The COVID-19 pandemic catalyzed health systems to make swift decisions and implement innovative solutions to manage the disruption of traditional health care created by pandemic-related surges in patient volume, morbidity and mortality. Previous literature has shown that observation units (OUs) offer flexible, scalable delivery models during times of disaster. The three case studies show how OUs can be leveraged to address capacity constraints during a disaster such as a global pandemic. It demonstrates that OUs can be repurposed in a variety of hospital settings and clinical models, ranging from large, multi-hospital health systems to a single hospital site. Each example illustrates the challenge faced by the emergency department (ED), the physical space and infrastructure required to meet requirements, the staffing requirements to fill the new physical or virtual space, and how the OU mitigated the challenge. The COVID-19 pandemic highlights the importance of flexibility, interdisciplinary collaboration, and managing infrastructural challenges. The ability, experience, and protocols generated from repurposing an OU or expanding remote OU health services is invaluable as we will likely continue to face pandemics throughout our lifetimes.