Coronavirus pandemic: US hospitals, cities could be overrun with patients by March 23, warns former Obama aide

Andy Slavitt, former Medicare, Medicaid, and Affordable Care Act head for Barack Obama, says that the “original sin” was Donald Trump’s months long denial and his dismantling of public health and response infrastructure


                            Coronavirus pandemic: US hospitals, cities could be overrun with patients by March 23, warns former Obama aide
(AP Photo/Robert F. Bukaty)

Hospitals and cities in the US could be overrun with COVID-19 cases by March 23. Andy Slavitt -- former Medicare, Medicaid, and Affordable Care Act head for Barack Obama -- took to twitter to issue this stark warning.

“Last night I was on with state and local officials around the US well into the night. By March 23 many of our largest cities and hospitals are on course to be overrun with cases. Currently, experts expect over 1 million deaths in the US since the virus was not contained and we cannot even test for it. This will be recorded as a major preventable public health disaster,” Slavitt tweeted on March 14. 

He said that the US and every country that has not taken better preventive measures like South Korea and Japan are “directly on course, lagging two weeks behind.”

“Every report describes this (the situation in Italy as a tsunami. And if it happens like a tsunami, in major cities, we will have 10s of thousands of more cases than we have beds & we will have 1 ventilator for every 8 people who need one. The only way to prevent Italy given our lack of testing is to socially isolate. Congress even allocates money for people to stay home. That rarely happens. But we blew our chance at containment,” he says.

He suggests Americans should stay socially isolated for real. “Not for you, but for everyone. And if someone minimizes this all, patiently listen & explain. People can’t be bullied,” he says

“We can’t afford 10,000s of thousands to be hospitalized at once so we need to prevent & slow down the pace. And if this sweeps through nursing homes, it is fatal to our loved ones,” Slavitt adds. 

In the US, over 2,950 have been infected with the virus, and at least 57 have died. 

Steve Moody, director of nursing at Central Maine Medical Center, mops the floor of a tent outside the emergency entrance to the hospital where patients are tested for COVID-19 in Lewiston, Maine.
(AP Photo/Robert F. Bukaty)

Slavitt says that the “original sin” is Trump’s months long “denial and his dismantling of public health and response infrastructure.”

“That wasn’t all, but it led to other fatal mistakes. The public health infrastructure could have been prepared. What does that mean: nasal swabs, respirators, ventilators, RNA kits to read tests, machines, gloves. We can at best do 10,000 tests/day. We should be able to do millions,” he says. 

Slavitt, however, asked Americans to root for the government to succeed “here whether you like them or not.” “The stakes are higher than any most of us have ever experienced: wars, 9/11, whatever. Let’s have an election with this behind us having pulled together. This does spread from Republican to Democrat,” he emphasizes. 

Disease modelers at the US Centers for Disease Control and Prevention (CDC) have projected that as much as 65% of the American population could eventually be infected by the new coronavirus, according to the New York Times.

38M may need medical care in moderate pandemic scenario

A previous analysis has suggested that if a Wuhan-like outbreak were to happen in an American city, US hospitals would be too overwhelmed to handle the crisis. The reason is that even on any given day, the occupancy rate of hospital beds in the US is about 65.5%, shows an estimate by the CDC. 

Disease modelers at the CDC project that as much as 65% of the American population could be infected by the new coronavirus, reports the New York Times.

According to the report, the CDC shared its models with 50 expert teams, all working to estimate how fast the virus will spread and how severe the cases of flu-like illness it causes will be. The worst-case figures reflect what would happen if no action is taken to slow the virus. If this transmission is unchecked, each person with the virus could infect about two to three others, causing the contagion to grow.  

“Between 160 million and 214 million people in the US could be infected over the course of the epidemic, according to a projection that encompasses the range of the four scenarios. That could last months or even over a year, with infections concentrated in shorter periods, staggered across time in different communities, experts said. As many as 200,000 to 1.7 million people could die,” says the report.

A nurse at a drive up COVID-19 coronavirus testing station set up by the University of Washington Medical Center exits a tent while holding a bag containing a swab used to take a sample from the nose of a person in their car. (AP Photo/Ted S. Warren)

The US Department of Health and Human Services (HHS) also has official planning assumptions for pandemic influenza, ranging from a moderate pandemic like 1968 or 1957 to one based on a very severe pandemic like 1918, says the Center for Health Security at Johns Hopkins

Based on these tools available, experts at the John Hopkins Center say that in a moderate pandemic scenario (1968-like), 38 million Americans will need medical care, there will be 1 million hospitalizations, and 200,000 will need intensive care. Again, in a very severe pandemic scenario (1918-like), 38 million will requite medical help in the US, 9.6 million will need to be hospitalization, and 2.9 will need ICU.

“As a comparison, there are about 46,500 medical ICU beds in the US and perhaps an equal number of other ICU beds that could be used in a crisis. Even spread out over several months, the mismatch between demand and resources is clear,” says Dr Eric Toner, and Dr Richard Waldhorn, in the analysis.

They add, “Some patients in China have been treated with extracorporeal membrane oxygenation (ECMO), and some US medical centers with this technology are preparing to use it as well. For US hospitals with this capability, it would be prudent to think through how this scarce resource would be allocated if demand exceeds resources.”

According to the experts, based on such calculations, it would seem that preparing for a pandemic of even moderate severity is a difficult challenge.

They recommend that individual hospitals and groups of hospitals involved in regional coordination of pandemic preparedness should focus their initial preparedness efforts through realistic planning based on actual CDC flu surge projections in each hospital, and collaborative planning among all hospitals in a region.

“Limiting the nosocomial spread of the virus to protect the healthcare workers and, thus, maintain a hospital workforce; prevent the hospital from being a disease amplifier; and protect the non–COVID-19 patients from infection, so as to maintain the ability to provide essential non–COVID-19 health care,” the researchers recommend.

Slavitt suggests expanding medical capacity, which he says has to be done but will only make a tiny difference if we don’t self-isolate. “Hospitals must get rid of elective procedures, expand negative pressure rooms, move ventilator capacity to hot spots & seek additional where possible, create isolation negative pressure rooms, get tests for every frontline worker, get masks and other supplies even on the black market,” he says. 


Disclaimer : This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.