The United States on Thursday surpassed China and Italy as the country with the most coronavirus cases, according to a Reuters tally, as New York, New Orleans and other hot spots faced a surge in hospitalizations and looming shortages in supplies, staff and sick beds.
Medical facilities were running low on ventilators and protective masks and were hampered by limited diagnostic testing capacity.
The number of U.S. cases of coronavirus reached 81,378, the Reuters tally showed. China was second with 81,285 cases, and Italy third with 80,539 cases.
At least 1,178 people in the United States have died from COVID-19, which has proven especially dangerous to the elderly and people with underlying chronic health conditions, according to a running tally based on reports from state and local public health authorities.
An expected shortfall of ventilators - machines that support respiration for people who have lost the ability to breathe on their own - was substantial, as a surge of cases overwhelms New York hospitals, New York Governor Andrew Cuomo told a news conference.
“Any scenario that is realistic will overwhelm the capacity of the healthcare system,” he said. “The number of ventilators we need is so astronomical - it’s not like they have them sitting in the warehouse,” Cuomo added. “There is no stockpile available.”
At least one New York hospital has begun a trial of sharing single ventilators between two patients.
Dr. Craig Smith, surgeon in chief at New York-Presbyterian/Columbia University Medical Center in Manhattan, wrote to staff that teams had worked “day and night” to get the split-ventilation experiment going.
While New York was the coronavirus epicenter in the United States this week, Louisiana could be the next. In New Orleans, the state’s biggest city, Mardi Gras celebrations last month were believed to have fueled the outbreak.
VENTILATOR DEMAND SOARS
Demand for ventilators has doubled in Louisiana, with some 80% of intensive care unit patients now on the breathing machines, said Warner Thomas, chief executive of Ochsner Health System, the state’s healthcare group.
Louisiana Governor John Bel Edwards warned that his state, reporting about 1,800 infections, including at least 83 deaths is rapidly running out of beds and ventilators.
“If we don’t flatten the infection curve soon, we will be out of ventilators in New Orleans by April 2, and we would potentially be out of bed space for individuals by April 7,” he said at a press conference.
“It’s not conjecture, it’s not some flimsy theory, it’s not some scare tactic. This is what is going to happen.”
In New York state, the goal is to make as many as 140,000 hospital beds available, up from the current capacity of 53,000, and authorities are scouting new sites, Cuomo said.
Asked about media reports of some New York City healthcare workers resorting to using plastic trash bags to try to protect themselves, Cuomo acknowledged issues with the distribution of protective equipment and said there was enough in stock for the “immediate need” but not for the longer term.
New York hospitals were scrambling to comply with Cuomo’s directive that they increase capacity by at least 50%. At Mount Sinai Hospital’s Upper East Side location, rooms were being constructed within an atrium to open up more space for beds.
At Elmhurst Hospital in New York’s borough of Queens, about a hundred people, many wearing masks with their hoods pulled up, stood in line behind barriers outside the emergency room entrance, waiting to enter a tent to be screened for the coronavirus.
The city coroner’s office has posted refrigerated trucks outside Elmhurst and Bellevue Hospital to temporarily store bodies of the deceased.
Deborah White, vice chair of emergency medicine at Jack D. Weiler Hospital in the city’s Bronx borough, said 80% of its emergency room visits were patients with coronavirus-like symptoms.
’HAUNTED’ BY PROSPECT OF RATIONING
The projected ventilator shortfall and surge in hospitalizations has already raised the prospect of rationing healthcare.
Asked about guidelines being drafted on how to allocate ventilators to patients in case of a shortage, New Jersey Governor Phil Murphy said such bioethical discussions “haunted him” but were unavoidable in the current situation.
“We have to hope for the best, but plan for the worst,” Murphy told a news conference.
Desperate to slow the spread of the virus by limiting physical contact among people, state and local governments have issued stay-at-home orders covering about half the U.S. population. A major side effect has been the strangulation of the economy, unleashing a wave of layoffs.
The U.S. Labor Department reported Thursday the number of Americans filing claims for unemployment benefits last week soared to a record of nearly 3.28 million - almost five times the previous weekly record of 695,000 during the 1982 recession.
Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases, told WNYC public radio that the changing weather could help fight the virus because generally warm and moist conditions are better than a cold, dry winter. Fauci said the virus could return for the Northern Hemisphere’s next winter.
“We hope we get a respite as we get into April, May and June. It is likely to come around next season because it’s a very vigorous virus,” Fauci said.
President Donald Trump said Thursday that federal officials are developing guidelines to rate counties by risk of virus spread, as he aims to begin to ease nationwide guidelines meant to stem the coronavirus outbreak.
In a letter to the nation’s governors, Trump said the new guidelines are meant to enable state and local leaders to make “decisions about maintaining, increasing, or relaxing social distancing and other measures they have put in place.” States and municipalities would still retain authority to set whatever restrictions deem necessary.
“I think we can start by opening up certain parts of the country: you know, the farm belt, certain parts of the Midwest, other places,” Trump said Thursday in an interview with Fox News Channel’s Sean Hannity. “I think we can open up sections, quadrants, and then just keep them going until the whole country is opened up.”
The president has been trying for days to determine how to contain the economic fallout of the guidelines issued by his administration as well as local leaders to slow the tide of infections.
“Every day that we stay out it gets harder to bring it back very quickly,” Trump said during a Thursday press conference.
Outside New York and New Orleans, other hot spots appeared to be emerging around the country, including Houston and Detroit.
Brandon Allen, 48, bought groceries in Detroit for his 72-year-old mother who has tested positive for the coronavirus and was self-quarantining at home.
“It’s surreal,” Allen said. “People around me I know are dying. I know of a couple people who have died. I know a couple of people who are fighting for their lives. Everyday you hear of another person who has it.”
With a report from The Associated Press
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