Doctors on the front lines are shouting from the rooftops.

click to read this Wall Street Journal article

Comparing annual influenza deaths to overall coronavirus deaths misses the point. Influenza doesn’t decimate modern health care systems.

It doesn’t shut down operating rooms, or require bone specialists to start treating lung patients.

It doesn’t kill alarming numbers of doctors and nurses,

necessitate hundreds of field hospitals,

or transform underground parking garages into patient reception areas.

This virus is a threat to our medical systems as we now know them. If large numbers of doctors, nurses, respiratory technicians, and first responders perish over the next several weeks, things will go downhill fast.

Highly trained, seasoned medical professionals aren’t widgets that can be produced with 3D printers. Replacement doctors can’t be rolled off an assembly line in auto parts factories splendidly repurposed in this time of need.

In the US and Canada alone, half a million people depend on kidney dialysis to keep them alive. A medical system that has been brought to its knees may no longer be able to provide that service. The same goes for chemotherapy and radiation treatments.

Those tens of thousands of patients in sick kids hospitals will have less chance of surviving if their surgeon or other specialist dies. Resource intensive procedures such as organ transplants will become less likely.

Don’t fool yourself. Being strong and healthy doesn’t make you safe. Should you be in a car accident, or fall off a ladder at work, emergency medical care may look quite different.

Where I live, dentists have now closed their offices. Should I experience a dental emergency, no services are available in my corner of the world unless I “pass a COVID-19 screening.” Keep in mind there’s a shortage of those tests right now, and that it currently takes days to get results due to laboratory backlogs.

Those of us who live in affluent countries are used to a health care system that is, broadly speaking, reliable. That health care system is now under siege. Frontline doctors are comparing the current situation to wartime. They are shouting from the rooftops that we are at exceptional risk.

Unless we  do a better job of supporting and protecting these medical personnel, all of our lives will become more precarious.

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The tragedy unfolding in Italy’s hospitals has spread elsewhere. Eighteen hundred people have died of this virus in Spain. 1,800 more are in serious/critical condition in that country. France, too, has 1,700 patients in critical condition. (These numbers swell dramatically with each passing day; see here for the latest).

Italian doctors have described how caseloads start off manageable and then explode. An account, by a respiratory technician in Louisiana, sounds eerily similar:

We had one or two patients at our hospital, and then five to 10 patients, and then 20 patients. Every day, the intensity kept ratcheting up. More patients, and the patients themselves are starting to get sicker and sicker. When it first started, we all had tons of equipment, tons of supplies, and as we started getting more patients, we started to run out. They had to ration supplies. At first we were trying to use one mask per patient. Then it was just: You get one mask for positive patients, another mask for everyone else. And now it’s just: You get one mask. [bold added]

Three days ago the Wall Street Journal reported:

New York City hospitals are already straining under the onslaught of novel coronavirus cases, even as state officials say the real peak of the outbreak is nearly a month and a half away. Doctors at the largest public hospital in New York say equipment shortages have resulted in them wearing the same masks for as long as a week… ‘We’re getting pounded’ [says a doctor at]…the largest hospital system in New York. ‘I’ve been in ICU care for 15 years, and this is the worst I have ever seen things.’ [bold added]

Here’s part of a firsthand account from a frontline doctor in a London, UK hospital:

despite restructuring the wards to ensure there was room for the coronavirus sufferers and that they would be totally isolated, it soon became apparent that the virus was already rampaging throughout the hospital…This individual had been admitted to hospital for something totally unrelated and now…it was clear they had caught the virus in the very place they had every reason to expect would help them get better. My eyes darted around the ward. He was surrounded by other beds full of patients, as well as nurses and doctors who were not protected – myself included.

…Any hope we’d had of keeping Covid-19 sufferers separate from the rest of our patients became almost totally blurred as the influx just became greater, and greater, and greater.

Finally, here’s a news story in which the president of a Boston hospital pleads for masks, gowns, and gloves to protect his staff: [Massachusetts] General ‘Desperately’ Needs Supplies, even 3-D Printed Ones.

This is real. This is serious.

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READING LIST:

• a Pennsylvania cardiologist who treated two dozen patients at a children’s hospital (and came in contact with 17 staff members) is himself hospitalized in critical condition (see this news story from March 10th)
• a doctor in Sydney, Australia who tested positive for the virus was in contact with “13 doctors, 23 nurses and four other health workers” as well as nearly 40 patients
• news story: Hamilton’s first case of COVID-19 is a cancer doctor

• Italian doctor dies after working without gloves due to shortage
• Five more Italian doctors die battling coronavirus
• Coronavirus Is Killing Italy’s Doctors. The U.S. Could Be Next
• Italy’s hardest-hit city wants you to see how COVID-19 is affecting its hospitals
• Italy has a world-class health system. The coronavirus has pushed it to the breaking point.
• this news story, “triage and lies for virus patients,” calls this the “most devastating medical crisis in Italy since World War Two”
• Italy is graduating nurses early and calling doctors out of retirement, Coronavirus in Italy fills hospital beds and turns doctors into patients
• Italy rushes new doctors into service
• this news story, ‘Get ready’: Italian doctors warn Europe of coronavirus impact on hospitals, dated March 7th, talks about 233 deaths in Italy. Today, 16 days later, Italy’s official virus death total has reached 5,500.

• Italy’s Virus Epicenter Grapples With Huge Toll, Some Hidden, “Last week alone, 400 people died in Bergamo…four times the number who died the same week the previous year…Only 91 of those had tested positive for the virus”
• Italy’s coronavirus victims face death alone, with funerals postponed
• The view from Bergamo, Italy, where at least 11 priests have died from the coronavirus
• Coronavirus strikes two Italian convents, infecting 59 nuns

• on Facebook, California doctor Sam Fink wrote: “I have practiced for over 30 years, and I have seen it all, or so I thought. Nothing has worried me like this.”
• A [New Orleans] Medical Worker Describes Terrifying Lung Failure From COVID-19 – Even in His Young Patients
• Frontline NHS doctor reveals how coronavirus has unleashed terror in hospital
• Medical staff treating coronavirus patients share heartbreaking struggles: “We’re facing our own death”
• a 5-minute video message from a Canadian emergency department doctor

the title of this post was changed approximately 24 hours after it appeared. Originally it read: Protect Hospital Staff or Medical System Collapses

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