The deteriorating COVID-19 situation is constantly challenging the limits of American medical resources. According to the data, the number of hospitalizations for coronavirus patients in the United States has recently reached a new high, and the data is even twice as high as a month ago.
According to a report by NPR on the 25th, in the face of sharply tight medical resources such as medical staff, wards, equipment, etc., many hospitals in the United States are trying to expand medical resources and maximize the use of resources, such as setting up temporary hospitals, increasing beds, and even “teletherapy”.
The report pointed out that many hospitals in the United States are changing the way nursing resources are provided, and even starting to make decisions about “care rationing”. During the crisis, American hospitals have a mechanism of how to manage resources, known as the American Crisis Care Standard. The standard will guide hospitals to make clinical and ethical decisions on how to allocate care in a resource-strapped situation.
“It’s a last resort—a fundamental change: from doing everything possible for one patient to getting the best out of the good for many patients.” Dan Hanfling, the National Academy (NASEM) Crisis Care Standards Committee, said.
Although crisis care standards have not been officially launched in many parts of the United States, some experts believe that many clinicians have informally made decisions similar to “care rationing”.
Hundreds of patients were sent home for “telemedicine”
In response to the increasing shortage of medical resources, hospitals in all states in the United States are trying to find ways to allocate and expand medical resources. Temporary beds have been set up in Wisconsin’s Expo Park to accommodate mildly ill COVID-19 patients. Mayo Hospital in the state has moved beds into waiting rooms, even parking lots.
Utah, on the other hand, warned that a state-wide crisis plan would be implemented. Kevin McCulley, director of the Utah Department of Health’s Program Response, said the state plans to move mild COVID-19 patients to designated care locations to free up more hospital beds.
At St. Luke’s Hospital in Idaho, hundreds of COVID-19 patients have been sent home, but they carry blood pressure instruments, pulse oxygen meters and iPad tablets with them to allow doctors to remotely monitor patients’ vital signs. In order to maximize the use of doctor resources, the hospital has also set up intensive care ward doctors to take care of more patients through telemedicine.
Hard ethical decisions
The NPR reports that the larger restrictions facing the vast majority of hospitals in the U.S. are currently facing compared to the shortage of ventilator equipment during the pandemic this spring are the lack of experienced medical staff who can care for patients in the intensive care unit (ICU).
At the same time, these medical staff still need to make many difficult ethical decisions. For example, how many ICU patients should a nurse take care of? When is it reasonable to let patients leave the hospital and make room for others early? Which patients should be transferred to temporary hospitals with fewer medical staff?
“I really don’t feel like these are black or white decisions,” said John Hick, an emergency physician at Hennepin County Medical Center in Minnesota. One of the purposes of the Crisis Standards of Care program in U.S. hospitals is to prevent clinicians from making difficult ethical decisions about patient care on their own, the report pointed out.
Recently, the epidemic situation in the United States has continued to deteriorate. According to the epidemic data of the New York Times, at present, the cumulative number of confirmed COVID-19 cases in the United States is more than 12.85 million, and the cumulative number of deaths is more than 260,000.
On November 25, the number of new confirmed cases in the United States has exceeded 180,000, and the average number of new cases per day in the past seven days has reached 170,000. At the same time, the number of new hospitalized cases in the United States has also continued to hit a new high in the near future, with nearly 90,000 hospitalizations on the 25th.