Coronavirus: Washington hospitals 'dangerously low' on protective equipment as they enter crucial two weeks

Q&A: US’s original Covid-19 epicentre remains on ‘shelter at home’ status

Hospitals in Washington state – the original epicentre of the US’s coronavirus crisis – are running “dangerously low” on personal protective equipment as they prepare for a critical two week period, a top official has warned.

While a new projection released by experts at the University of Washington suggests the state may have hit its peak of total medical demands on April 2, more than a week earlier than estimated for the nation, doctors will not know for another week or two.

They have warned that social distancing measures must remain in place and that people ought not to relax their guard. The state has recorded 372 deaths so far and at least 8,384 confirmed infections.

On Monday, governor Jay Inslee ordered schools to stay shut until the end of the academy year. At the same time, he returned 400 ventilators to the federal government for use in New York state.

“We simply cannot take the chance of reopening on-site instruction in this calendar school year,” he said from the state capital, Olympia. “We cannot risk losing the gains we have made after the peak of this pandemic presumably will have passed.”

Meanwhile, even as experts lowered their projected death toll for the state to between 557 and 741, down from 1,600, the Washington State Hospital Association’s senior VP, Beth Zborowski, told The Independent its members faced a tough struggle. Read the Q&A below:

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Q What is the current situation being confronted by hospitals across the state. Are there shortages of equipment such as ventilators or gowns. How severe is this shortage and what are the potential impacts?

A The biggest challenges our hospitals are facing are lack of personal protective supplies like masks to ensure staff stay healthy. By order of our governor, all non-urgent procedures that can safely be rescheduled for three months have been cancelled to preserve supplies and space in our hospitals. The governor has also ordered everyone to stay home (with the exception of essential workers or when folks need food or medical care) to slow the spread of the virus. (People can still be outside, but they can’t congregate and must stay 6 feet apart.)

Given the behaviour of the virus, it will still be another week or two until we see how much this has slowed the spread.

One of the big goals of slowing the spread is that it will help hospitals keep from getting overwhelmed. We are starting to collect data about discharges after Covid hospitalisations, as we are hearing some success stories of patients being discharged to finish their recovery at home. We’re doing alright at the moment, but the state is setting up field hospitals in anticipation of greater need for capacity.

As for supplies, our state is dangerously low on personal protective equipment.

We are working closely with our state and federal government to secure as many supplies as possible from the US’s Strategic National Stockpile. Manufacturers are quickly ramping up their production of these supplies, and we’ve even heard of our member hospitals receiving some wonderful donations (like Elon Musk and Tesla sending 50,000 N95 masks to the University of Washington).

If hospitals were to run out of supplies, they wouldn’t have the supplies they need to protect themselves from the virus. We haven’t heard of facilities running out, but supplies are low, and we are doing everything we can to help them get what they need.

Q How many patients are currently being treated for Covid-19 in WA hospitals?

A While we know the total number of confirmed cases [currently at least 8,384], we’re do not currently have data on the number requiring hospitalisation.

Q Experts suggest there will be an increase in the number of infections in the coming weeks. What are your expectations or projections about the number of patients you will see? What sort of impact might this have. Is there a danger of hospitals being overwhelmed?

A Yes, we are preparing for an increase in the number of patients who will need medical care due to Covid-19. We don’t know just yet what that will look like, but we are preparing for the worst and hoping for the best.

In a worst case scenario, if the entire regional system was overwhelmed, there may need to be a move to ‘crisis standards of care’ where the health system moves from giving the very best care to each individual to determining what can save the most people. There has been a lot of thought put into these plans over years as part of disaster preparedness.

We are working to do our very best not to reach that point, which is why we are advocating to get the additional resources we need and to coordinate among hospitals to share resources in the event of a surge. No individual organisation would move to crisis standards of care, it would only happen if the whole regional health care system was overwhelmed.

Q What are hospitals doing to prepare for any anticipated increase. Are they getting sufficient help from state or local authorities? What more could Donald Trump do to help?

A The field hospitals and delaying of surgeries are helping create space in the health system. We have gotten support from the state and federal government (including state support for our hospitals), but the biggest thing we need are more supplies and more testing capacity. Specimen collection kits and the supplies needed to run tests are still in short supply. Expediting those is of top importance.

Q What has been the impact on your staff of this pandemic? What steps are being taken to help ensure their physical and mental safety? Have you seen a lot of people falling sick themselves?

A The health care teams in our member hospitals are on the front lines every day and they are doing remarkable work. Our number-one priority is keeping them protected from Covid-19 exposure and ensure they remain well. Every member we have talked with is concerned about keeping staff well physically and mentally and are taking steps to take care of their staff, from providing meals to leading mindfulness exercises and yoga stretching breaks. We have not seen a large number of staff getting sick at this point, but it is something we are concerned about.

Q The president has suggested the social distancing ordered last week may come to an end in a few weeks. Meanwhile, Governor Inslee has ordered a stay at home declaration. What do you think is the correct approach for Washington state to combat the disease?

A We believe social distancing is critical for preventing the spread of the virus, and we are following the guidance from the Washington State Department of Health and the Centres for Disease Control and Prevention on best practices. Prematurely ending social distancing measures could be lethal to our most vulnerable residents.