It’s a situation that has played out in Italy, where hospitals were overrun by a surge of coronavirus patients. Ventilators soon had to be rationed, forcing difficult decisions by doctors and hospitals.
(TNS) — Hospitals across New Jersey have enough ventilators to meet their needs — for now.
But some are bracing for a potential surge of coronavirus patients that could leave medical facilities without enough of the life-saving respiratory machines and oxygen, according state health officials.
The nightmare scenario includes an escalating number of COVID-19 infections that lead to a crush of the sick rushing to emergency rooms for treatment.
“It could very well happen,” said Dr. David Cennimo, an infectious disease expert at Rutgers University Medical School.
“It is quite possible that we could run out of this stuff, and everybody is understanding that, and thinking about that,” he added.
It’s a situation that has already played out in Italy, where hospitals were overrun by a surge of coronavirus patients. Ventilators were soon in short supply and had to be rationed, forcing difficult decisions by doctors and hospitals.
Some are worried medical equipment shortages could happen at Garden State hospitals as the number of cases continues to rise.
The New Jersey Department of Health has “enough ventilators for the patients that require ventilator-assistance,” spokeswoman Donna Leusner said in an email.
But the department also noted it is “working with our healthcare partners and the federal government to obtain additional ventilators," she said.
“Every acute care hospital in New Jersey is required to have its own plan to prepare for and respond to disease outbreaks like COVID and other respiratory viruses,” Leusner added. “Hospital emergency operations plans include planning for adequate supplies, equipment and surge capacity.”
There are about 62,000 ventilators in hospitals nationwide, according to a study published by Cambridge University.
To put it in perspective, there are 23,687 acute care beds and 1,983 intensive care beds in New Jersey alone.
On Monday, New Jersey Health Commissioner Judith Persichilli hosted a teleconference with hospitals, requesting they respond to a survey seeking updated figures for equipment.
The department did not respond to a request asking for the number of ventilators in New Jersey, how many each hospital is required to have and whether the agency believes medical facilities have enough if a surge in patient volume occurs.
But everyone from health officials to politicians are talking about how they need more ventilators. And fast.
On Monday, New York Gov. Andrew Cuomo discussed the difficulty states are having in obtaining medical equipment.
“Everybody wants to buy a ventilator,” he said. "Everyone is trying to buy oxygen.”
Dr. Shereef Elnahal, president and CEO of University Hospital in Newark and the former state health commissioner, said his facility — like every other in the state — is bracing for the unknown. His hospital has been taking steps for months, starting when the outbreak emerged in China.
“The worst-case scenario would be when we have to start rationing care, when the number of patients exceeds the capacity for intensive care, things like ventilators," Elnahal said. "We are nowhere near that yet thankfully.”
An influx of sick patients spread out over time can be managed, experts say. But a crush of patients with COVID-19, the disease caused by the novel coronavirus, could spell disaster for facilities.
If the worst-case scenario were to happen, desperate measures such as repurposing equipment ad hoc to create makeshift ventilators may need to be taken to treat the most critical patients.
There are “many other things that could become a ventilator,” Cennimo said. “There are high-tech BiPAP machines that can do ventilation. That’s not the first line, but it’s possible.”
The fact that such ideas are even being raised shows the desperate circumstances the state could find itself in.
The alternative is the situation in Italy, where ventilators are being rationed due to a shortage. It is forcing doctors to determine survivability, Cennimo said.
The coming weeks will be the test for an already saturated health system, with hospitals already running near capacity as part of their business models.
Medical facilities commonly operate at 85% or 90% capacity at all times. And under usual circumstances, it’s manageable. For example, Saint Barnabas Medical Center in Livingston sees about 300 emergency room patients daily and 100,000 in a year, hospital officials said.
That was before the pandemic swept across the globe — a crisis with a scale not seen in the U.S. for more than a century.
“There is a lot of anxiety, there is no exception to that,” Elnahal said. “Everyone is preparing and hoping for the best.”
Cennimo said hospitals could call on each other to help with supplies if facilities run low. Hospitals from other states could even be needed if they are less affected by COVID-19.
During the Sept. 11 terrorist attacks, Cennimo remembers a hand truck full of blood products that came from Pennsylvania to a New Jersey hospital. But with coronavirus spreading throughout the U.S., is that even possible now?
“What if Pennsylvania is getting hit just as bad as you?” Cennimo asked.
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