Preparing for compounding crises: Staff shortages and cyber-attack vulnerability in the era of COVID-19

In 2020, while the USA was experiencing successive waves of COVID-19, Universal Health Services experienced a major cyber attack that crippled electronic systems in over 200 hospitals, including a major academic medical centre that was playing a key regional role in COVID-19 care and clinical trials. This paper discusses the impact of the attack on clinical operations, informatics, research and teaching, contextualising the case study within more wide-scale trends driving the rise in cyber attacks on healthcare systems. The compounding relationships between COVID-19, healthcare workforce depletion and cyber-security vulnerabilities form the framework of the discussion and action plan. Commitments to institutional best practices, large-scale investments in infrastructure, and above all increasing support for the critical human actors carrying out the work, are urgently needed to secure the healthcare system against these destabilising threats. Within this context, this paper argues that information security in the healthcare sector must be reimagined and integrated with greater support for the needs of frontline healthcare workers.