Which patient gets the ventilator? Doctors may have tough choices ahead
But in coming weeks, if COVID-19 continues to surge, such decisions will be inevitable.
Statewide, there are about 9,500 ventilators, a total that includes recent additions made by state leaders and others in anticipation of increased numbers of COVID-19 patients. The federal government’s national stockpile, which states can tap when their local supplies run low, has an additional 16,000.
Colwell, the San Francisco doctor, said he is already considering what to do in such a situation. The city’s hospitals have about 750 ventilators and officials are trying to obtain others from reserve supplies, he said. Rationing such care has been the subject of ongoing discussions at Sutter Health Network, where one of those weighing in said she believes the best model is to allow a panel of doctors, instead of individual physicians, to decide who receives the care, said Dr. Janice Manjuck, a critical care specialist at an Oakland hospital.
New York, now the national epicenter of the outbreak, recently procured 7,000 ventilators in addition to the roughly 4,000 that were already available in the state, according to Gov. Andrew Cuomo. But at least 30,000 more will be needed to cope with the ongoing outbreak, he said in a press briefing Tuesday.
In extreme situations, a lack of ventilators could also mean that staff use a hand-held pump to push air in and out of patients’ lungs, said Dr. Wally Ghurabi, ER medical director at UCLA Medical Center in Santa Monica. Other places already severely impacted by COVID-19 have offered horror stories that have put U.S. providers on edge. In one hospital in Lombardy, a hard-hit region in Northern Italy, doctors reported patients in the hospital sleeping on mattresses on the floor. There, 70% of the ICU beds are reserved for COVID-19 patients “with a reasonable chance to survive,” the doctors wrote in a recent paper.
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