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COVID-19: What Hospital Nurses and Doctors Want Us to Know
Doctors and nurses working in hospitals across the country share the realities of COVID-19.
The number of COVID-19 hospital patients across the country was on the brink of 100,000 on Wednesday, an alarming statistic fueling enormous pressure on the healthcare system and its brave but besieged workers.
Some experts have said the total, compiled by the COVID Tracking Project, could soon double. Robert Glatter, an emergency room doctor at Lenox Hill Hospital in New York City, said the country had reached a “dangerous inflection point”.
“I wouldn’t be surprised if we had 200,000 people hospitalized next month,” Glatter told USA TODAY. “The explosive growth of the virus has the potential to exceed our ability to provide care. Not only for patients with COVID-19, but also for basic medical conditions.”
Many hospitals will be forced to suspend elective surgeries and other routine operations, create temporary field hospitals and stretch staff to the limit, experts said.
California Governor Gavin Newsom said intensive care beds in the nation’s most populous state could be full by mid-December. He warned that “drastic action”, including a tightening of stay-at-home orders, could come within days.
Little Rhode Island also has a big problem. StateThe emergency alert system issued this message to residents this week: “RIGOV COVID ALERT: Hospitals at capacity due to COVID. Help the front line by staying home as much as possible for the next two weeks. Work remotely if you can, avoid social gatherings, get tested. If we all reduce our mobility, we will save lives. The state has established two temporary field hospitals with a capacity of nearly 1,000 beds to meet the growing demand.
New Mexico’s 534 intensive care beds were at 101% of capacity on Tuesday – the highest rate in the country, according to estimates from the US Department of Health and Human Services. New York Governor Andrew Cuomo said hospitalizations had reached a level not seen since the state was the focal point for the virus last spring.
“Our # 1 priority is the capacity of the hospital,” Cuomo said. “It has always been my nightmare.”
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Hospitalizations across the country have soared well above previous pandemic highs of around 60,000 in the spring and summer. November’s death toll of 36,918 is lower than the monthly totals for April and May. Experts said the total number of deaths in November was lower – despite more than double the number of infections – due to several factors, including improved treatment plans and higher concentration of cases in younger patients less likely to succumb to the virus.
Ogbonnaya Omenka, associate professor and public health specialist at Butler University, said it is normal to consider the number of deaths as the main indicator of the severity of an illness, but the hospital crisis shows that there are other ways, besides mortality, that an infectious epidemic can pose serious problems.
Glatter said the coming months could be a nationwide recall of last spring in New York City, where lines formed outside emergency rooms and hospitals were dedicating all COVID-19 care to the detriment for the treatment of strokes, heart attacks, overdoses and other illnesses.
The data will reflect a corresponding spike in “excessive deaths” as a result of the upcoming outbreak, he said.
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Will hospitals run out of Health care Staff?
The availability of critical medical personnel – intensive care unit physicians, intensive care nurses, emergency room physicians and respiratory therapists – will determine whether the supply of care can meet the rapidly growing demand.
“People are our most precious resource, dictating our success or failure as a country in this time of need,” Glatter said.
Hospital workers can be exposed to the virus at work, at home and in their community. The impact on healthcare workers has become so severe in North Dakota that Gov. Doug Burgum issued an order last month allowing staff who test positive for the virus but show no symptoms to continue to nurse. caring for COVID-19 patients.
In many states, those who test positive are sidelined for two weeks. Troy Clark, president and CEO of the New Mexico Hospital Association, said nurses and therapists exposed to the virus often wait up to four days for test results. If the test is positive, health workers are absent for an additional 10 days, even without symptoms.
The Centers for Disease Control and Prevention on Wednesday released guidelines that could shorten those quarantines, but not enough to remove the major bottleneck of finding enough doctors, nurses and respiratory therapists to care for patients.
“This is where we get stressed,” Clark said. “Although there may be physical beds, there is no nurse, technical nurse or respiratory therapist to look after these patients.
Rick Pollack, CEO of the American Hospital Association, said COVID-19 is putting “unprecedented strain on our heroic frontline caregivers” and on the healthcare system.
“They naturally experience physical and mental fatigue after months of battling COVID-19,” Pollack said.
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Vaccines are not an immediate response
The vaccines that are expected to obtain emergency authorization in the coming weeks will not be an immediate panacea. Omenka warned that while participants in vaccine clinical trials are ideally selected to represent the general population, it is unclear how the results “will translate into real life.”
Melissa Nolan, an infectious disease expert and professor at the University of South Carolina, said vacation travel and the growing number of infections could cause mutations that reduce the effectiveness of vaccines.
Some surveys indicate that nearly half of Americans might not want to be vaccinated.
“The reality is that most of the population will not begin vaccination until early spring, which makes it a tall order, especially in light of the ‘vaccine hesitation’ that complicates our efforts. vaccinate AmericansGlatter said.
Increased travel and socialization means increased risks of exposure and infection. The flu season also remains a factor.
“We are in the holiday season and Christmas is approaching, followed by New Year’s celebrations, so it is reasonable to expect a continued increase in cases and hospitalizations,” Omenka said. “The number of hospitalizations could reach almost double the current number by the end of January.”
A person’s illness may not require hospitalization, but the number of people seeking help could adversely affect the quality of care or the medical professionals themselves, Omenka said.
Although the vaccine is shown to be as effective in the general population as it is in clinical trials, it is not known how long the immunity will last. Social restrictions and their continued refinement, according to emerging evidence, are truly “our best approaches yet,” Omenka said.
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Not all indicators are gloomy as the New Year approaches. Students, harshly criticized in some areas for failing to keep up with mitigation efforts such as masks and social distancing, could build resistance to the virus, said Nolan said. She said early data indicates a high prevalence of antibodies in some groups – up to 50% of students in some areas may have antibody protection.
“So that means that by coming back for the spring (semester), we hope to have lower transmission in some populations,” she said. “We could talk in January about how college campuses are among the safest places in the country.”
Yet experts continue to urge Americans to wear masks in public, practice social distancing, and wash their hands often. Travel and gatherings remain on most bucket list.
“The vaccine is the expected exit strategy,” Omenka said, but the nation cannot “hastily withdraw or abandon certain public health measures that have proven helpful in mitigating COVID-19”.
Contributor: Ken Alltucker, USA TODAY; Jack Perry, the journal of Providence
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