U.S. hospital association warns of ventilator shortage if coronavirus proliferates

"The best way not to overtax the health care system is to keep more people healthy."

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By Elizabeth Chuck

The largest national hospital organization is pleading with Americans to abide by precautions to prevent the spread of the coronavirus, warning it's the only way to avoid running out of ventilators or otherwise overwhelming the health care system.

"There are limited supplies of ventilators and hospital beds, which is why hospitals and public health officials all across the country are urging the public to follow the guidance of the CDC and other public health leaders on social distancing and other actions," Nancy Foster, vice president for quality and patient safety policy at the American Hospital Association, which represents nearly 5,000 hospitals and other health care organizations, said in a statement to NBC News.

"The best way not to overtax the health care system is to keep more people healthy."

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Social distancing, or maintaining enough space among individuals so they cannot catch the virus from one another, has been put into practice across the country as cities and states shutter schools, libraries, gyms and other public arenas where there are large groups of people. Public health experts say it is best to stay 3 to 6 feet away from others to avoid spreading COVID-19, the illness caused by the coronavirus.

The Centers for Disease Control and Prevention also recommends staying home if you are sick, proper hand-washing, and covering your mouth and nose when coughing or sneezing, among other suggestions. Gatherings of 50 people or more should be canceled for the next eight weeks, the federal agency said.

All these steps are crucial to reducing the number of critical patients who will come into hospitals, although most who get sick do not get that ill.

A report last month from the World Health Organization-China Joint Mission found that while 80 percent of people who got the coronavirus in China had only mild symptoms that could be treated at home, 20 percent got symptoms severe enough to require hospitalization. Of those, 13.8 percent had severe disease, including respiratory problems, and 6.1 percent had critical illness, including respiratory failure.

The idea behind social distancing and other preventative measures is to reduce the overall number of patients, but especially those who will get sick enough to be hospitalized. Hospitals around the country have been preparing for weeks for coronavirus patients and now that cases in the United States have topped 5,500 and the death toll has reached nearly 100, many are preparing for worst-case scenarios.

At the 23 hospitals at Northwell Health, New York's largest health care provider, employees have "made careful preparations throughout the operation for surge capacity, including surge capacity within intensive care units," said Dr. David Battinelli, Northwell Health's senior vice president and chief medical officer.

The health system is less concerned about running out of ICU beds than it is about having a ventilator shortage, Battinelli said. The bedside machines, which mechanically provide oxygen, are used on the sickest patients.

Northwell Health has an excess of ventilators available at the moment, Battinelli said, although he did not know how many. In the event of an influx of patients requiring ventilators, the health system would first look within its own operations to see if they could move ventilators from one hospital to another that needs them more. Then, they would look to neighboring states that could spare some. The health system is proactively reaching out to suppliers to see if they can get more, he added.

Battinelli said having enough ICU beds and staff are not nearly as big of a concern as a ventilator shortage: "Anybody can turn a room into an ICU-level room and we can get the staff [needed], but there are only so many ventilators available," he said.

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New York had about 1,500 diagnosed cases of the coronavirus as of Tuesday afternoon, more than any other state. About 19 percent are in hospitals; Gov. Andrew Cuomo warned that the state, which has 3,000 ICU beds, could potentially see anywhere from 18,600 to 37,200 ICU patients, according to estimates from state health officials.

The state is working with hospitals to create more spaces to put patients, both in and outside of the hospitals.

Trump this week encouraged states not to wait on the federal government to order ventilators, giving governors the right to order them from private suppliers.

Symptoms of the coronavirus include cough, fever and shortness of breath. Those most at-risk for complications are the elderly and people with underlying health conditions.

The American Hospital Association's Foster said she hoped guidelines restricting visitors and group events in nursing homes would "reduce the surge of acutely ill patients that hospitals will see."

"Hospitals and our dedicated doctors and nurses are doing their part to combat this virus," she said. "We hope everyone else will, as well."

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