Covid: The potentially crushing toll of rationing health care

Health, Fitness & Food

The chief medical officer at Presbyterian Healthcare Services, Dr. Jason Mitchell, told CNBC that doctors are doing “everything we can do” to prevent rationing care as his state’s governor signed an executive order that moved New Mexico a step closer to rationing care at any place where patients are being treated for coronavirus.

“It’s really important to recognize that as we move into a crisis standard of care, the goal is to expand services so we don’t have to ration,” Mitchell said. “Additionally, we’ll use places we don’t normally use, whether that’s tents or clinics to put hospital beds, we really will do everything. That’s what we’re focused on, is trying to do everything so that you don’t get to that point.”

The Albuquerque doctor added that hospitals will bring in physicians and nurses that typically practice in clinics, as well as rotating doctors who do not typically work in ICUs. ICUs in New Mexico hit 103% capacity, the highest in the country. 935 people are hospitalized with Covid in New Mexico, with hospitalizations more than doubling over the past month, according to the Covid Tracking Project.

Mitchell said that a group of physicians, nurses, ethicists and academics were working on an equitable way to potentially ration care to ensure that healthcare providers can give as many resources to as many people as possible. 

“The other important thing is that we all do it together, so every healthcare organization uses the same criteria, the same mechanisms to ensure that equity, and to ensure that patients are distributed across the state, and that we give as much care and save as many lives as we can,” said Mitchell in a Tuesday evening interview on “The News with Shepard Smith”.

The United States has topped more than 15 million confirmed coronavirus cases. For context, that means roughly one out of every 22 Americans have tested positive since the pandemic began according to a CNBC analysis of Johns Hopkins data. Mitchell explained to host Shepard Smith that while medical professionals are already exhausted, the toll that potentially “not having what you need for every patient is just crushing.”

Dr. Bruce Becker, adjunct professor of behavioral medicine and social science at Brown University’s School of Public Health, echoed Mitchell’s concerns regarding care rationing policy. 

“The individual healthcare worker on the frontline has to carry out the policy at the personal level, and  look in the eye of a patient or family member and tell them they don’t meet a certain policy criteria,” Becker said. “That chips away at a person’s soul, it chips away at their heart, bit by bit, and day by day, because they are taking on the brunt of the pain and suffering of the patient or family who has been condemned by policy to not receive everything that exists.” 

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