Hospitals prepare for jump in cases

From major cities to rural communities, US hospitals are preparing for a surge in the number of coronavirus patients that many may not be able to handle, according to health officials.

The Centers for Disease Control and Prevention has said 2.4 million to 21 million people across the country could require hospitalization.

The World Health Organization said there are fewer hospital beds per capita in the US than in most other nations, including Italy and China.

"This is where Italy got into trouble," New York Governor Mario Cuomo said last week. "They didn't have enough ICU (intensive care unit) beds to handle the number of patients who needed intensive care. That is going to be a problem in this state and in this country. That's something that we have to watch very, very carefully."

New York state has approximately 3,000 ICU beds, about 80 percent of which are occupied, he said.

On Sunday, Cuomo asked US President Donald Trump to allow the Army Corps of Engineers to help states more quickly combat the spread of the coronavirus and expand the capacity of hospitals.

Cuomo wrote in an op-ed article in The New York Times that the corps could "leverage its expertise, equipment and people power to retrofit and equip existing facilities－like military bases or college dormitories－to serve as temporary medical centers".

Cuomo said on Saturday that increases in the number of cases reflected the state's ability to test people rather than the outbreak's severity.

He also said, however, that he expected thousands of additional cases statewide as the virus continues to spread. "The infection rate will be massive," he said.

New York City Mayor Bill de Blasio has predicted that there could be 1,000 cases in the city by next week, and some doctors are expecting many more.

In New York City, New York-Presbyterian Hospital said it would postpone all elective procedures and surgeries until further notice so that it could "concentrate on the adequacy of our equipment and supplies during this challenging period".

"We are not prepared to deal with a rapid and severe surge of patients－we're just not," said doctor Christopher M. Tedeschi, a longtime emergency physician and assistant professor at the Columbia University Medical Center. "We're sort of planning for what's going on right now, and we're trying to make up for lost time, but I'm not sure we're planning for a month from now, or even two weeks from now."

Role of ventilators

Hospitals across the nation also could be pressed to provide sufficient numbers of doctors, nurses and ventilators.

Ventilators can be a matter of life or death for a respiratory disease such as COVID-19, because they allow patients with the virus to breathe when they can't do so on their own.

US hospitals have a total of 160,000 ventilators－62,000 full-featured ventilators, and 98,000 more basic ones that can be used in an emergency, according to a 2020 study by Johns Hopkins University, with at least an additional 8,900 in the national stockpile.

"I believe that if we have a major outbreak, we are definitely vulnerable to shortages," Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, told a House of Representatives panel last week, referring to ventilators.

Hospitals also could face staffing shortages if healthcare workers contract the virus and must stay home with children because of school cancellations.

The Greater New York Hospital Association said it was in talks with a large union about hiring retirees to help with day care for the children of hospital workers.

Cuomo announced on Saturday that the state is calling up retired and former doctors and nurses and expediting their recertification.

There are about 53,000 hospital beds in New York state, according to the American Hospital Association. About 20,000 of the beds are in the city, according to de Blasio.

In San Francisco, city health officials have leased recreational vehicles for those who have tested positive for coronavirus but do not need to be hospitalized. They are putting them in Presidio, a park and former fort in the northern part of the city.

Officials also are looking for other quarantine housing, including unoccupied residential properties and vacant hotels, said Grant Colfax, San Francisco's director of health.