Stop gun violence, hospitals need beds for coronavirus patients, Pennsylvania doctor begs Americans
America is facing an epidemic along with the COVID-19 pandemic. As COVID-19 overwhelms the US’s healthcare system, the nation continues to battle the uniquely American epidemic of gun violence. A US doctor has now appealed to Americans to stop gun violence as hospitals across the country need beds, ventilators and personal protective equipment (PPE) to treat COVID-19 patients.
Dr Elinore Kaufman, a fellow in surgical critical care and trauma surgery at University of Pennsylvania, wrote in The New York Times that while doctors are trying to keep the world safe from the coronavirus pandemic, "thousands of families in America are battling the country's existing epidemic: gun violence."
"We need ICU beds, we need ventilators, we need personnel to care for the wave of COVID-19 patients. But gunshot victims are now fighting for space and resources inside America's overcrowded ICUs. I feel this crisis intimately at my hospital here. There were more than 120 shootings in Philadelphia last month (March), according to the city. Our team has taken care of 11 patients injured by bullets over the last seven days alone. All this as the COVID-19 epidemic ramps up in Philadelphia," said Dr Kaufman in the April 1 opinion piece.
According to available data, the number of shooting victims in Philadelphia was 110 in January this year, 85 in February and 141 in March. She further said, "As our ICUs fill up with patients struggling to breathe, we look around and ask: Can we save a bed, can we save two beds, for the gunshot victims we know are coming next? Who can watch these ventilated patients if we have to call doctors to the operating room to give a hand?"
Over 465,700 cases have been reported from across the US as of April 10, and more than 16,600 have died in the coronavirus pandemic, according to the John Hopkins tracker.
Gun violence in the US
Gunshot wound injuries remain a significant public health problem in the US, with escalating deaths and health costs. According to the US Centers for Disease Control and Prevention, 39,773 people died from gun-related injuries in the country in 2017. The firearm death rate is 12.2 deaths per 100,000 total population in the US.
Four major mechanisms of injury in 2017 — poisoning, motor-vehicle traffic, firearm and fall — accounted for 78.7% of all injury deaths. The two major causes of gun injury deaths in 2017 were suicide (60%) and homicide (36.6%).
"In 2017, the age-adjusted death rate for firearm-related injuries for the total population increased significantly, by 1.7% from 11.8 in 2016 to 12.0 in 2017. For males in 2017, the death rate for firearm-related injuries was 6.1 times the rate for females. The rate for firearm-related mortality increased by 2.0% for males from 2016 to 2017. The rate for females in 2017 was unchanged from 2016. The death rate for non-Hispanic white males was 54.9% lower than for non-Hispanic black males and 73.9% higher than for Hispanic males. The rate for non-Hispanic white females was 15.6% lower than for non-Hispanic black females and 111.1% higher than for Hispanic females," says the CDC report.
In 2016, there were an estimated 251,000 gun deaths globally, a global age-standardized rate of 3.4 deaths per 100,000 people. A group of six countries made up more than half of those deaths, and the US is one of them, according to a study that estimated mortality due to firearm injury deaths from 1990 to 2016 in 195 countries and territories.
“Worldwide, it was estimated that 251,000 people died from firearm injuries in 2016, with 6 countries — Brazil (43,200 deaths), US (37,200), Mexico (15,400), Colombia (13,300), Venezuela (12,800) and Guatemala (5,090) — accounting for 50.5% of those deaths," says the study published in JAMA. These countries had less than 10% of the global population in that year.
The report says that in 1990, there were an estimated 209,000 firearm injury deaths. Globally, the number of firearm injury deaths were greater than those from conflict in almost every year between 1990 and 2016, say experts.
According to the research team, the majority of the firearm deaths in 2016 were homicides (161,000 or 64%). The researchers say though public perception is frequently focused on the use of gun in homicides, particularly mass shootings, suicides involving firearms greatly outnumber firearm homicides in many countries. Among these countries, the presence of firearms in the home has been directly linked to their greater use as a means of suicide and unintentional firearm injury deaths. In the US, firearm suicides represented 35.3% of global firearm suicides in 2016. In that year, 4.3% of the global population was in the US.
"Both suicide and homicide are defined as intentional behaviors, and thus it should be possible to develop strategies to reduce these forms of violence," the study says.
And while the COVID-19 pandemic is sinking economies around the globe, reports suggest that some businesses such as guns have seen a massive spike in their sales due to panic-buying among Americans.
Unit sales topped an estimated 2.5M, up 85.3% year-over-year, according to the Federal Bureau of Investigation’s National Instant Criminal Background Check System, says an April 2 Bloomberg Quint report.
Larry Hyatt, owner of one of US’s largest gun shops, Hyatt Guns, in Charlotte, North Carolina, told The Guardian that this is only the second time in his 61 years of business that they have seen such mass buying of guns. He said the first occasion was the aftermath of the mass shooting at Sandy Hook elementary school in Connecticut in 2012. "We are experiencing a massive rush to buy guns and ammunition as people feel the need to protect themselves and their families," he told The Guardian.
Hospitals are already overwhelmed
On a normal day, the occupancy rate of hospital beds in the US is about 65.5%, shows an estimate by the CDC. With the COVID-19 pandemic, hospitals and medical workers are feeling overstretched.
In a report by the US Department of Health and Human Services (HHS), experts found that hospitals are anticipating being overwhelmed by a surge in COVID-19 patients, who would need specialty beds and isolation areas for effective treatment. Specifically, hospitals reported concerns about potential shortages of intensive care unit beds, negative pressure rooms and isolation units. Hospitals also reported that, given the limitations to bed availability, it was challenging to sufficiently separate COVID-19 and non-COVID-19 patients within their facilities.
Separating patients is required to allow health care workers to better coordinate and direct treatment specific to COVID-19 patients as well as reduce the spread of infection. One hospital administrator said, "Being a rural hospital, we have to be ready to convert beds to prepare for surge capacity. We still have to take care of our non-COVID situations. We have to make people feel like we can still take care of them if they have (an) emergent situation."
Hospitals across the country also said there was a shortage of PPE that was threatening their ability to keep staff safe while they worked to treat patients with COVID-19. The most commonly needed PPE items across hospitals were masks (including N95 masks, surgical masks and face shields), followed by gowns and gloves.
"I get these pages almost every night (regarding gunshot victims) at the trauma center where I work. I rush to put on my protective equipment to guard against blood and other bodily fluids. But for the first time, I’m saving clean masks to reuse them. Because of coronavirus, the parents of my patients need a special escort because visitors are not allowed in the waiting room. I can’t bring a family to a gunshot victim’s bedside in the intensive care unit. I can’t tell a frightened mother that she can stay as long as she wants," says Dr Kaufman.
She wrote that each patient injured by firearms admitted to the intensive care unit is its own tragedy. "Every one of these ICU admissions are preventable because every one of these injuries is preventable. We have overcome public health crises in the past. The same kind of public health approach that cut death rates from motor vehicles by half, even though we drive more now than ever, could be used to reduce firearm injuries," says Dr Kaufman. She has called for evidence-based solutions to bring down gun violence ranging from licensing laws for firearm dealers and purchasers and red-flag laws to community-based focused deterrence programs.
"COVID-19 is going to require all our public health resources, but it is far from the only public health crisis we are facing. If we can come together to combat this latest challenge, let us stay together to work on another. So please, stop shooting. We need the beds," says Dr Kaufman.