A Critical-Care Challenge: The Real Danger of COVID-19 for Hospitals
by Heather Hitchcock, on Mar 13, 2020 8:46:00 AM
“Shifts in the way that healthcare is delivered during a COVID-19 outbreak response will be complex.” The Centers for Disease Control & Prevention (CDC) included those thoughts in its “Interim Guidance for Healthcare Facilities: Preparing for Community Transmission of COVID-19 in the United States,” which outlined goals and strategies for all U.S. healthcare facilities to prepare for and respond to community spread of COVID-2019.
Beds Are an Issue
At the center of the issue is the fact that there simply aren’t enough hospital beds to support the number of cases. What healthcare facilities know, what the CDC alludes to, and what patients on the ground in other countries are experiencing — is that a traditional care delivery model doesn’t easily expand to allow for mass numbers of critically ill patients.
This is especially pertinent considering this COVID-19 virus outbreak, which causes patients to become critically ill quickly, with 26 percent of those infected requiring admission to the ICU. When only 16 percent of bed count is dedicated to critical care on average, and most of those are already at 80 percent capacity with other critically ill patients, this presents a great challenge for hospitals.
Emily Landon, an infectious disease specialist and hospital epidemiologist at the University of Chicago, told Vox.com that a widespread COVID-19 infection could impact availability of care. “Right now there’s always a doctor available when you need one, but that may not be the case if we’re not careful,” Landon said. “The more young and healthy people are sick at the same time, the more old people will be sick, and the more pressure there will be on the health care system,” she said.
In China, the battle for beds is one fought literally to the death. In a heart-breaking first-person account, Zhu Wei’s mother passed and then her father was infected. “I’m not proud of it but there was no time to hesitate. I literally fought my way through for a bed for my father,” she wrote after she donned a haz-mat suit and three masks, and went to claim a bed recently vacated by a patient who had passed. There are thousands more like Zhu Wei.
Also at the top of the list should be concerns around healthcare providers.
Staffing and expertise becomes thin when dealing with a tidal wave of patients – especially if healthcare workers become infected themselves. It’s been reported that in the Wuhan province alone, 1,000 healthcare workers became infected. Approximately 15 percent of them needed critical care.
According to Zunyou Wu, M.D., Ph.D., and Jennifer McGoogan, Ph.D., in an article they authored that appeared in JAMA, “Characteristics of an Important Lessons from the Coronavirus Disease 2019 (COVID-19) Outbreak in China,” COVID-19 rapidly spread from a single city to the entire country of China in just 30 days. “The sheer speed of both the geographical expansion and the sudden increase in numbers of cases surprised and quickly overwhelmed health and public health services in China,” the article noted. It’s not clear yet exactly how fast it will spread now that it has reached the U.S., but it’s certain that avenues to extend the reach of healthcare workers, and to protect them, have to be explored.
Technology to Transform Care
The challenges related to bed shortages were further reinforced in Vox’s recent article, “US hospitals have about 45,000 beds in their intensive care units. In a moderate outbreak, about 200,000 patients may need to be put in the ICU, but under a more severe outbreak, it could be nearly 3 million. While it’s unlikely that 3 million people would need ICU beds all at once, ICU beds in the U.S. are already pretty full, thanks to the normal crush of patients with influenza and other major medical problems.”
To best meet the challenges related to this lack of available beds, hospitals need to utilize technology to transform and flex as needs arise. Specifically they need to look for creative ways to enable more virtualized critical care medicine. Some of the key elements that will be required for their creation include:
- A flexible architecture to scale ICU beds on demand within the hospital and healthcare system
- Isolation units that can be quickly converted to virtual ICUs
- Flexible remote monitoring workflows to ensure that patients within hospitals or isolations units can be remotely monitored from anywhere in the world by top providers, including providers that are still healthy but in quarantine due to exposure
- Ability to enable real-time risk scores to support scalable triaging of patients
Helping to Solve the Bed and Provider Shortage
While we continue to monitor the impact on COVID-19 worldwide, what we already know is that hospitals are seeing the opportunity that technology provides to transform care on the fly, and looking for solutions to ensure that they are in the best possible position to respond if needed.
As Aurora Aguilar stated in Modern Healthcare, now is the time for healthcare to make changes that will allow hospitals to fight this virus — and the ones we will battle in years to come.
MIC’s remote monitoring solution could be deployed within days to stand up virtual care anywhere, across units, vendors, and facilities to solve the challenges outlined above.
“I believe we all have a responsibility to help where we can when presented with a global crisis. Our ability to use our tools and creatively deploy technology can mean the difference in saving millions of lives and helping to minimize suffering. This crisis has the potential to bring together people and organizations under one mission, adapting to real-world constraints, in order to drive us to action and protect our communities and the ones we love,” says Emma Fauss, CEO of Medical Informatics Corp. (MIC).
To learn more about how MIC’s Sickbay platform is currently being utilized to support the growing needs of flexible remote monitoring and virtual ICUs click here.
We would love the chance to meet to learn more about your coronavirus response strategy and see if there is anything we might be able to do with our partners to help. If you’re interested in discussing, please click here to schedule a call with a member of our clinical advisory team.