Hospitals nationwide again buckle under pressure from COVID-19 cases as omicron ultra-transmissible wave crashes into already critical health systems short of staff and exhausted by previous waves of the pandemic.
The current situation is forcing states and hospitals to declare emergencies, deploy the National Guard, delay or cancel elective procedures, institute crisis care standards and allow healthcare providers to stay on the job even if they themselves test positive for COVID-19 because there is no one available to take their place. Taken together, the situation has resulted in some doctors being openly concerned that the omicron wave will cause some systems to collapse in the weeks to come.
“The heartwarming news that this variant usually causes milder illness overlooks the tragedy that unfolds on the front lines,” wrote Craig Spencer, emergency physician and director of global health in emergency medicine at NewYork-Presbyterian / Columbia University Irving. Medical Center. a New York Times opinion piece on Monday.
Spencer noted that, unlike the same time last year, there are effective treatment plans, therapies and vaccines for COVID-19. “Yet these tools are still not enough to slow the rapid influx of patients we are now seeing from omicron, and the situation is grim for health workers and hospitals.”
Figures and projections
Currently, the seven-day average of daily COVID-19 cases is around 700,000, an all-time high in the pandemic. Meanwhile, daily hospitalizations average over 132,000, up 83% in two weeks. The number of hospitalizations is quickly approaching the all-time high of around 137,000 hospitalizations per day during the pandemic, which was set in mid-January last year.
According to the date reported by the Ministry of Health and Social Services, 77% of the country’s hospital beds are occupied and 78% of intensive care unit beds are full. But the department’s data may have lags, reflecting hospital uses that may be one to two weeks late. For example, doctors and researchers who track hospital capacity suggest that hospitals in Maryland may now reach capacity, projection based overdue hospital data from the HHS which suggests hospital beds are only 79 percent full.
In its online newsletter, Inside medicineHarvard emergency physician Jeremy Faust quoted a fellow doctor from Maryland as supporting the screening on Monday, saying:
I can attest that the situation in Maryland is [expletive] horrible. The condition has been at maximum for about 2 weeks. Several hospitals operate to crisis care standards. SMU [i.e. ambulances] is now taxed so heavily that Baltimore County began transporting people in fire trucks last week. It is absolutely incredible and absurd. Reports of people waiting more than one to two hours at the scene with the fire department before an EMS unit arrives. Then when they get to the hospital, they literally wait hours for a bed. Transfer centers now laugh when you call, so the system is registered again. It’s mind-boggling for me to see how none of this has been national news.
Although a smaller proportion of people infected with omicron appear to develop severe COVID-19, there is still a crush of patients, and some of them are suffering the worst of the disease. Last Friday, for example, a Kansas hospital lack of fans amid an increase in COVID-19 cases, prompting the county council to issue a local emergency. Additionally, omicron reaches vulnerable populations who end up needing hospital care after omicron exacerbates a previous disease, such as diabetes. Meanwhile, the seasonal flu and other conditions that bring people to the hospital are also at high levels.
The influx of patients comes at a time when overcrowded hospitals are already understaffed and providers face extreme burnout.
Virginia Governor Ralph Northam released a 30 day state of emergency to try to ease the pressure on overcrowded hospitals after the state recorded a record number of hospitalizations last week. The ordinance allows hospitals to increase their bed capacity and increase staffing through a number of technical changes, such as adding flexibility for active out-of-state providers to practice. in the state and expanding the capacity of medical assistants to provide care.
“Healthcare workers and hospitals are exhausted and they are once again facing an increasing number of patients, which is affecting their ability to provide care,” Governor Northam said. A declaration. “These steps will help relieve the strain, giving healthcare professionals more flexibility to take care of people. Ultimately, the best thing anyone can do for our hospitals and their staff is get vaccinated. “
Maryland’s neighbor issued a similar 30-day state of emergency last week to bolster health facilities across the state amid record hospitalizations for COVID-19.
“The truth is, the next four to six weeks will be the toughest of the entire pandemic,” Maryland Gov. Larry Hogan said in a statement last week. “All of the emergency measures we take today are aimed at keeping our hospitals from overflowing, keeping our children in school and keeping Maryland open for business, and we will continue to take whatever action is necessary during the day. and the very difficult weeks. ahead. “
Governor Hogan’s order mobilized 1,000 members of the Maryland National Guard to assist state and local health officials. At least 10 states have called members of the National Guard, stretching from Oregon to New York, to help respond to the tidal wave of omicron cases and hospitalizations. For example, Massachusetts deployed members of the National Guard in late December to hospitals flooded with COVID-19 patients. One of those facilities is UMass Memorial Medical Center, the main hospital in central Massachusetts, which is currently operating at 115%, according to a Jan.9 report. CNN report.
“It’s just the perfect storm for a nightmare here in the emergency department,” said Dr. Eric Dickson, hospital CEO and emergency physician.
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