Hospitals ‘Already Stretched To Capacity’ Shift Into Surge Mode But Many Warn Coronavirus Patients Will Still Overwhelm System
One of the top concerns for public health experts is how virus cases are likely to overwhelm hospitals, like is happening in Italy. Patients there are dying while waiting for treatment and doctors are forced to choose who to treat and who to let die. European health officials say Italy's experience with its faltering health system is just a preview of things to come for other countries.
One Seattle-area hospital has already seen patient care delayed by the stringent infection-control practices that the government recommended for suspected coronavirus cases. Another in Chicago switched Thursday morning into 鈥渟urge鈥 mode, setting up triage tents in its ambulance bay and dedicating an entire floor to coronavirus patients. At least one is already receiving emergency supplies from the federal government鈥檚 stockpile. With the bow wave of coronavirus infections still to come, hospitals across the country are trying to prepare for a flood of critically ill patients who will strain their capacities like nothing they have seen in at least a generation. Even with some time to prepare, administrators fear they will not be ready. (Kliff, 3/12)
William Olson, the chief of operations for eight Oregon hospitals, grew worried when he was shown a heat map of coronavirus cases and flulike symptoms among patients across seven Western states. The maps captured trends for patients of Providence, which owns 51 hospitals and shared the results early Monday with its hospital executives. Seattle鈥檚 outbreak, depicted in blue dots, was already ballooning. And now Portland had its own blue specks. If the pattern held, his hospitals were about to be severely tested. 鈥淭hat was the alarm bells going off,鈥 he said. Mr. Olson said Renton, Wash.-based Providence has sent its real-estate team to hunt for empty lots suitable for medical tents, an exercise under way in all its markets. Also on the Catholic health system鈥檚 list of possible extra space for patients: a former dormitory for nuns. (Evans and Wilde Mathews, 3/12)
The question was important, straightforward and crucial to the country鈥檚 preparedness for dealing with the coronavirus crisis: Are America鈥檚 hospitals equipped to treat a possible influx of patients afflicted with covid-19? Do they have enough intensive care units and enough ventilators? And the official being questioned by Fox News anchor Martha MacCallum on Thursday night was in a position to know. After all, Seema Verma is the administrator of the Centers for Medicare and Medicaid Services, which, as its website says, 鈥渙versees one of the largest federal agencies that administers vital health care programs to over 100 million Americans.鈥 She is also on the White House coronavirus task force. As hard as she tried, however, MacCallum could not get a straight answer. (Barbash, 3/13)
The mayor of one town complained that doctors were forced to decide not to treat the very old, leaving them to die. In another town, patients with coronavirus-caused pneumonia were being sent home. Elsewhere, a nurse collapsed with her mask on, her photograph becoming a symbol of overwhelmed medical staff. In less than three weeks, the coronavirus has overloaded the heath care system all over northern Italy. It has turned the hard hit Lombardy region into a grim glimpse of what awaits countries if they cannot slow the spread of the virus and 鈥樷榝latten the curve鈥欌 of new cases 鈥 allowing the sick to be treated without swamping the capacity of hospitals. (Horowitz, 3/12)
When her hospital in the northern Italian city of Cremona had its first case of coronavirus three weeks ago,聽Francesca Mangiatordi was on a night shift. Since then, as dozens of new cases poured in, the emergency-room doctor has been faced with heart-rending choices, such as how to allocate scarce oxygen supplies among critically ill patients. 鈥淭hese are the choices I would have never wanted to make,鈥 she said. 鈥淚t鈥檚 somewhat like being in war.鈥 (Lombardi and Petroni, 3/12)
In a stark and urgent COVID-19 risk assessment update today, the European Centre for Disease Prevention and Control (ECDC) said that, in a few weeks or even days, other countries in the region may face huge surges that mirror those of China and Italy. It advised countries to quickly shift to mitigation strategies to protect vulnerable people and prevent overwhelmed hospitals. (Schnirring, 3/12)
Kaiser Health News:
Coronavirus Pushes Hospitals To Share Information About Stocks Of Protective Gear
Masks, gloves and other equipment are crucial as health care workers face the COVID-19 outbreak. There聽is a strategic national stockpile that the U.S. government controls 鈥 but no one knows what, beyond that stockpile, is available in the private sector. Some hospitals have a surplus of the protective equipment and some not enough. The Centers for Disease Control and Prevention is working on a system that would track the inventory across the U.S. (Farmer, 3/13)
Hospital responses to the pandemic have varied. While some are actively communicating and being transparent, others are declining to publicly disclose if one of their patients has COVID-19 to minimize liability. Hospitals weigh these decisions as they toe a fine line between disclosing accurate information, complying with privacy laws and not inciting fear. (Kacik, 3/12)
To illustrate the gulf between the nation鈥檚 costly health care and its underfunded public health, Alfred Sommer, former dean of the Johns Hopkins Bloomberg School of Public Health, often tells a story: When people wake up after triple bypass surgery at the famous hospital across the street in Baltimore, they typically thank their doctors for the lifesaving miracles they performed 鈥 and sometimes even make donations to the institution. 鈥淣obody wakes up in the morning and says, 鈥楾hank God I don鈥檛 have smallpox.鈥 Or, 鈥楾hank God my water is potable,鈥欌夆 Sommer said. (Sellers, 3/12)
Meanwhile, in the states 鈥
New York hospitals may need to halt all elective surgeries and recall former doctors and nurses to handle a surge in novel coronavirus patients, Gov. Andrew Cuomo said Thursday. Mr. Cuomo said at a press conference that stopping the surgeries would help avoid overwhelming the health-care system. The move would add 25% to 30% to the system鈥檚 capacity he said. New York鈥檚 Department of Health would expedite recertification for former doctors and nurses, he said. The state is also considering how the capacity of healthcare systems in upstate New York could relieve those downstate. (West, 3/12)
Maryland鈥檚 four dozen hospitals are scrambling to prepare for a potential surge of patients sickened by the new coronavirus. Officials are upgrading old flu pandemic plans and inventorying protective gear, medical equipment, staff and beds. They are, however, facing some tough math. (Cohn and Miller, 3/13)
As Ohio accelerates its defense against the spread of the novel coronavirus, hospital officials across the state worked Thursday to reassure residents that their facilities can handle a major increase in patients who get sick from the infection. The executives also said doctors, nurses and other caregivers are prepared to manage a surge in patient counts from the highly contagious virus and the upper-respiratory disease it causes, COVID-19. (Saker, 3/13)
Visitors to licensed health care facilities in Louisiana will be limited in an effort to stop the spread of coronavirus, according to a statement from the Louisiana Department of Health.聽The only visitors allowed into any licensed facility are "those deemed essential, vital or necessary to the care and well-being of patients, clients and residents," according to a statement from the Department.聽(Woodruff, 3/12)
At least one hospital in the Las Vegas Valley had tents set up outside their emergency room entrances on Thursday morning. Signs alerting patients that health screenings would be done before they enter the ER were in place at Sunrise Hospital and Medical Center and Desert Springs Hospital. Neither hospital had a line. (Przybys, 3/12)