After a few months of calm, many US hospitals welcomed a new wave of Covid-19 patients, mostly unvaccinated people, making everything overloaded.
Daniel Wilkinson, a 46-year-old veteran of Bellville, Texas, was taken to the emergency room and diagnosed with gallstone pancreatitis. It was a treatable disease, but Bellville Hospital was unable to treat him.
Doctors have called many hospitals in Texas, Oklahoma, Arkansas, but nowhere can receive Wilkinson, when they are all overwhelmed with the highest Covid-19 hospitalization rate in the country.
Eventually, they found a single vacant intensive care unit (ICU) bed at a veterans hospital in Houston, more than an hour’s drive from Bellvilla. But Wilkinson died while on a helicopter to the hospital from organ failure. It all happened within seven hours of Wilkinson’s mother taking him to the local emergency room.
Texas is seeing another Covid-19 wave as bad as last winter, with a peak of more than 14,200 people hospitalized with Covid-19. More than 90% of the state’s ICU beds are already in use, according to Covid Act Now.
Texas is not the only state struggling with a new outbreak. In Idaho, where 88% of ICU beds are full, the hospital had to activate a “crisis care standard,” which allows doctors to prioritize treating patients with a good prognosis.
Stories like Wilkinson’s are not uncommon in the US today, after a while Covid-19 subsided. Washington Post On September 12, it was reported that a 73-year-old Alabama man died of heart disease after being denied emergency care by 43 hospitals due to overcrowding.
The nearest hospital that agreed to accept this patient was in Mississippi, more than 320 km away. Alabama currently has the second-highest Covid-19 hospitalization rate per capita in the US.
Many unvaccinated Americans have become vulnerable to outbreaks of the highly contagious Delta strain. A quarter of Americans over the age of 18 have yet to receive any Covid-19 vaccine, while children under 12 are not yet eligible for vaccination.
Hospitalization trends in the US are changing from previous outbreaks. Those over 65, which used to account for more than half of hospital admissions last December and January this year, have now dropped to a third. But the US is recording the highest number of pediatric and young patients hospitalized for Covid-19 ever.
The average number of daily hospitalizations in the US as of September 14 is nearly 100,000, while the number of deaths is 1,888, almost at an all-time high. Tennessee, Kentucky, Alaska, Wyoming and West Virginia, states with vaccination rates below the national average, are recording the worst outbreaks currently in the US.
Across the south, a region with low vaccination rates, hospitals are reporting intensive care patients exceeding the number of ICU beds available.
Hospitals in the US are trying to balance between responding to the new wave of Covid-19 with providing medical care to other patients. However, that forces them to make tough choices.
Karen Joynt Maddox, a physician and health policy researcher at Washington University in St. Louis, said that during the pandemic, her hospital was instructed not to accept patients from small care facilities in rural areas, except in emergencies. This means they sometimes have to refuse a patient’s family transfer request.
America doesn’t have as many hospital beds as many other rich countries. The average US hospital bed rate is 2.9 per 1,000 people, while the rich-country average is 4.6, according to the Peterson-Kaiser health tracking system.
Over the decades, many U.S. health services have moved from inpatient to outpatient treatment to save costs, leading to a reduction in the number of beds in hospitals. Many experts add that the US also does not want to maintain an overcapacity health system, which costs more.
Even in normal times, many US city hospitals are operating at nearly 100% capacity, while rural hospitals are about half empty.
“We have hospital beds but they’re not in the right places and we don’t have a system in place to make the best use of the available beds,” Joynt Maddox said.
The current crisis has exposed holes in the American health system. Hospitals in the US do not have a stable budget as in countries that allocate annual budgets to the health system.
The US also does not have a focal point to handle patient overload at hospitals. Instead, the doctor must find a way to coordinate himself. Many local hospital leaders in the US even have to desperately call for medical facilities hundreds of kilometers away, according to NPR.
Other wealthy countries also saw overwhelmed health systems during the first outbreaks of Covid-19. However, after a year and a half of dealing with the pandemic, they appear to be better equipped than the US to handle overcrowding.
Canada and the UK, with their government-run health systems, have lower beds per capita than the US. The health systems of the two countries have also been close to the threshold of the worst outbreaks.
The NHS was forced to move ICU patients to less overcrowded areas last autumn and winter. In Canada, more than 2,500 patients in Ontario were also transferred to other cities for treatment. Even in France, where the average number of hospital beds is higher than the US, more than 100 Covid-19 patients had to be evacuated from Paris because of a lack of hospital beds.
However, their condition is not as bad as the US because the health system is closely coordinated. In these countries, the government or local authorities are responsible for coordinating patients between hospitals. This doesn’t exist in the US, where hospitals have to manage on their own to handle overcrowding.
“There’s also a lot of pressure in hospitals in the UK, but they can always handle emergencies,” said Nick Scriven, a British doctor and former president of the Society for Acute Medicine. “People are not turned away if they need a hospital bed.”
“This way of coordination helps countries build a rational patient allocation system to manage health resources,” said Dylan Scott, commentator of the World Health Organization. Vox, identify. “That strategy puts them in a better position to deal with waves of patients during the pandemic. And the US, one of the richest countries in the world, is paying the price for not being able to do so.”
Thanh Tam (Follow Vox)