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Medicine United States

Are America's Hospitals Becoming Overwhelmed? (theatlantic.com) 312

New Mexico's governor announced plans to allow hospitals "to ration care depending on a patient's likelihood of surviving," according to the Washington Post.

But in fact, many of America's hospitals are now "overwhelmed," reports CBS News, adding "A record-breaking 227,00 new cases were reported in the U.S. on Friday alone — the first time the daily case count has topped 220,000, according to a tally from Johns Hopkins University."

Two co-founders of the COVID Tracking Project offer this assessment of the state of America: On Wednesday, the country tore past a nauseating virus record. For the first time since the pandemic began, more than 100,000 people were hospitalized with COVID-19 in the United States, nearly double the record highs seen during the spring and summer surges. The pandemic nightmare scenario — the buckling of hospital and health-care systems nationwide — has arrived. Several lines of evidence are now sending us the same message: Hospitals are becoming overwhelmed, causing them to restrict whom they admit and leading more Americans to die needlessly...

Many states have reported that their hospitals are running out of room and restricting which patients can be admitted. In South Dakota, a network of 37 hospitals reported sending more than 150 people home with oxygen tanks to keep beds open for even sicker patients. A hospital in Amarillo, Texas, reported that COVID-19 patients are waiting in the emergency room for beds to become available. Some patients in Laredo, Texas, were sent to hospitals in San Antonio — until that city stopped accepting transfers. Elsewhere in Texas, patients were sent to Oklahoma, but hospitals there have also tightened their admission criteria....

The bulk of evidence now suggests that one of the worst fears of the pandemic — that hospitals would become overwhelmed, leading to needless deaths — is happening now. Americans are dying of COVID-19 who, had they gotten sick a month earlier, would have lived.

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Are America's Hospitals Becoming Overwhelmed?

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  • by Kisai ( 213879 ) on Saturday December 05, 2020 @12:43PM (#60797776)

    You know a few years back about the hand wringing over death panels by right-wing anti-medicare-for-all types? Well here you go, the death panels exist because your private health care system was only designed to care for the wealthy and is still overwhelmed.

    In other countries (eg everywhere with a public health care system) they are not presently overwhelmed, but it's also probably not fair to blame this entirely on the medical system in the US, as most of it has to blamed directly on the orange clown in the white house, who tried to dismiss the pandemic as hoax, and cost the US substantial preparation time, as well as making the right-wing "my freedumbs" people into super-spreaders.

    So it's only fair now to ration care to those who made every effort to protect others. If they didn't then, well you dug your own grave.

    • by ClickOnThis ( 137803 ) on Saturday December 05, 2020 @01:01PM (#60797846) Journal

      Don't get me wrong. I am, like you, a supporter of public health-care systems. I wish the USA would wake up and join the rest of the world in this regard.

      But I don't think the overwhelming of hospitals with COVID-19 cases in the USA is caused by private health-care. Every system, private or public, will have limited resources that require triage. If anything, a private health-care system can and has affected outcomes by implicitly rationing care to those who can afford it. Perhaps that's putting it a bit too simply, but it is a tenable argument.

      Rather, as you say, it is caused by a "live free or die" mentality in (too) many Americans, egged on by a prevaricator-in-chief who has encouraged people to scoff at the danger. Simply put, Americans and their leaders have been reckless to a degree unlike other parts of the world. And now the chickens have come home to roost.

    • Re: (Score:3, Insightful)

      by shanen ( 462549 )

      You know a few years back about the hand wringing over death panels by right-wing anti-medicare-for-all types? Well here you go, the death panels exist because your private health care system was only designed to care for the wealthy and is still overwhelmed.

      In other countries (eg everywhere with a public health care system) they are not presently overwhelmed, but it's also probably not fair to blame this entirely on the medical system in the US, as most of it has to blamed directly on the orange clown in the white house, who tried to dismiss the pandemic as hoax, and cost the US substantial preparation time, as well as making the right-wing "my freedumbs" people into super-spreaders.

      So it's only fair now to ration care to those who made every effort to protect others. If they didn't then, well you dug your own grave.

      Quoted against the censor trolls with mod points, though I don't fully agree with you.

      Mostly I feel sorry for the medical professionals. Most of them sincerely care about their patients as human beings. Plus some of them will catch Covid-19.

