Medical staff members prepare to perform a percutaneous tracheostomy procedure on a patient in the COVID-19 intensive care unit (ICU) during Thanksgiving at the United Memorial Medical Center on November 26, 2020 in Houston, Texas.
Go Nakamura | Getty Images
More than 100,000 people are currently in hospitals across the U.S. sick with Covid-19, as the pandemic pushes doctors, nurses and other health workers to their limits.
The current number of hospitalized patients underscores the scope and severity of the current phase of the U.S. outbreak. Never before had the number of hospitalized Covid patients surpassed 60,000, according to data compiled by the Covid Tracking Project, which is run by journalists at The Atlantic.
In fact, Dr. Janis Orlowski, chief health care officer at the Association of American Medical Colleges, said in a phone interview with CNBC that she doesn’t recall any disease sickening so many Americans all at once ever before.
“I don’t think we’ve ever seen this number. We certainly never saw this number with HIV or any of the other new diseases that we’ve had,” Orlowksi said. “It’s an astonishing, astonishing number and the shame of it is it’s a number that we could have impacted and we didn’t.”
Earlier this week, Orlowski’s organization, the AAMC, announced that it is encouraging all health systems to prepare to deploy ”Crisis Standards of Care,” which is typically used in severe situations such as the Sept. 11 terrorist attacks and natural disasters.
Orlowski explained that crisis care essentially means the rationing of care in hospitals. The goal is “to provide the best care possible to the largest number of people with the resources available,” AAMC said. But it also means difficult decisions will be made about whom to use scarce resources on, Orlowski added.
Hospitals in some parts of the country are already at the point of crisis care, Orlowski said, such as El Paso, Texas, parts of Utah, North Dakota and parts of Nebraska. She added that “most hospitals are going to be there in the next two weeks” if current trends persist or get worse, owing to a surge driven by Thanksgiving travel and gatherings.
The situation is further complicated, Orlowski said, by the backlog of elective surgeries that were delayed in the spring when hospitals prepared for an initial surge in Covid-19 patients. Most hospitals resumed elective surgeries over the summer, but with hospitalizations rising so rapidly some state officials are again warning that hospitals should be prepared to cancel elective procedures.
“What we have found is people suffered harm because of delays,” she said. “What we had thought in the fall is we’re going to be able to do some of those cases in the winter. Now I worry that we’re not going to be able to do those cases. … We’re headed into a bad, bad, bad two or three weeks.”
Dr. Megan Ranney, an emergency physician and director of the Brown-Lifespan Center for Digital Health, said that her hospital system in Rhode Island has about 1,000 beds. She said she struggled to imagine 100 more systems like hers all filled with Covid patients.
“We’re running out of beds, and we’re also going to run out of staff,” she said. “Our health-care system is full even in normal times, so to add an extra 100,000 patients on top of our existing burden of disease and injury is almost unfathomable.”
The situation in Rhode Island is bad, Ranney said, but she’s heard from colleagues elsewhere of dire situations, where health workers have to ration care, like in “low-income countries.” Ranney said her time training in East Africa as a Peace Corps volunteer helped her prepare for the current crisis.
“I witnessed decisions being made about patients being put on ventilators that I never thought I would experience in the United States,” she said.
The staff in Ranney’s hospital work hard every day and come prepared to “do battle with Covid-19, but it is exhausting,” she said.
“We’re all on edge. We made it through the first week in the spring, and it is frustrating and exhausting to be going through this again,” Ranney said. “It feels sometimes hopeless. … And it feels even more hopeless because we don’t see any sign of the surge stopping.”
She added, however, that no matter how bleak the situation seems, she and her colleagues won’t be giving up. Vaccines, and hope, are on the horizon, she said.
‘Surge with no staff’
Dr. Syra Madad, senior director of the systemwide special pathogens program at New York City Health + Hospitals, said the country is in a “very dire moment.”
“This is a surge with no staff,” she said. “This is widespread, and it’s happening all at the same time, and everybody’s getting hit simultaneously. Before, we were able to share resources and assets, whether it’s staffing, whether it’s supplies, whether it’s the bed space, but now that’s something that is a luxury.”
Hospitalizations aren’t rising as rapidly in New York City as they did in the spring, Madad said, but hospital systems across the state are preparing for a potential surge. Gov. Andrew Cuomo announced Monday that the state is implementing emergency measures to help hospitals cope with what he called “a new phase in the war against Covid.”
One of these measures is the identification of retired nurses and doctors in case their service is needed as hospitals fill up.
“You can add as many beds as you want, but if you have nobody to man those beds and actually be able to provide patient care, then that is absolutely useless,” she said. “Staffed beds are everything. Beds by itself are nothing.”