The Coronavirus epidemic has exposed gaps in the US health system. The country ranked first in the global health security rankings will lack breathing apparatus if a pandemic occurs.
The rapidly rising number of Coronavirus infections in the US is showing serious gaps in the country’s health system’s ability to respond to pandemics. Hospitals and doctors have to come up with a daily improvisation plan even though they don’t know how the disease will turn out.
Nursing home care came to prominence when California announced its first death from Coronavirus on March 4, while the total number of Coronavirus deaths in the United States rose to 17. There are more than 1 million people. The elderly are living in nursing homes in the US and they are often not in good health. Many of these nursing homes have failed to control common diseases.
However, gaps in the health system appear across the country and affect every type of health facility.
“We need breathing machines and we need them now.”
In Rhode Island, where 2 cases of Coronavirus were found, doctors wearing protective clothing examined patients with mild symptoms in the hospital parking lot instead of allowing them to go to the emergency room. Officials said emergency measures had been mitigated after the state improved its testing capacity.
Officials in King County, Washington state this week said they were buying an inn to look after patients in need of isolation.
In rural parts of Texas and elsewhere, small hospitals don’t have test kits and laboratories can do this for hours. That means hospitals will not be able to determine if someone has Covid-19 among regular seasonal flu patients.
John Henderson, head of the association of rural hospitals in Texas told the Washington Post : “Not enough to test kits, isolation or control all of these patients.”
Breathing apparatus and intensive care unit are needed for severe cases. However, these devices are largely confined to larger hospitals and health centers in cities.
Equipment suppliers are re-using the standards applied in the handling of SARS, MERS, H1N1 and Ebola. However, the new coronavirus is spreading very quickly and is harder to detect because the patient has flu-like symptoms.
Worrying about the lack of a hospital bed to isolate and treat patients infected with the virus is increasing in the United States because large medical centers often lack beds even when there is no epidemic.
“Our hospitals and health systems cannot afford to receive large numbers of patients and isolate them,” said Gerard Anderson, professor of health policy and management at Johns Hopkins University.
Despite weeks of preparation, health officials remain concerned about the lack of masks and protective gear for hospital staff as well as ventilators for seriously ill patients.
“We need masks, we need breathing machines and we need them now,” said Sen. Patty Murray of Washington State, the most contested case in the US today.
The World Health Organization (WHO) on March 3 warned that the panic buying and hoarding is dangerously creating a global shortage of protective equipment. China , where the epidemic originated, stopped exporting these items.
Health budgets have decreased over the last 15 years
The health system with limited budget is not enough to maintain the supply of reserves for the pandemic,” said William Jaquis, president of the American Academy of Emergency Physicians. This makes the US health system vulnerable.
Federal funding for emergency health conditions has decreased over the past 15 years.
According to Crystal Watson, a scholar at the Johns Hopkins Health Security Center, the amount of federal funding for states and localities preparing for health emergencies has halved or more in a few decades.
In 2003, two major federal programs were worth $ 1.4 billion . This year, the amount spent for these two programs is only 662 million USD .
“Presidential life always cuts the money on these programs,” Mr. Watson added.
Federal officials estimated in 2005 that in the case of a serious pandemic like the Spanish flu in 1918, more than 740,000 people would need ventilators. But there are only about 200,000 machines at health facilities and a few in the US national stockpile, according to experts.
“If a serious situation occurs, we won’t have enough ventilators,” Mr. Watson told the Washington Post . “I don’t think the Covid-19 epidemic led to serious situations, but if it did, we would have to make some tough decisions.”
Similarly, a Texas study published in 2017 showed that the state would lack breathing machines if a serious epidemic were to occur.
“I do not want to say that Covid-19 belongs to a serious pandemic group. “This outbreak can range from mild to severe because we don’t have reliable data,” said Lauren Ancel Meyers, a professor at the University of Texas, who studies infectious disease surveillance.
The situation in the study points out that “there is a huge gap in the amount of ventilators in stockpiles and what we need in a serious pandemic”.
Demand is increasing globally
Manufacturers of ventilators said they saw strong demand.
Mr. Elijah A. White, president of the medical device company ZOLL Resuscitation, said: “We see an increasing demand for ventilators and I think other companies are feeling the same. Not just in China or in the US but the demand is increasing everywhere ”.
“If an epidemic breaks out and each state has hundreds or thousands of patients instead of just a few people, there must be a plan to coordinate care in the area,” said Christopher Greene, a doctor at the University of Alabama in Birmingham. said.
Severely ill patients need ventilators, but not every hospital has it, Mr. Greene said. Many hospitals in rural Texas do not have any ventilators. The patient will have to be transferred to the higher level hospital and this poses a new challenge for the ambulance staff, Greene said.
“In a few days, we can go from 60 cases to lots of cases,” Mr. Greene said. Large hospitals are thinking of a contingency plan for the Covid-19 epidemic, he said, “but we want to see this state of emergency preparedness”.
Leaders at Rhode Island Hospital in Providence City, Rhode Island, have been planning to deal with Covid-19 for weeks. Last week, a student and an employee who traveled to Italy on a trip sponsored by a high school in Pawtucket were positive for the virus.
As more people in Rhode Island became anxious, people who had to go to a test hospital were asked to sit in their car so that the doctor could come to take the sample.
“We send doctors wearing protective gear to the car, take testimony of travel history, test screening and then do tests, usually taking nasal secretions,” said John B. Murphy, chairman Rhode Island Hospital and Hasbro Children’s Hospital said. In the two positive cases above, the test result is given in 4 hours.
Now Rhode Island officials are looking for patients’ journeys as well as making lists of staff and students on their trip to Italy.
Rhode Island Hospital has 70 negative pressure rooms which can be used to isolate patients. Hospital engineers are learning how to turn a floor of a hospital into quarantine.
The hospital has about 25 patients who need mechanical ventilation in a normal day. If demand increases, the hospital could treat more than 100 people on ventilators, Murphy said. If the number of patients exceeds that number, the hospital will be forced to work with state officials to find other places to isolate and treat patients.
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