Guidelines for redeploying psychiatrists to medicine during a pandemic crisis

In January 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, was identified as the causative agent for pneumonia cases in the Hubei Province of China. By March 11, 2020, coronavirus disease 2019 (COVID-19) reached pandemic levels and had spread to nearly every continent. Due to an exponential growth of cases and high rate of hospital admission, patient volume rapidly exceeded capacity. To meet demand, physicians in Asia, Europe, and the United States, regardless of their specialty, were redeployed to COVID-19 units. Redeployment of physicians involves complex decisions, such as whom to reassign, where to reassign, and how to balance needs of frontline services with those of other critical services. Guidelines for these challenging decisions are scarce. To address this critical gap in policy, we present general recommendations for redeploying psychiatrists to the medical front lines. We address levels of preparedness, complexity of the medical settings, use of house staff, medical supervision, emotional support, risk management, back-filling psychiatric services, provider diversity, and ethical, legal, and regulatory challenges. Our guidelines are general and not intended to be “one size fits all,” as we recognize that local conditions will necessitate adaptation.