The coronavirus is straining the healthcare systems of the richest nations in the world.

Two weeks ago, a branch of the US government conducted a survey of 323 hospitals across the country. Most (76%) are now treating confirmed or suspected cases of the coronavirus. Big picture, America’s medical personnel are struggling.

A shortage of tests is a huge problem. Hospitals don’t have sufficient tests to determine whether members of their own staff are infected or in the clear. Before nursing homes will accept the transfer of a hospital patient, they want to know that patient has tested negative. These transfers are often delayed because test results can take a week or longer. In the words of one hospital administrator, millions of tests are needed, “and we only have hundreds.”

Everyone needs more protective gear. Masks, face shields, gloves, and gowns are all in short supply. Hospitals that normally use 200 masks per day, are now using 2,000. Because they’re all competing with each other for these supplies, some are being advised their orders won’t be filled for months. Prices have skyrocketed. Masks that used to cost 50 cents each now cost $6. In the words of one hospital spokesperson: “We need gloves, we need masks with fluid shields on – N95 masks – and we need gowns. It’s the number one challenge all across the system.”

Ventilators are in short supply, as are trained personnel to operate them. Unable to breathe on their own, the sickest patients require ventilators to mechanically assist them. Under normal circumstances, smaller or rural hospitals rarely use this equipment. They’ve never had multiple patients needing them for weeks at a time. Says the report:

One hospital administrator said his hospital has only one ventilator and only one respiratory therapist, adding that the therapist can’t work 24 hours a day monitoring the ventilator. Another administrator said, ‘You can build thousands of ventilators but you need an army to manage that equipment and care for those patients.’

Cross-training other staff members has become a necessity, but it’s far from ideal. Normally, it takes two to four years to become a certified respiratory therapist.

Staff are anxious and confused.  They’re worried about catching this virus. Those concerns are well-founded. 95 doctors have now died in Italy.

Advice regarding how to protect themselves constantly changes. Different agencies, and different levels of government sometimes provide contradictory guidelines.

Medical personnel are worried about infecting their own families, especially elderly parents who live with them. Those with school-aged children face childcare challenges.

Worst of all, everyone knows this situation could drag on for months. This isn’t an earthquake or a transportation accident, in which the strain to the healthcare system is sharp but relatively brief. In the words of one hospital administrator, “The level of anxiety among staff is like nothing I’ve ever seen.”

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LINKS:

• Read the 41-page report, Hospital Experiences Responding to the COVID-19 Pandemic: Results of a National Pulse Survey March 24-27, 2020. Archive.org has backed it up here.
• Because this survey is two weeks old and this is a quickly-changing environment, it’s possible some of the above concerns have been addressed to some degree.
• For all its shortcomings, healthcare in the United States is superior to the healthcare available in most countries – think Africa, South America, and the least affluent nations of Eastern Europe. Given the damage this virus is inflicting in the US, the effect on medical systems elsewhere could well be devastating. To get a sense of how matters are developing elsewhere, see this news story, As coronavirus spreads in Ecuador, bodies are being left on streets and this one, Troops gather scores of bodies of virus victims in Ecuador city.
• I put myself through university working clerical jobs in downtown Toronto hospitals. Having spent 5+ years in that milieu, my sensitivity to – and appreciation of – these issues is perhaps different from other journalists.

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