When the Coronavirus began to spread in the U.S., no one knew what to expect. Public health officials weren’t sure what infections, hospitalizations, or deaths would look like in our country compared to others. Now, more than four months into the pandemic in the U.S., we have a much better understanding of how to deal with the virus.
Early on, hospitals became the battlefields for patients who contracted COVID-19. Hospital leaders had to make difficult decisions about how to use the equipment they possessed, how to separate patients, and how to manage visitors. None of these are easy, especially when facing a pandemic of which so much was unknown.
As we move through the summer months, experts and public health officials weigh how to handle a potential “second wave” of coronavirus infections. A small silver lining in the original speed and severity in which the initial wave of Coronavirus spread through the U.S. is now that hospitals have somewhat of a road map on how to handle this disease better.
A recent ProPublica article chronicles the experience of U.S. hospitals in the early stages of the coronavirus. Towards the end of the article, the authors draw on expertise from health care experts and hospital leaders as to how hospitals can better prepare for another wave. Here are the suggestions:
Having testing readily available, as it now is, to more quickly spot a resurgence of the virus.
Stocking up now on PPE and other supplies. “We definitely have to stockpile PPE by the fall,” Gershon of NYU said. “We have to. … [Hospitals and health departments] have to really get those contracts nailed down now. They should have been doing this, of course, all the time, but no one expected this kind of event.”
Being able to quickly move personnel and equipment from one hot spot to the next.
Planning for how to care for those with other medical ailments but who are scared of contracting COVID-19. “We have to have some sort of a mechanism by which we can offer people assurance that if they come in, they won’t get sick,” Jha said. “We can’t repeat in the fall what we just did in the spring. It’s terrible for hospitals. It’s terrible for patients.”
Providing mental health resources for front-line caregivers who have been deeply affected by their work. The intensity of the work, combined with watching patients suffer and die alone, was immensely taxing.
Coming up with ways to allow visitors in the hospital. Wachter said the visitor bans in place at many hospitals, though well intentioned, may have backfired. “When all hell was breaking loose and we were just doing the best we could in the face of a tsunami, it was reasonable to just keep everybody out,” he said. “We didn’t fully understand how important that was for patients, how much it might be contributing to some people not coming in for care when they really should have.”
Hospital visitation is an issue being debated at the North Carolina General Assembly right now. As Carolina Journal reported, a bill passed the North Carolina Senate that would allow hospitalized patients to have one visitor stay with them. As the ProPublica suggestion notes, these visitation policies may have backfired by discouraging patients suffering from non-COVID issues to choose not to seek care. Utilization was already down due to stay-at-home orders and fear of contracting the virus in a health care setting, the visitation policies may have further decreased utilization. As I discuss in a small research brief series this week, this delay in care can have serious implications for future health outcomes and health spending. Be sure to check out my 2-part series on healthcare supply and demand shock this week.