      Meanwhile, "He whose name need not be mentioned" is only focused on some scam to get "his case" to "his" Supreme Court. And most of the GOT (nee GOP) is okay with stomping on the idea of democracy.

      • by AleRunner ( 4556245 ) on Saturday December 05, 2020 @03:16PM (#60798278)

        Mostly I feel sorry for the medical professionals. Most of them sincerely care about their patients as human beings. Plus some of them will catch Covid-19.

        It was reading this article [independent.co.uk] about a nurse's tweets [twitter.com] that really got me angry about this. Imagine your relatives with their last conscious words screaming in anger at the nurse who's trying to save them instead of getting the chance to talk with their children for the last time because they completely misunderstand what happened to them and why. If I was an American I would have great difficulty forgiving Trump or anyone with high levels of education and understanding who still provides him with support.

        • by shanen ( 462549 ) on Saturday December 05, 2020 @05:35PM (#60798596) Homepage Journal

          I've seen some of those stories, too. It seems incredible what cognitive dissonance can do to people. Yeah, everyone tends to believe what they want to believe, and everyone was born a fool, but the percentage who "get better" is depressingly low. I feel sorrow for the damage they do, but I don't feel like they've earned much if any actual pity. And Covid-19 has no capacity for mercy no matter how pitiful the victim.

          I wonder how many of them learn from their experiences in the cases where their stupidity doesn't actually kill them and they recover from Covid-19. 10%? 20%? I would wager it isn't a majority. Negative optimism to hope that at least their family members might learn more from the evidence than the victims do?

          As for the persistent supporters of "He whose name need not be mentioned", I think that's a somewhat different aspect of the problem. Yes, some of them are so sincerely stupid or so proudly ignorant, but I think many of them, especially many of the most visible supporters, are doing it for selfish monetary reasons. In some cases I even think they are paid specifically to fake ignorant stupidity to create bandwagon effects for various focal aspects of the raging stupidity. I even speculate that their professional efforts are further amplified by microtargeting using huge troves of personal data mined to find the best targets for brainphishing and the best bait to brainphish the targets with.

          (But why was my comment moderated Informative?)

        • by apoc.famine ( 621563 ) <apoc.famine@noSpAM.gmail.com> on Saturday December 05, 2020 @06:50PM (#60798780) Journal

          f I was an American I would have great difficulty forgiving Trump or anyone with high levels of education and understanding who still provides him with support.

          That's what's so shocking to me about the last election. 74m people think this is better than an alternative. At this point I'm in the very odd position to be living in a country where at least 23% of the people think that a criminal grifter who has undermined a pandemic response and an election is a better choice than a guy who looks like a pretty typical member of that same party.

          What's worse to me is that the rest of the Republican party has lined up behind him. They refused to consider impeachment, and the direct result of that was a mishandled pandemic to the point that we're losing about a 9-11 terrorist attack worth of people every day, and we're headed rapidly to a half million dead. At this point, it's likely that the only other event responsible for more loss of life in all of US history will have been the civil war.

          I don't see myself or a lot of other people forgetting that sort of evil depravity.

        • If it helps, at least 80 million Americans agree with you. If you want a more sobering, realize 74 million Americans don't.

          I at least understand billionaires who voted for Trump because, well, they can fly to their private islands or shelter on their yachts. But they are getting paid to shit on the country. I don't get the non-billionaires though.

  • Some are (Score:5, Informative)

    by LatencyKills ( 1213908 ) on Saturday December 05, 2020 @12:46PM (#60797784)
    My sister is the head of anesthesiology at the VA in Norfolk, VA. They've filled the space designated as their COVID ward,stopped all elective surgery that would require a bed, displaced the OB patients to make more room, and pitched at tent outside (which is apparently now full). My sister tells me next they boot out non-critical post-surgical patients, move non-infected elderly post surgicals to senior centers, and when those beds are gone, and she's pretty sure they will be, they reroute patients to Richmond (though things are bad there too). They used to send to MD, but there's no room at that inn already.
    • by SuperKendall ( 25149 ) on Saturday December 05, 2020 @01:33PM (#60797962)

      ...Norfolk, VA. They've filled the space designated as their COVID ward...

      I went to look for overall national hospital utilization and came across this CDC page [cdc.gov]....

      It looked like a great resource, until I realized it hadn't been updated since July!!

      That to me is nuts, a centralized account of what hospitals are getting full where, would the the ultimate guide as to how much of a real problem COVID is in your area.

