Conflict is no longer a distant concern; it is edging ever closer to the hospital ward. From cyberattacks on healthcare systems to fragile global supply chains and the realities of modern warfare, intensive care and emergency medicine specialists are being forced to reconsider how their units would function in a crisis.
During ISICEM’s morning session, Prof Alexander Vlaar delivered a clear warning: the ICU and emergency medicine community must begin preparing for the disruption of hospital care caused by conflict, as the threat is coming closer than expected.
The urgency of the issue is already evident. Already, a global supplier of critical emergency medicine products is facing disruptions in order processing, manufacturing, and shipping due to a cyberattack linked to the Iran conflict. This shows how real and immediate the problem is.
Healthcare systems are increasingly vulnerable. A recent cyberattack on pathology services for Guy’s and St Thomas’ in London exposed how easily essential services can be compromised. If the blood bank is affected, cross-matching and the release of blood products are delayed, creating major risks for patient care. Prof Vlaar highlighted the need for critical care professionals to be ready for these scenarios.
Beyond cybersecurity, supply chain fragility presents another major risk. Many ICUs depend on a single geographic source for critical drugs, devices, and disposables. If a region is affected by conflict, ICUs become extremely vulnerable. This has already been experienced during COVID-19.
There is also the growing possibility that hospitals themselves may be drawn closer to the frontline. Facilities outside Ukraine are already treating casualties from the war, and modern warfare, particularly the expanded reach of drones, is blurring traditional boundaries.
These realities raise urgent operational questions: how can hospitals continue to function if digital systems fail, or if electricity and water supplies are disrupted? Healthcare systems cannot close. ICUs and emergency departments must remain operational 24/7.
Preparation is essential, and COVID-19 has already shown what is possible. That experience has prompted greater focus on resilience, including efforts within the European Union to localise production of critical medicines and reduce reliance on vulnerable supply chains.
Professor Vlaar highlighted two key priorities: diversifying supply sources for essential materials and ensuring ICUs can operate under severe infrastructural constraints. At a minimum, hospitals should be able to function independently for 72 hours.
Achieving this requires comprehensive disaster planning, regular training, and scenario-based exercises. Hospitals must assess their readiness: Can they operate without digital systems? Without external power? How will teams communicate if phones and email fail? In some cases, even a return to paper-based processes may be necessary, though this too requires preparation and training.
Ultimately, resilience depends not only on systems, but on people. Prof Vlaar emphasised the importance of unity within the critical care community. During COVID-19, ICU teams worked exceptionally well together. In times of conflict, divisions may arise, but it is vital that healthcare professionals stand together and do not let politics come between them.
Source: ISICEM
Image Credit: iStock
