The latest influx of Covid-19 is forcing American hospitals to take drastic measures – creating temporary facilities or preparing to transport patients to other cities and states – to avoid overcrowding.
The number of Americans currently hospitalized with Covid-19 has increased by 12,000 in the last month, reaching 41,753 on Oct. 25, according to the Covid Tracking Project. Some hospitals make ration plans if they have more patients than beds, the worst case scenario they hoped to avoid.
Case numbers are still rising: The United States now averages nearly 69,000 new Covid-1
Deaths are already reported, with the United States now averaging more than 800 every day, and usually follow the same trends as cases and hospitalizations with slightly longer delays. (Fortunately, hospitals have figured out how to better treat Covid-19, leading to lower mortality rates. But still, more patients in the hospital will inevitably mean more deaths.)
And the terrible feature of this new wave is that cases and hospitalizations are rising everywhere. In previous waves, cases flowed in one part of the country while they jumped elsewhere. But now the whole country is experiencing a wave at the same time.
In all states except Hawaii, Delaware and Louisiana (and Washington, DC), the number of cases has increased in the past two weeks, according to Covid Exit Strategy. More than 40 states have more people hospitalized with Covid-19 now than 14 days ago.
Public health experts have long expected that the incidence will increase during the winter months, when social alienation becomes more difficult and colder weather facilitates the spread of the coronavirus. But these new data show that the difficult days are already here.
And hospitals are experiencing stress, just like in the previous jumps. The weekend brought numerous reports of hospitals taking urgent action to deal with the influx of patients with Covid-19. According to the Covid Exit Strategy, 20 countries currently have more than 70 percent of the intensive care unit; this remaining capacity may shrink rapidly if current trends continue. In some cities, hospitals have already reached their capacity.
Here are just a few examples of hospitals pushed to the brink in the third wave of the pandemic.
El Paso, Texas, set up a field hospital and ordered a mandatory curfew
El Paso County issued a mandatory curfew from 10pm to 5am in the morning after hospitalizations rose by 300 percent in less than three weeks. A recent study by the University of Texas predicts a 96 percent chance that there will be more patients in the intensive care unit in the area by Nov. 8, and an 85 percent chance that all hospital beds will be filled.
Several other regions in the state – around Amarillo, Lubbock, Wichita Falls, Abilene, Dallas / Fort Worth and Odessa – also have better than even chances of exceeding their intensive care unit capacity over the next two weeks. Across the country, the number of hospitalized patients with Covid-19 increased from 3,190 on October 1 to 5,206 on October 25.
“We are in a crisis phase,” El Paso County Judge Ricardo Samaniego said this weekend, according to CBS News.
A field hospital is being set up at the Center for Congresses and Performing Arts in El Paso, initially with 50 beds but with the capacity to add another 50. More than 1,000 state and federal health workers have moved to the county in recent days to try to provide more support. As Vox has already reported, one problem that hospitals experience during Kovid overvoltages is staffing; sometimes they may have open beds, but not enough nurses and doctors to care for patients.
Hospitals are also preparing to transport patients from the El Paso area to other parts of Texas with more beds available. Governor Greg Abbott has raised the possibility of opening a military hospital for civilians.
“Hospitals are reaching a point where they have expanded, within their existing bricks and mortar, as far as they can,” a statement from El Paso University Medical Center said in a statement.
Utah hospitals are preparing to distribute medical care to Covid-19 patients
Covid-19 has exploded in Utah in the last two months. On September 1, the state averaged less than 400 new cases each day; as of October 25, the average number of new cases per day had reached nearly 1,500. Hospitalizations followed the same trend, with the number of patients currently hospitalized with Covid-19 more than doubling from 145 to 313 over the same period.
With some hospitals already forced to activate their emergency plans, hospital staff have begun to develop criteria for how to allocate care if they have more patients than available beds.
It can literally be a matter of choosing which patients to live and which patients to die. From the Salt Lake grandstand:
Greg Bell, president of the Utah Hospital Association, said state hospital administrators faced Governor Gary Herbert on Thursday with a grim list: Criteria doctors suggest they use if they are forced to decide which patients can stay in overcrowded wards. for intensive care.
According to the criteria that will require Herbert’s approval, patients who worsen despite receiving intensive care will be evicted first. If the conditions of two patients are equal, the young are given priority over the old, as older patients are more likely to die.
“We told him, ‘Looks like we’re going to have to ask for these to be activated if this trend continues,'” Bell said, “and we see no reason why it shouldn’t.”
Hospitals in Utah are also facing the same staffing problems seen elsewhere: Although the state has made plans to set up a field hospital at an exhibition center, medical officials warn that doctors or nurses are not available to service these new beds. Health workers describe a sense of grief during the Covid-19 crisis and are now being asked to do more, months after the pandemic.
“Hundreds and hundreds of nurses are not able to work as before [before] because of their own illness or infection in the family, or they are mothers and fathers with school problems, “Bell told the Tribune. “Some are worn out, others are on leave because they have been doing so for seven months.”
Hospitals in Idaho plan to send patients out of state while beds are filled
Idaho set a record for Covid-19 hospitalizations over the weekend with 259 people currently hospitalized, up from 135 in early October. In addition, the state has, on average, nearly twice as many new cases as a few weeks ago, which means more hospitalizations are likely to follow.
Hospitals may have to send patients to hospitals in other states when their beds fill up, a huge logistical challenge for facilities and an emotional challenge for families who can be separated from their loved ones by hundreds of miles.
At least one hospital in northern Idaho has already planned such a case. Kootenai Health at the Coeur d’Alene announced late last week that it had reached 99 percent capacity. The health care system will send patients to Portland, Oregon or Seattle, Washington, if their numbers continue to rise as nearby hospitals experience the same jump and have no room to accept additional patients.
Another hospital, the Magic Valley of St. Luke in Twin Falls, has announced it will begin transferring children in need of hospitalization to hospitals in the state capital Boise to reserve more beds for Covid-19 patients.
The increase in hospitalizations at Covid will worsen before it improves
There are more stories like this across the country:
- Wisconsin set up a field hospital at the state fairgrounds near Milwaukee. (Covid-19 hospitalizations in the state have doubled since the beginning of the month.)
- Hospitals in Kansas City, Missouri, are reportedly refusing ambulances because they have no beds available, and city hospitals warn they may not be able to accept overflow patients from rural areas. (Missouri hospitalizations reached a new record last week.)
- Hospitals in Oklahoma City are activating their surge plans to add more beds, call in additional staff and possibly reduce non-Covid services. (Oklahoma is another state to see a record number of Covid-19 hospitalizations in the last few days.)
As the number of cases increases, hospitalizations and deaths will follow. This is an established model. This will get worse before it gets better.
But we can try to ease the burden on hospitals and their staff. As Vox explained at the start of the pandemic, the goal of social distancing is to suppress the spread of Covid-19 so that hospitals are not overwhelmed. Time is also being bought for hospitals to introduce their surge capacity and staffing plans.
It will not be easy. The federal government will not provide more resources to hospitals in the foreseeable future, with hopes for another aid package Covid-19 before it disappears in January. Some state and local governments continue to oppose mandates (even in these stressful areas such as Idaho) and other social constraints.
Wearing a mask and keeping your distance is something that each of us can do on our own to reduce the spread of Covid-19 and slow the rapid growth of hospitalizations. No time to waste.
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