Hospitals removed as a vaccine several months later for most of the United States

Photographer: Apu Gomes / AFP / Getty Images

Covid-19 hospitalized nearly twice as many Americans as at any time during the pandemic, leaving healthcare providers on the brink of the vaccine dose a few months away for most people.

The health care system in the United States and those who serve it endure more stress than ever before. And virus control over hospitals has shifted to several rural communities, where treatment alternatives are rare.

In the short term, patient-borne loads threaten to accelerate deaths as access to critical care decreases in intensive care units. In the longer term, the risks are more systemic: fatigue, wear and tear and deterioration of the mental health of doctors and nurses working to care for the sick.

“The moment when percent of beds occupied by patients with Covid increases, which really causes a lot of staff problems, “said Pinar Karaca-Mandic, professor of health risk management at Covid. University of Minnesota. “It exposed much of the fragmentation of our health care system.”

Hospitals swell

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

Source: Covid Tracking Project

More than 115,000 Americans are currently hospitalized with coronavirus, according to the Covid Tracking Project – a number that has grown along with daily cases since early October. California, Texas and New York account for more than a quarter of the national total.

Nearly one in five U.S. hospitals reported critical staff shortages on Friday, according to the report data from the Department of Health and Human Services. Earlier this month, HHS released figures that provided a more localized picture of the devastation, which was previously hidden by national or state figures.

Non-metro areas are suffering the most in 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 at least 90 percent of ICU beds full of Covid-19 cases, leaving it difficult to treat others. Karaca-Mandic’s research has linked the use of the ICU bed to increased mortality.

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

The western United States is facing some of the most acute repercussions. When adapted to the population, Nevada and Arizona reported the highest hospitalization rates nationwide Monday.

Late calls

In Mesa, Arizona, about 20 miles east of Phoenix, Lee Allen walks past families glued to the windows of the hospital where he works as an anesthesiologist. Some hold cardboard signs with words of encouragement.

Right inside, patients are treated in almost complete ICU, which has been extended to underused parts of the building. Many cannot read the signs when facing down to improve the flow of air to the lungs.

Although Allen’s main specialty is obstetric anesthesia, he has received more frequent calls for assistance with particularly difficult intubations, such as patients who have comorbidities or are morbidly obese. Just a few days ago, he was called at 2 in the morning

“I hope the vaccine will help,” said Allen, who is himself immunocompromised and received the vaccine Monday.

In neighboring California, the virus exploded with renewed fury. Cases, hospitalizations and deaths collapsed last week.

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

“Some counties or regions may begin to exceed their existing hospital capacity, declared – not just intensive care capacity – by the end of the month and beginning of January,” said Mark Ghaly, secretary of California Health and Human Services. . a press conference on Monday. “We don’t see this in the whole state at the moment, but we are watching it very closely.”

California has opened four temporary care facilities and has seven more ready, if needed. Ghaly said hospitals had made emergency plans to activate “crisis care teams”, which would make difficult decisions to set care priorities among sick patients if facilities were overwhelmed.

So far, the state has managed to transfer patients from overcrowded hospitals to larger ones, but this is becoming more difficult as the outbreak grows, he said.

UTI full

Twenty-one states reported that more than 80% of ICU beds were full

Source: US Department of Health and Human Services

Although the availability of beds is limited in some parts of the country, blockages often stem from staff constraints. Those with coronavirus are more time consuming, expensive, and labor-intensive than regular patients.

“We can’t minimize emotional tension,” said Ann-Marie Alameddin, president and CEO of Arizona Hospital. Health Association, where is the hospital bed occupancy estimated at 78% at the state level. “I think there will be lasting effects that we will navigate in the coming months and years.”