      It's the most important data that could really make people behave a lot more rationally as it was easy to follow, unlike the metric of "cases" which means nothing if you do not know the hospitalization rate around you. I've known several people who have had Covid with extremely mild symptoms and if a lot of people are like that, of course they will not treat Covid seriously without understanding just how many people are going to hospitals.

      So why can't the CDC provide a centralized report on this that is updated at least daily? This seems like exactly the kind of thing that is a perfect fir for them, indeed at this point it's probably all they should be working on.

      • by Immerman ( 2627577 ) on Saturday December 05, 2020 @02:01PM (#60798078)

        >So why can't the CDC provide a centralized report on this that is updated at least daily?

        Because reality was starting to make the President look bad, so he leaned hard on the CDC to shut down the flow of public information. That's always a risk when the chief executive of your organization is more interested in perpetuating his own narrative than getting the job done.

      • by Camel Pilot ( 78781 ) on Saturday December 05, 2020 @02:17PM (#60798122) Homepage Journal

        So why can't the CDC provide a centralized report on this that is updated at least daily?

        The current administration governs based on "gut feelings" do you really want data and science to mess with the gut feelings?

      • Also in July Trump adminstration, stopped allowing data to be dispursed and the hhs ( under a trump appointee)was put to in charge of data collection. We haven had good dAta since July because of republican liars.

      • by ClickOnThis ( 137803 ) on Saturday December 05, 2020 @04:18PM (#60798426) Journal

        I went to look for overall national hospital utilization and came across this CDC page [cdc.gov]....

        It looked like a great resource, until I realized it hadn't been updated since July!!

        That to me is nuts, a centralized account of what hospitals are getting full where, would the the ultimate guide as to how much of a real problem COVID is in your area.

        It's the most important data that could really make people behave a lot more rationally as it was easy to follow, unlike the metric of "cases" which means nothing if you do not know the hospitalization rate around you. I've known several people who have had Covid with extremely mild symptoms and if a lot of people are like that, of course they will not treat Covid seriously without understanding just how many people are going to hospitals.

        So why can't the CDC provide a centralized report on this that is updated at least daily? This seems like exactly the kind of thing that is a perfect fir for them, indeed at this point it's probably all they should be working on.

        Why can't they? Because Trump's HHS took away that responsibility from them in July of this year. [cnbc.com] What you're seeing is the last data that the CDC had before Trump's HHS cut off the flow.

        I agree that managing this information is in the CDC's bailiwick. Maybe you should tell that to the White House.

  • by RyanFenton ( 230700 ) on Saturday December 05, 2020 @12:50PM (#60797800)

    It's always fascinating to see relatively conservative websites like what Slashdot has become try and address how "not so bad" a record number of human deaths from disease is, in the middle of a pandemic.

    I mean sure - 10,000 deaths in 4 days (many states not reporting deaths on any given day, so you kind of have to bundle them together to get a representative number) - it's only 3 or so September 11ths, less that one a day!

    I can see the wheels turning in folks heads though - that denial/justification motivation - that "well, if we stretch that over a year, it's still only a small percent of the population being lost"... as if it hasn't increased - as if diseases don't spread exponentially the less you prevent that spread.

    People evidently needed some level of immediate personal proof before they believed a major disease really existed near them.

    Well - that proof is is basically every community now.

    And if any other justification we've ever had for a war in the past, or other major reaction to human tragedy motivated anything... wearing mask and maybe putting our shared tax money into careful vaccination usage might be wise - even from a modern conservative perspective.

    What do you think though? Will what we call conservatism now ever decide that responding with shared effort to a shared challenge is worth any level of cooperation?

    Or have we moved past that stage - and even a major human tragedy like this is to 'corrupted' by the whiff of liberals that it must be rejected at all costs?

    Is that what half the nation really believes now?

    Ryan Fenton

    • Re: (Score:3, Informative)

      Yes.

    • are ones that haven't lost their jobs and either haven't got it and haven't had any close family or friends get it or they've gotten over it. As a result they either don't care or don't think it's a big deal.

      Some of that is just plain selfishness bordering on psychopathy. But some of it is, at least in my experience, a profound lack of imagination.


