Hospital systems and health authorities are improvising like crazy, given the record level of COVID-19 hospitalizations that is now in effect. On Nov. 24, there were 87,000 Americans hospitalized. Indicative reports:
COVID-POSITIVE STAFF AT WORK. Some states are doing this, reported a Tennessee physician this week, also telling WZTV. Dr. Lisa Piercey said of her state, “We have not made any official recommendations on that—that will be industry driven, but it is allowable by the CDC.” North Dakota Gov. Doug Burgum has approved COVID-19 positive staff to stay on the job—not a requirement, but an OK for hospitals and staff to do this.
PATIENTS SHIPPED OUT OF STATE. Besides patients being shunted around within cities and counties, many are being shipped out of state to find care. In Tennessee, Vanderbilt University Medical Center ICU physician Dr. Matthew Semler on Nov. 24 told Nashville WZTV: “In our intensive care unit in our last week we’ve gotten patients from Arkansas, Kentucky, Virginia, Alabama—all of those patients are bypassing three or four different hospitals that are closed, on the way to our hospital.”
“TRAVEL NURSES” POOL is running full tilt, and still not enough. Since the whole country is seeking staff all at the same time, the ranks of nurses willing to work in different locations are fully deployed. The agencies which do the bookings have never handled this number of placements. Nurses these days may make from $800 a week to $10,000 a week, but may have no health insurance themselves, depending on their gig. (See Nov. 24 review by Kaiser Health Network, “Need a Covid-19 Nurse? That’ll Be $8,000 a Week.” https://khn.org/news/highly-paid-traveling-nurses-fill-staffing-shortages-during-covid-pandemic/)
“INFORMAL RATIONING” of care is the buzzword in Utah, where in October, formal criteria were issued as a contingency by the state’s hospital association. But now, medical staff are saying that formality aside, they will not be able to treat everyone. “Our hospital already is at 100% capacity,” stated Dr. Sean Callahan, a critical care physician at the University of Utah Medical Center, told the Salt Lake Tribune Nov. 23. Statewide, as of Nov. 19, there were only 45 intensive care beds free in the whole state, but then this weekend record numbers of new virus cases in the state, some of which will show up at the doors of hospitals. The Tribune report is headlined: “Utah Hospitals Have Begun Informal Rationing of Care, Doctors Say, as They Cope with Surge of COVID-19 Patients.”
BURNOUT of doctors, nurses and staff is reported widely. Note a new report reviewing last spring: “Crisis Standards of Care: Lessons from New York City Hospitals’ COVID-19 Experience,” from the Johns Hopkins Center for Health Security on Nov. 24. But now the crisis is nationwide, and international. https://www.centerforhealthsecurity.org/our-work/publications/crisis-standards-of-care-lessons-from-new-york-city-hospitals-covid-19-experience
