COVID-19: Can the US Avoid Italy’s Fate?

Doctors in Italy are begging the United States to start preparing for a massive increase in COVID-19 infections.

“Any substantial increase in the number of critically ill patients would rapidly exceed total ICU capacity, without even considering other critical admissions, such as for trauma, stroke, and other emergencies,” wrote a group of doctors from Milan.

The United States must dramatically increase COVID-19 testing, create facilities reserved for the treatment of infected patients, and double down on communicating the risks to the American people.

Any hospital that is not part of an emergency network should create or join one, added the doctors, and strict enforcement of community and individual quarantines is vital.

“In practice, the healthcare system cannot sustain an uncontrolled outbreak and stronger containment measures are now the only realistic option to avoid the total collapse of the ICU system.”

As reported this week, a lack of personal protective gear in Italy’s hospitals has resulted in the infection of roughly 1,700 healthcare workers. Some have already died. To date, Italy has reported 35,713 cases and 2,978 deaths.

While the Trump Administration has implemented several strategies to help shield industries, businesses, and individuals from the economic fallout, medical preparation is another story.

Writing in the Wall Street Journal, Dr. Luciana Borio, former director for medical and biodefense preparedness policy at the National Security Council, and Scott Gottlieb, former commissioner of the FDA, outlined several steps American hospitals and policymakers can take now to increase America’s capacity to deal with the crisis:

• Hospitals should be reserved for patients with severe cases of the virus and should not admit those with mild symptoms.
• Patients with mild symptoms should stay isolated at home.
• The nation should expand telemedicine and create satellite testing clinics away from hospitals.
• The federal government should allow physicians to practice medicine in states where they are not licensed and waive restrictions that require physicians to be on-site for physician assistants to practice.
• Elective procedures should be postponed in order to free up hospitals from routine medical care.
• Hospitals should immediately implement disaster plans to create more space for patients.

Experts agree that US cities are grossly unprepared for the projected number of cases. Take New York, which could need up to 37,200 ICU beds at the projected peak of infections. The state currency has 3,200 ICU beds, many of which are occupied by very ill patients.

America as a whole has roughly 64,000 ICU beds and 100,000 ventilators, most of which are already in use.

The only way to increase bed capacity quickly may be to utilize the military to build field hospitals; New York Andrew Cuomo has already suggested this step.

“The Italian healthcare system has largely collapsed through a surge in critical cases,” continues Borio. “The biggest risk for the US may be that multiple cities have been seeded at once. Italy and China proved that the only way to save lives is to make sure the medical system can keep pace with the need for critical care. There is still a window to prepare.”

As it stands, New York City and Seattle are the cities most at risk for an outbreak.