Had a very concerning chat with a hospital exec recently about preparedness for nCoV.
US hospitals nowhere near ready for conditions like we're seeing in China. Neither are those in the developing world.
If anything, this NYT report may be too rosy.
nytimes.com/2020/02/07/hea…
US hospitals nowhere near ready for conditions like we're seeing in China. Neither are those in the developing world.
If anything, this NYT report may be too rosy.
nytimes.com/2020/02/07/hea…
Can't say for sure yet that China-level spread will begin appearing elsewhere. But plenty of reasons to think it could. We shouldn't take too much comfort in the low numbers we're still seeing outside of China. 👇
US hospitals are running full-tilt with flu season already, and beginning to face supply shortfalls due to nCoV-driven surge in PPE demand. Major supplier of N95 facemasks has told hospitals that ability to fulfill orders will be questionable for next 4 months.
And it's not just PPE; other critical medicines, supplies, and diagnostic materials are in growing demand and will face supply shortfalls.
Not to mention that bed space and isolation capacity are very tight.
Not to mention that bed space and isolation capacity are very tight.
Support and guidance from CDC and HHS remains insufficient. Community transmission in the US would rapidly push hospitals into crisis standards of care - forcing hard trade-offs on prioritizing beds, limited equipment, and supplies. Hospitals not receiving clear guidance on this.
Patient screening criteria are out of date. CDC guidance still only relates to China, which means hospitals cannot screen or test for nCoV in patients coming from the other 20+ countries with cases. This is a problem, as @ScottGottliebMD explains here. buff.ly/2Svgtxx
And resources are stretched thin. The scant outbreak preparedness funding that does exist dates back to the post-Ebola era and is about to expire. No plans to replace it. Hard for hospitals to cover on their own. washingtonpost.com/opinions/a-pro…
Collectively a very concerning picture. Which makes it all the more indefensible that the USG remains in more a wait-and-see mode on nCoV pandemic prep/funding, than a no-regrets mode. Window for action to prep US health system is closing.
The administration continues to repeat that "the immediate risk to the US remains low." While not exactly false, it is somewhat misleading, given the huge remaining uncertainties about the virus and the potential for community transmission in the US.
And as crisis comms strategy, I think this approach is problematic. They're trying to avoid sparking panic - which is right - but I fear those statements will look misguidedly optimistic if/when larger-scale transmission starts in the US. Could undermine trust.
And given the lack of readiness in the US health system, this approach risks squandering a headstart, fighting a losing battle to keep the virus out of the US rather than acting decisively and aggressively to prepare the health system for its likely arrival.
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PS - White House 2021 budget request actually proposes *cuts* to the sorts of programs that would be helping strengthen health system readiness.
