From May 2020, A typical American hospital during coronapanic:
The author of Medical School 2020 gave me an update on his training hospital. They have roughly 1,100 beds. They have admitted 24 Covid-19 patients since the plague began. There are currently 7 Covid-19 patients in the hospital. Residents have been working week-on/week-off due to the shortage of cases from which they might learn. “We’re allowed to do elective surgeries as of this week,” he said, “and I thought there would be a huge backlog, but there isn’t. We’re still not busy.”
How about now? “Every bed is full. The ICU is full. The ED has 55 patients waiting for rooms [in the rest of the hospital].” Is COVID-19 that prevalent? “No,” he responded, “but we have to test every patient before discharge even if we have no reason to suspect Covid. If someone tests positive, he or she can’t go back to the nursing home for three weeks. People who would have been in the hospital for 4 days in 2019 are staying 6 weeks. We will have to shut down elective surgeries soon if we can’t do better at placing discharged patients.”
What about the COVID-19 patients per se? “Most of them are on 1 liter of oxygen [per minute], which is nothing,” he said. “They might not notice if it were stopped. People can be at home on 5 liters.” In his opinion, the ones who were on ventilators had to be in the hospital because they needed to be managed by nurses, but none of the other Covid-19 or Covid-19-positive patients had any medical need to be in the hospital. They were there because no infrastructure had been built to accommodate patients who didn’t need to be in the hospital, but who could be sent back into nursing homes for fear that they would infect others (enter the hero Governor Cuomo!).
Essentially, the hospital is packed because, even with nearly a year to prepare, state and local health departments that regulate hospitals and track hospital capacity couldn’t get organized to turn empty hotels into Covid-19 halfway houses.
Department of Nobody Listens to Me… from April 2, 2020… If we could build renal dialysis capacity, why not COVID-19 treatment centers?: treat COVID-19 patients in strip malls.
Update: A medical school professor who read the above… “It’s all true. But one big additional reason is that discharging all those patients would be a loss of $$$$$.” (I’m disappointed in myself for not immediately realizing that a 100-percent full hospital, and a ready excuse in the form of hysterical headlines for why it is 100-percent full, is not the end of the world from the hospital CEO’s perspective.)
- Health care workers in Aruba plead with you to stay home and avoid travel, in which a med school prof and our hero answer the question of whether Covid patients should be in the hospital: “Many things could be done from home cheaper and safer but we don’t have the infrastructure or culture. Home model kills the rationale for the hospital cash cow.”