      This is how/why you'll see Conservatives make 180s when it hits them personally. It's not that they're hypocritical, it's that they literally don't under
    • A good percentage of the population are pleading and giving prayers to a false god for four more years of their dear leader. That is where their concern is right now. And to make it more ironic this is the subsection of the population that likes to think of themselves as "pro-life".

  • by shilly ( 142940 ) on Saturday December 05, 2020 @01:00PM (#60797840)

    If you think it's bad now, wait till winter kicks in properly and the voting and Thanksgiving and Xmas surges kick in, and then you'll see what a true collapse looks like. It's going to be pretty medieval.

  • by rsilvergun ( 571051 ) on Saturday December 05, 2020 @01:04PM (#60797854)
    without an economic stimulus. And not the fake one the Republicans are offering, but the real one the House passed months ago. e.g. one that includes direct payouts to working Americans and enough unemployment that people can pay their bills while their jobs are shut down.

    We're unlikely to get that though. At this point we're all part of a simple political calculus. If the stimulus is blocked the economy will crash. Voters will blame the party "in charge" (e.g. Biden & the Dems) and give back control of Congress in 2022. Then more obstruction will happen and again voters will blame Biden & the Dems and hand the Whitehouse back to the Republican party in 2024. Most likely with Mitt Romney as president.

    It was a tactic started by Newt Gingrich, and you can read about it on his Wikipedia article. As long as you're willing to risk everybody's jobs, livelihoods and lives it works great.

    TL;DR; we're all being held hostage for political power.
    • Most likely with Mitt Romney as president.

      That depends on what Republican voters' opinions of Trump are in 3 years time. Romney is clearly setting himself up as the Republican who opposed Trump. That will either work well, or fail catastrophically.

  • The rest of america is doing okay because they don't have as many stupid people.
    • (1) America is short for US of A. Always has been.

      (2) Brazil (to choose the second largest country in the Americas) is doing pretty shit right now too.

  • For better or worse, this is standard for mass casualty events. You have a wreck of a passenger train, and yeah, you're going to triage the casualties because there is an imperative to save as many as possible.

    Should COVID have become a mass casualty event? No, but it now is what it is, and this is the consequence of poor government leadership, inadequate healthcare (increasing co-morbidities), and the selfishness of a good chunk of the population.

    • That affects public reaction. We expect humans in nursing homes to die because that is what they go there to do though it's unfashionable to say so. I'm old too and elders often shed illusions about death those young enough for denial cherish. Our society can easily process the dead when they are of little or no FUNCTIONAL value. We shrug off the deaths from heart disease, smoking etc because most of the dead are old and long finished contributing to the economy except as consumers.

      Old people are supposed t

  • Rationing health care... How fucked up is that??

    • by Actually, I do RTFA ( 1058596 ) on Saturday December 05, 2020 @01:28PM (#60797952)

      I mean, the US has always rationed health care. Only normally it's bureaucrats in insurance companies who get bonuses based on denying care that are doing the rationing.

      But yes, it's fucked up.

    • The US has always rationed Health Care through the filter of who can pay.

      Ironically the hardest hit rationed section of the population is the working poor - the people who work low-end jobs, or people who work for companies that don't provide health-care or provide shit policies. These are the people who make the country run daily.

  • Well, Trump did warn us the US would be "sick of winning".

  • Yes, they are (Score:3, Informative)

    by quonset ( 4839537 ) on Saturday December 05, 2020 @01:56PM (#60798058)

    Here is a story about how the Republican governor of Iowa has caused the hospitals to be overwhelmed [theatlantic.com] by parroting the lies of the con artist.

    Back in October, some smaller hospitals were already being overwhelmed [miamiherald.com] and some larger hospitals were unable to take patients from elsewhere due to a shortage of beds.

    Ohio is being overwhelmed [msn.com] with the surge in covid cases appearing in its hospitals.

    On top of all the new cases, hospital workers are being overwhelmed [cnn.com], both physically and mentally [msn.com], as they work day after day without rest. Hundreds of hospital workers, mainly nurses, have died after themselves contracting the virus while others have quit. You have a heart attack and need treatment? Good luck getting care with the staff shortages [jsonline.com].

    So yes, hospitals are being overwhelmed, and with Thanksgiving over but Christmas and New Year's around the corner, expect the number of cases and deaths to keep soaring [usatoday.com]. Oh, and don't forget about those death panels [theguardian.com], which were instituted as far back as March, as hospitals are forced to decide who should get treatment [ibj.com].

