News and Commentary

State Governments Propose Rationing Care During COVID-19 Second Wave
TOPSHOT - A COVID-19 coronavirus patient lies in bed at the Intensive Unit Care of the Povisa Hospital in Vigo, northwestern Spain, on April 16, 2020. - Spain's coronavirus death toll soared past 19,000 with another 551 deaths, but questions over the counting method have raised some regional concerns the real figure is much higher. (Photo by MIGUEL RIOPA / AFP) (Photo by MIGUEL RIOPA/AFP via Getty Images)
MIGUEL RIOPA/AFP via Getty Images

State governments are reportedly considering asking hospitals to consider rationing care amid concerns that the second wave of coronavirus cases is overwhelming health care systems, and New Mexico and Idaho may be the first to take action on the plan if cases in those states do not decline, according to local media.

Both New Mexico and Idaho are seeing record numbers of coronavirus cases. While positivity rates and positive cases do seem to be in slight decline, at least in New Mexico, both states are concerned that the Thanksgiving holiday could give rise to a steep uptick in cases as early as this week — and that means hospitals, which are already overwhelmed, could be further hindered.

“A medical dam-break had been part of repeated warnings by state officials for weeks as COVID-19 counts surged in October and November,” the Santa Fe New Mexican reported. “The human toll includes health care workers — at least 18 have died since the crisis began earlier this year, state Human Services Department Secretary David Scrase said during a separate news conference with Gov. Michelle Lujan Grisham later in the day.”

Grisham ultimately noted that she would encourage some hospitals, particularly rural hospitals, to reroute coronavirus patients to larger hospitals in nearby major cities, where the intensive care unit (ICU) capacity is higher. She also suggested that hospitals could move to “crisis standards of care,” which may involve rationing care or putting patients on wait-lists if their issues are less serious.

In Idaho, the hospitals themselves are considering rationing care, according to Idaho Statesman.

“I think it’s more probable than not that in the next two to four weeks, we will find ourselves’ at a point of needing to ration care due to COVID-19,” one hospital director told a board of health in Boise, noting that there are no signs of the “second wave” letting up, and hospitals could be overwhelmed through January.

Like New Mexico, though, the state of Idaho would have to allow for “crisis standards of care,” and Idaho’s governor, Brad Little, would have to approve the change. “At that point, a scoring system would determine which patients receive life-saving care,” the Statesman notes, and care for non-COVID patients could be delayed indefinitely.

The Wall Street Journal reports that, although western and midwestern states appear to be suffering the worst of the pandemic’s second wave, COVID-19 cases are spiking across the country.

“The U.S. recorded 2,804 deaths on Wednesday, according to Johns Hopkins University, and newly reported infections topped 200,000 for the second time in less than a week. More than 100,000 people were hospitalized with Covid-19 as of Wednesday, according to the Covid Tracking Project, including a record number of people in intensive care and near-record numbers of patients on ventilators,” the outlet noted on Friday.

Even in states where care rationing has yet to be mentioned, “[h]ospital administrators say they are racing to hire more nurses, squeezing extra beds onto floors and, in some cases, moving patients across state lines to find room for the critically ill. In some overrun pockets of the country, these emergency measures are no longer enough, doctors and nurses say.”

More than a thousand hospitals nationwide say they are at “crisis” levels, per the WSJ.

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