‘Agonizing Decisions’: Stressed Hospital Workers Told To Make Rationing Plans

Bloomberg: States, Hospitals Told To Make Rationing Plans As Covid Surges
States and hospitals need to be in crisis mode, ready to make “agonizing decisions about how resources are used” as Covid-19 infections surge nationwide, several major groups representing doctors and nurses said Friday. The U.S. has “reached a point in the crisis at which critical decisions must be made in order to do the most good possible for the largest number of people with limited resources,” nine organizations, including the American Medical Association, the American Nurses Association and the National Academy of Medicine, warned in a statement Friday. Many intensive care units are already over capacity and more will be in the coming weeks, the statement said. (Edney, 12/18)

Modern Healthcare: COVID-19 Stretches Rural Health Safety Net
About 40% of adult hospitalizations at rural hospitals were COVID-19 related as of Nov. 27, up from a median of 28% in late July, Chartis Center for Rural Health's analysis of HHS data shows. The share of COVID-related hospitalizations at urban hospitals increased from 14% to 23% over that span. Rural hospitals typically lack the capacity, equipment and staffing to best manage acute cases. There is one ICU bed for every 9,500 Americans who live in rural communities, where intensive care beds are hard to come by. Nearly two-thirds of rural hospitals don't have any ICU beds, Chartis data show. (Kacik, 12/18)

Nashville Tennessean: Tennessee Department Of Health Warns Of 'Broken' Hospital System If COVID-19 Cases Surge
Tennessee Department of Health officials announced Sunday that the state could "break" its hospital system if a Christmas surge of COVID-19 cases matches that of Thanksgiving. Commissioner Lisa Piercey said there have been multiple household gatherings where people have been affected statewide, as Thanksgiving surges proved. "We know how this happens," she said. "People get together and think, 'It's OK for me to be home or not at a bar,' and think having a few friends over is OK. That's a dangerous mentality. We want to preserve access to hospital resources. If we have another surge over Christmas, it will break our hospitals. Don't gather with those outside of your households. We have to change our behavior over the next several weeks." (West, 12/20)

AP: Hospital Staffs Stretched Thin During California Virus Surge
Medical staffing is stretched increasingly thin as California hospitals scramble to find beds for patients amid an explosion of coronavirus cases that threatens to overwhelm the state’s emergency care system. As of Sunday, more than 16,840 people were hospitalized with confirmed COVID-19 infections — more than double the previous peak reached in July — and a state model that uses current data to forecast future trends shows the number could reach 75,000 by mid-January. (Weber, 12/20)

Also —

The New York Times: Hospitals Are Still Facing Shortages Of Masks And Other Protective Gear 
As Americans celebrate the rollout of a coronavirus vaccine, many of the doctors and nurses first in line for inoculation say a victory lap is premature. They fear that the optimism stirred by the vaccine will overshadow a crisis that has drawn scant public attention in recent months: the alarming shortage of personal protective equipment, or P.P.E., that has led frontline medical workers to ration their use of the disposable gloves, gowns and N95 respirator masks that reduce the spread of infection. (Jacobs, 12/20)

Stat: Pandemic-Induced Demoralization Is Sapping Clinicians' Spirits 
“There’s a surge in calls. We need more backup,” read the text I got last week from my colleague Mona Masood, a psychiatrist and co-founder of the Physician Support Line, a peer-to-peer hotline that she, I, and others developed in response to the Covid-19 pandemic. With 700 volunteer psychiatrists staffing the hotline, my first thought was, “How is that possible?” My second thought was “Ah, yes. We are still demoralized.” (Song, 12/19)

KHN: ‘Nine Months Into It, The Adrenaline Is Gone And It’s Just Exhausting’ 
In March, during the first week of the San Francisco Bay Area’s first-in-the-nation stay-at-home order, KHN spoke with emergency department physicians working on the front lines of the burgeoning COVID-19 pandemic. At the time, these doctors reported dire shortages of personal protective equipment and testing supplies. Health officials had no idea how widespread the virus was, and some experts warned hospitals would be overwhelmed by critically ill patients. In the end, due to both the early sweeping shutdown order and a state-sponsored effort to bolster the supply chain, Bay Area hospitals were able to avert that catastrophe. (Barry-Jester, 12/21)