ideally be integrated into the established security plan, “indicating a layered approach, which may include zones, control points, circulation routes, and required egress paths” (International Association for Healthcare Security and Safety [IAHSS], 2020a).