    • Re:Yes, they are (Score:4, Insightful)

      by malkavian ( 9512 ) on Saturday December 05, 2020 @03:02PM (#60798240)

      I'd take anything The Guardian says with a pinch of salt (at least as far as the tone goes). Everywhere in the world has set up ethical panels to determine protocol on provision of care for when the service gets overwhelmed.
      What The Guardian is saying is a "Death Panel" (note the heavily emotionally loaded term, designed to immediately set you against it) is little more than a clinical ethics panel to say "When we are faced with a probable lack of clinical resource due to numbers expected coming in from the population compared to our limited ICU resources, how do we handle this". This is of course, the correct way to deal with it. Very sensible, and the world at large has been doing this since the first wave of COVID.

      I work in a hospital, and I've planned the changes required to my own department, and been involved with the planning for the surrounding departments as well, to ensure we can all continue service. So yeah, I know what overloaded is like. It's been exhausting since the start, and we're all frazzled. That's because the numbers of trained staff are present in numbers that are sustainable for predicted events plus error margin. We've blown right past that, and without huge investment, capacity doesn't expand much. Interestingly, this seems to have worked better in socialised medicine as the Government has pulled spend to the infrastructure and added a healthy extra capacity at places identified at the most risk (i.e. the UK's Nightingale Hospitals etc.). But that's a slightly different debate.

      Yes, I'd expect the holiday season to cause another spike. But that's entirely on people.

      I still don't understand why you're so caught up on people making clinically essential decisions on an ethical basis about who gets care, when this event predicts a resource requirement that goes way beyond expected ability to provide. That's practical and ethical. Please stop making it out to be something nefarious because it's not (and yes, I've served on both research and clinical ethics boards, so I know what goes on in them and why).

      • by sjames ( 1099 )

        It's being called a "death panel" because that's the term the GOP used when it was fighting against universal healthcare. Some people need a reminder that the "death panel" is not an exclusive feature of single payer healthcare.

    • As a follow up, Idaho now has soldiers triaging patients in parking lots [go.com] due to the massive rise in cases. They're even preparing their death panels:

      Now, hospitals are planning what to do if there aren’t enough workers or beds available in an entire region. Health care workers would have to choose who gets treatment and who doesn’t.

      “That's really when we're at risk for what's called the ‘crisis standards,'" said Hill, noting that the state would decide when to institute them. "We're very concerned in the next two weeks.”

      Idaho's crisis plan divides the sick into categories, prioritizing those with life-threatening illnesses or injuries who are expected to survive and giving only comfort care to those who aren't.

  • A recent article in our local newspaper reported that should hospitals be overwhelmed a scoring system has been developed for incoming, and presumably in house patients, consisting of a total score based on the sum of two numbers

    - The first number ranging from 1 to 4 based on breathing, kidney, liver, heart function, nervous system platelet count.

    - The second number ranging from 1 to 4 based on patient's long term health as the likely hood of dying in the next 12 months using age and health history.
  • by ErichTheRed ( 39327 ) on Saturday December 05, 2020 @02:09PM (#60798096)

    Looking at the data, we had three major spikes in caseload so far. The first was concentrated in the Northeast and I lived through it in NYC. Until things shut down and the volume went down it was pretty crazy...no one really knew how many people were going to get sick, hospitals were indeed overwhelmed and the city was digging temporary cemeteries. The second spike was more generalized in other parts of the country and for whatever reason the patchwork of rules and treatment improvements was able to keep hospital capacity to reasonable levels. This spike is way more generalized across the whole population and it seems like it's a throughput problem this time. Fewer people are dying for now because treatments are improving. Hospital stays are also shorter, and fewer people need to go to the hospital. (Either the first rounds got the most vulnerable, enough people are listening, and/or the virus is adapting to not kill its host.) But when you have even a small percentage of the population needing the services of a system not designed to cater to that level, all at once, you're going to have a problem.

    Here in NY, they're planning for yet another round of insanity as all the idiots gathering for Thanksgiving and Christmas get each other sick. Ever since the beginning it's been all about reducing the influx and maintaining throughput without having to resort to measures like building more hospitals and finding healthcare workers from somewhere. Problem is since it's almost everywhere now, it's hard to move people around to keep up with the demand. Hopefully enough people will listen, people won't need hospital care, and we can hang on until most people are either infected or vaccinated.

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