A Covid Surge Is Overwhelming U.S. Hospitals, Raising Fears About Rationed Care: NPR
Sept. 5, 2021. - Ed.
The U.S. health care system is again buckling under the weight of a COVID-19 surge that has filled more than 100,000 hospital beds nationwide and forced some states to consider enacting "crisis standards of care" — a last resort plan for rationing medical care during a catastrophic event. The idea is an alarming sign of how the delta variant has ripped through large swaths of the country — primarily sickening the unvaccinated and straining an already depleted health care workforce.
In recent weeks, more than 10 states have reached their highest hospital admissions for COVID-19 of the pandemic, from the Southeast to the Pacific Northwest. And the U.S. continues to average more than 160,000 new coronavirus cases a day.
Many hospitals are "right on the edge" "We're in a very dangerous place, given the level of our surge," says Dr. Bruce Siegel, president of America's Essential Hospitals, a trade group that represents hundreds of public hospitals. "We are right on the edge of entering crisis standards of care. I hope we don't get to that point, but it could very easily happen," Siegel says. This is essentially a road map for how to divvy up medical care in a way that's equitable when resources are tight. While there are national guidelines for crisis standards, the actual plans can vary depending on the state, region or institution.
Declaring crisis standards does not necessarily mean patients will be denied care altogether, but it does give hospitals flexibility about whom to prioritize and provides legal protection for doctors. For example, certain patients deemed less likely to survive may not get a bed in the intensive care unit. Nurses may be asked to treat many more patients than is normally considered safe. Patients may have to be discharged from the hospital before they would normally go home, and some patients who would usually be admitted for hospital care might have to be denied.
Arizona had to activate its plan earlier in the pandemic. And some states came to the brink of doing so last winter. These plans can include a "scoring" system that evaluates a patient's chance of survival based on the functioning of the brain, heart, kidneys or other major organs. - "It's worse than ever" - Nurses overwhelmed. ICU patients being housed in the emergency room. Doctors scouring the state for the last bed. These are scenes that critical care doctor Kenneth Krell never expected to deal with in late 2021, once highly effective vaccines for COVID-19 were widely available...
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https://www.npr.org/sections/health-shots/2021/09/05/1034210487/covid-surge-overwhelming-hospitals-raising-fears-rationed-care
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