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New York is the first U.S. city to see a Covid-19 outbreak of this magnitude, but it likely won't be the last. For Barron's this week, I talked with a few New York doctors and epidemiologists about what other cities can learn from our experience. https://www.barrons.com/articles/u-s-hospital-systems-will-be-tested-by-coronavirus-just-look-at-new-york-city-51585948982
The bottom line, from Neil Schluger, a professor at the Columbia who has been treating Covid-19 patients: “There’s no way to over-prepare for this."
The first point seems obvious by now, but wasn't just a few days ago: Impose social distancing quickly, like the Bay Area counties did, rather than New York's stutter-step approach.
In the meantime, hospitals should get ready. “Hospitals should be thinking about how they can safely use as much space as they possibly can in their hospital,” Schluger said.
We've heard a lot about space shortages, staffing shortages, ventilator shortages. But that's only part of it. Lots of Covid-19 patients will need dialysis in the ICU. Hospitals will go through large quantities of the drugs used to sedate intubated patients.
Other things to plan for: What do you do with patients who are well enough to leave the hospital, but can't go home? New York had to order nursing homes to accept Covid-19 patients released from hospitals. Other cities should think this through.
Finally, limited resources means hard choices. Families need to think about their own wishes for end-of-life care. “The last person that should be making this decision is me, for a person I’ve never met,” said Brendan Carr, chairman of emergency medicine at Mount Sinai.
There is good news: Doctors in New York have learned a lot about Covid-19 so far. Their knowledge they're building, both through clinical drug trials and through raw experience, could help doctors elsewhere facing this in the coming weeks and months.
The story is here. https://www.barrons.com/articles/u-s-hospital-systems-will-be-tested-by-coronavirus-just-look-at-new-york-city-51585948982
