Despite what should have been ample warning, the U.S. may get blindsided

by Martin Makary MD, MPH, Editor-in-Chief, MedPage Today March 9, 2020

While it’s well known that China and Iran have under-reported their COVID-19 statistics, Italy has been fully transparent. What we are learning is very concerning. The Lombardy province alone has experienced a surge in deaths due to the coronavirus— from 20 to 66 deaths in just one day. Analyzing data for the country as a whole, new diagnoses and deaths are doubling every few days. At this rate, Italy’s entire healthcare system will be overwhelmed by next week. Remember that two weeks ago, Italy had reported seven deaths.

Italy is a preview of what we may see in the U.S. very soon.

In a recent statement, the American Hospital Association projects strain on U.S. hospitals and is requesting congressional funding for new hospital construction and increased housing for patients. Doing the math, the U.S. currently has approximately 100,000 ICU beds with most hospitals already functioning at full or near-full capacity. According the Johns Hopkins Center for Health Security, 200,000 to as many as 2.9 million patients could present to U.S. hospitals with coronavirus. It’s time we increase the capacity of our medical centers before the infection ramps up.

Wuhan was overrun even with 19 field hospitals set up for the pandemic. Healthcare workers are at the highest risk of getting infected, not only representing a risk to our lives but a strain to our capacity to care for the tsunami of patients expected. U.S. hospitals and health professionals are on track to soon be overrun with patients, following the pattern of hospitals overseas who describe rationing respiratory support. Within weeks, U.S. hospitals may be significantly under-resourced and deal with major staffing shortages. Washington State is already scrambling to hire hundreds of travel nurses to help staff the influx of infected patients.

If the virus stays on its current trajectory, what happened in Wuhan will happen in the U.S. There is no strong scientific argument to suggest otherwise. While we all hope the virus demonstrates an unexpected heat-sensitivity or mutates to a less virulent form, the virus has, so far, followed a highly predictable course. That path was mapped out over 3 week ago by Marc Lipsitch, PhD, of the Harvard T.H. Chan School of Public Health. Despite his dire warning that 40%-70% of the population could be infected, little was done to prepare for the pending crisis beyond standard handwashing and coughing instructions — a routine done every flu season. We need to mobilize quickly. In a national survey of 6,500 nurses in 48 states released last week, 63% of nurses report that they do not have access to N95 respirators in their units and many said they haven’t been fitted or trained on how to properly use them. At the same time, first responders are underprepared and most have not been given the protective gear they need to treat infected patients. . .

Marty Makary, MD, MPH, is MedPage Today’s Editor-in-Chief as well as professor of health policy & management at the Johns Hopkins Bloomberg School of Public Health and professor of surgery at Johns Hopkins University School of Medicine.

Click here to see all of MedPage Today’s COVID-19 coronavirus coverage

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Canadian Medicare does not give timely access to healthcare, it only gives access to a waiting list.

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