Hospitals flooded as vaccines for most in the US are still months away

Photographer: Apu Gomes / AFP / Getty Images

Covid-19 has hospitalized nearly twice as many Americans as at any point during the pandemic, putting medical providers on the brink of crisis with vaccine doses for most people.

The U.S. health care system and those who serve it are more taxed than ever. And the virus’s grip on hospitals has shifted to more rural communities, where treatment alternatives are scarce.

In the short term, continued stress on patients threatens to accelerate deaths as access to intensive care units in the intensive care unit diminishes. In the longer term, the risks are more systemic: fatigue, attrition and damage to the mental health of the doctors and nurses who care for the sick.

“The moment when the per cent of beds occupied by Covid patients is on the rise, which is really causing a lot of staffing problems, ”said Pinar Karaca-Mandic, professor of risk management in healthcare at the University of Minnesota. “It has exposed much of the fragmentation in our health care system.”

Hospitals are swelling

Almost twice as many Americans are hospitalized with Covid than in the spring

Source: Covid Tracking Project

According to data from the Covid Tracking Project, more than 115,000 Americans are currently in hospital with coronavirus – a number that has risen alongside daily cases since early October. California, Texas, and New York account for more than a quarter of the national total.

Nearly one in five US hospitals reported a critical staff shortage on Friday data from the Department of Health and Human Services. Earlier this month, HHS released figures that provided a more localized picture of the devastation previously obscured by national or national figures.

Non-urban areas are more affected by the current wave, with higher occupancy rates than densely populated regions, said Karaca-Mandic, whose team analyzed the data.

More than a dozen counties – such as Burke, North Carolina and Hale, Texas – reported that at least 90% of their ICU beds were filled with Covid-19 cases, leaving hardly any capacity to treat others. Karaca-Mandic’s investigation has linked IC bed use to increased mortality.

“What the facility-level data shows us is how localized the pandemic can be,” she said.

The American West is grappling with some of the most acute consequences. On a population scale, Nevada and Arizona reported the highest nationwide hospital admissions Monday.

Call late at night

In Mesa, Arizona, about 20 miles east of Phoenix, Lee Allen passes families pressed against the windows of the hospital where he works as a nurse anesthetist. Some hold up cardboard signs with words of encouragement.

Just inside, patients are being treated in the nearly entire ICU, which has expanded to underused areas of the building. Many cannot read the signs while lying face down to improve air flow to their lungs.

Although Allen’s primary specialty is obstetric anesthesia, he is more often asked for help with particularly difficult intubations, such as for patients with co-morbidities or morbid obesity. Just a few days ago he was called in at 2 AM

“I am hopeful that the vaccine will help,” said Allen, who himself is immunocompromised and received the vaccine on Monday.

In neighboring California, the virus has exploded with renewed rage. Cases, hospitalizations, and deaths all broke records last week.

Governor Gavin Newsom said Monday that the state could see more than 90,000 people with Covid-19 hospitalized in mid-January, if the current wave does not slow. California reported a record 18,359 Covid patients in its hospitals Monday, a 67% increase in two weeks. ICUs in Southern California and the San Joaquin Valley are actually full and only 2.5% of the statewide ICU capacity remains open. In the past two weeks alone, the state has lost 2,741 people to the coronavirus.

“Some counties or some regions may begin to exceed their existing declared hospital capacity by the end of the month and early January – not just ICU capacity,” said Mark Ghaly, secretary of the California’s Health and Human Services bureau, at a news conference. Monday. “We’re not seeing that statewide at the time, but we’re watching it very closely.”

California has opened four temporary care facilities and has seven more ready if needed. Ghaly said hospitals have been making contingency plans to activate “crisis care teams,” who would make the tough decisions to prioritize care for sick patients should the facilities become overwhelmed.

The state has so far managed to transfer patients from overloaded hospitals to more capacity hospitals, but that will become more difficult as the outbreak grows, he said.

ICUs vol

Twenty-one states reported that more than 80% of their intensive care beds were full

Source: US Department of Health & Human Services

While bed availability is tight in certain parts of the country, bottlenecks are often more the result of staff restrictions. Those with coronavirus are more time consuming, expensive and labor intensive than typical patients.

“We can’t really downplay the emotional tension,” said Ann-Marie Alameddin, Arizona Hospital’s president and chief executive officer. healthcare Association, where there is hospital bed occupation estimated at 78% statewide. “I think there will be lasting effects that we will navigate through for months and years to come.”