Health care system ill-prepared for Coronavirus

Gov. Andrew Cuomo told New Yorkers Tuesday the state’s health care system will likely be pushed beyond its limits battling the coronavirus pandemic.

Current projections indicate ventilators and hospital beds could be in short supply during the outbreak’s estimated peak in 45 days, Cuomo said during a press conference.

New York already has precious little unused capacity to handle the expected wave of patients, according to a report on ventilator distribution issued in 2015 by the state Department of Health.

The report, the most recent assessment Investigative Post has been able to obtain, said an estimated 85 percent of the ventilators, or 6,154, were typically in use in hospitals and other acute care facilities at the time of the report. That left 1,086 available for use. Another 1,750 were in reserve, according to the state report.

The expensive and complex machines move air in and out of the lungs of patients who cannot breathe sufficiently on their own.

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The report, issued by the state Health Department and the Task Force on Life and the Law, used moderate and severe pandemic scenarios based on prior flu outbreaks to illustrate the potential need for ventilators in pandemic situations.

Hospitals will be able to make due with their inventory of ventilators if the spread of a virus is sufficiently curbed, the report said. 

But, referring to the deadly Spanish flu of 1918, the report said that if “an (outbreak) on the scale of the 1918 pandemic were to occur, it is possible that New York would face a significant shortage of ventilators.”

Dr. Thomas Russo, professor and chief of the Infectious Disease division at the University at Buffalo Medical School, said based on current numbers he does not believe the coronavirus pandemic will reach 1918 levels. 

There’s no direct comparison, Russo said. A century ago, younger people were more susceptible to the flu virus strain that infected tens of millions of people. As well, there were no antibiotics. Medicine has moved 100 years forward since, he said.

But a potential lack of ventilators is a worry to Russo.

“I am concerned that we could be in the negative,” he said.

What happens if there’s not enough to go around? 

Doctors would have to ration their use, forcing them to decide who receives care and who doesn’t. That’s what’s happening now in Italy’s most acutely affected regions. Russo said the situation should be regarded as a worst case scenario.

Here in New York, additional purchases could only do so much, the 2015 Health Department report said. It theorized that a severe pandemic scenario would stretch the workforce to its limits. 

“Purchasing additional ventilators beyond a threshold will not save additional lives because there will not be a sufficient number of trained staff to operate them,” the report said.

Where any additional ventilators could come from is uncertain.  

The devices are not easy to get, Cuomo said. But they’ll be a necessary tool to help the growing numbers of the seriously infected individuals, many of whom will either have preexisting conditions or will develop secondary illnesses like pneumonia. 

“That’s the coronavirus,” he said.

Such patients are hooked up to ventilators in hospital intensive care units, or ICUs. The statewide need for beds in those units could be substantial enough to require the construction of temporary medical facilities to house and care for the sick, according to the governor’s office.

The state Health Department website reports the region has about 270 beds in intensive care units, a majority of which are already in use. 

The availability of ICU beds leave Western New York in better shape than elsewhere, said Russo of the UB Medical School. If social distancing and other measures blunt the growth of coronavirus cases, he said, “then we have a realistic chance of not overwhelming our healthcare system” in the region.

But things could get dire statewide, Cuomo said Tuesday. 

The governor expects hospitals to need between 18,000 and 37,000 ICU beds. There’s only 3,000 in New York. Medical providers will need between 55,000 and 110,000 hospital beds. There’s 53,000, as it stands.

“That, my friends, is the problem that we have been talking about,” he said.