In Boston, pediatric wards are being consolidated to fit all the adults battling covid-19. Philadelphia hospitals are once again barring family visitors due to transmission worries. And in Los Angeles, a public hospital canceled elective and scheduled surgeries because it cannot spare ICU beds.
Exponentially rising hospitalizations in these and other states are pushing some hospital systems to near breaking points, with many scrambling to reconfigure themselves to handle a crush of patients streaming in after holiday gatherings and the arrival of flu season.
Hospitals reported more than 110,000 coronavirus patients on each of the past two days, a record count for the pandemic, according to tracking by The Washington Post. That is more than three times the number they treated in September and nearly double that reported at the height of the spring surge.
In hard-hit California, officials activated a mutual aid program for coroners, designed to help local authorities cope with “mass fatality.” Gov. Gavin Newsom, a Democrat, said at a news conference Tuesday that the state had ordered 5,000 more body bags and 60 refrigerated storage units were on standby.
“I don’t want people to scare folks, but this is a deadly disease,” Newsom said. “And we need to be mindful of where we are in this current journey together, to the vaccine. We are not at the finish line.”
The southern region of California, which includes Los Angeles County, has emerged as one of the state’s bright-red hot spots, with 0.5 percent availability of intensive-care beds, according to the state’s coronavirus dashboard. Covid-19 patients at the Los Angeles County-University of Southern California Medical Center, a 600-bed public hospital, have “blown past” its earlier record in July, said Brad Spellberg, the hospital’s chief medical officer. The hospital has 150 covid-19 patients and 50 in the ICU.
“This is not the time to come to us for a hangnail,” Spellberg said. The hospital still has the capacity to treat heart attacks, strokes, car crashes and other emergencies, he added, but that’s about it. Even when treating such patients, it may take longer than normal to find beds for them.
He said the hospital is a step away from crisis triage levels when people will be discouraged from coming to the hospital altogether.
In the last week, 18 states have set single-day records in patients hospitalized for covid-19, the disease caused by the coronavirus, as cases soar all over the country.
Besides California, mounting cases and hospitalizations in Arizona, Pennsylvania, Ohio and North Carolina continue to push some regions and hospital systems to crisis conditions, while the Upper Midwest and Plains states are finally seeing plateaus.
“Now the entire country is one big red hot zone,” said Arizona Medical Association President Ross Goldberg. “That red map that shows the really bad places for covid – now it’s just red.”
That the current surge is so widespread means health-care systems have not been able to share the burden as they have in the past. Hospitals in rural areas, in particular, have been grappling with overflow conditions because some of their larger partners in urban centers have stopped accepting transfers. Such facilities are dependent on formal or informal partnerships with other institutions to handle critically ill patients after decades of financial challenges forced many to close or greatly reduce their intensive care units.
Many have only one ventilator for the entire facility and they are typically only used short-term – for a few hours or a day – until the patient can be sent to another facility. This process helped streamline operations in normal times, but has become a major vulnerability during the pandemic.
“Efficiency has been the mantra for health-care systems over the last decade but those efficiencies don’t work well in a pandemic,” said Brock Slabach, senior vice president for the National Rural Health Association.
That situation has left communities that might only have one ambulance without one for whole days so that people who have a heart attack or stroke may not have access to first responders, he said.
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Source: Houston Chronicle