Morgues can do it, hospitals can’t. Why the US is on the verge of disaster

Morgues can do it, hospitals can't. Why the US is on the verge of disaster

While President Donald Trump and state governors are figuring out who is in charge, the number of people infected with a new type of coronavirus in the country has exceeded half a million. With a total shortage of hospital beds in some cities, hospitals for hundreds of patients are empty. Only new York morgues seem to be able to handle the situation.

How the situation in the US is developing

The coronavirus has already killed more than ten thousand people in New York state. Governor Andrew Cuomo does not hide the horror of what is happening. For several weeks, he has been telling the government that he needs at least 30,000 ventilators but has received only 11,000 so far.

The White House is promising another two thousand. At the same time, at the end of March, the President reproached the Governor of the region, which accounts for six percent of all cases in the world, for being alarmist. Trump then believed that four thousand ventilators would have been enough for new York.

The situation became disastrous in a matter of days. At the end of February, there were only a few dozen cases of infection in the country — and the President assured that the situation was under control. By March 20, the number of infected people was close to ten thousand, and six days later it increased seven times. The United States came out on top in the world with 80 thousand cases and is not yet giving up this sad position.

Now, according to Johns Hopkins University, the coronavirus was detected in almost six hundred thousand Americans, and more than 23 thousand died.

Whose authority is ” absolute»

The situation is getting worse in all States. Federal authorities have declared an emergency and are coordinating overall efforts to combat the epidemic, but local decisions are made by governors.

Legislative initiatives are different. In Alabama, for example, a bill was issued calling for “hitting your fists, not shaking hands” when meeting. Public schools were closed in Arizona, New Jersey, Ohio, Tennessee, and Washington. Subsidizing the health system, helping businesses, the unemployed, and other measures are also at the discretion of regional governments.

Moreover, three States on the West coast-California, Washington, and Oregon-have signed an agreement to join forces in countering the epidemic. The Troika intends to cooperate even after the quarantine.

On the East coast, the governors of Connecticut, Delaware, Massachusetts, New Jersey, and new York also decided to create a Committee that would include representatives from the health and economic development sectors to discuss the possibility of opening States and returning to normal life.

But a few hours after this news, Donald Trump issued a sharp criticism of”arbitrariness”. “They can’t do anything without the approval of the President of the United States, he said. “The powers of the President are absolute.”

According to the 10th amendment to the Constitution of the country, in a crisis in the health sector, the States have the so-called policepower-the full power to introduce the necessary measures. It is unclear what “absolute powers” trump was talking about.

Why not all hospitals can be used

One of the main problems faced by doctors around the world at the height of the epidemic is the lack of beds. Health systems are overloaded, hospitals are overcrowded, and field hospitals are being built.

There are 6,146 hospitals in the United States, of which 5,198 are a so-called community, i.e. non-Federal institutions. These hospitals are divided into three types: non-governmental, non-profit (2,937), private (1,296), and state or local government-owned (965). There are 924,107 beds in the country.

Private and public hospitals are not evenly distributed. For example, Philadelphia (Pennsylvania), which has about seven thousand cases, is the largest American city where there is no public health facility. At the same time, there, as in some other megacities, there are more and more COVID-19 infected, and hospitals are empty.

In the administrative center of Pennsylvania, about 400 thousand people live below the poverty line or about 26 percent of the population. Until September last year, they were able to seek basic medical care at the Hahnemann University hospital, designed for 496 patients. But since its owner declared bankruptcy, the building in the heart of the city has been empty.

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You can use medical space, but the city authorities will have to rent it from the bankrupt owner — $ 27 per bed per day. Including taxes, maintenance costs, and insurance, it will cost the city about $ 900,000 a month.

In Los Angeles, under this scheme, city authorities are already renting beds from St. Vincent medical center, which also went bust in 2018.

On the other side of the country, in New Orleans, where the number of infected per capita is comparable to some areas of New York-1.5 thousand per 100 thousand people, charity hospital is empty in the middle of the city. The former public hospital, although part of a new private medical center, has not been operational since hurricane Katrina in 2005.

How do morgues cope

In the epicenter of the epidemic — new York-not only hospitals, but also morgues are working at the limit of their capabilities. Previously, in this metropolis, an average of 158 people died per day, but now only a few hundred people die every day from the coronavirus.

Yet the authorities were better prepared for mass mortality than for mass treatment. Back in 2008, a 93-page “Plan for dealing with a flu pandemic with hospital and community-based deaths” was published. The worst-case scenario is 50,000 deaths in two months.

Some of the developments in this document have already entered into force. In early April, 45 mobile morgues were installed on the streets of the city-cold storage chambers designed for 3,500 bodies. The district crematoria were ordered to operate around the clock until at least June 30.

The second part of the plan involves sending the bodies for burial on the HART island near the Bronx. The role of gravediggers should be performed by prisoners of the prison located on Riker’s Island. However, even there, the diagnosis of COVID-9 has already been confirmed in 200 people.

In extreme cases, the dead will be buried in local cemeteries in mass graves of ten bodies, each in a separate coffin. But it is worth emphasizing that this is the worst option that may be avoided.

It’s very dark in Chicago, too. The city authorities have already allocated an additional cold storage facility for two thousand bodies, as well as 14 mobile morgues.
Who can count on help

Another vulnerability in health care is that there is no nationwide system of mandatory insurance for citizens in the United States.

About 28 million Americans (almost ten percent of the population) do not have any medical “airbag” and in case of illness can go to the hospital only at their own expense. At the same time, the receipt for treatment for coronavirus can exceed 30 thousand dollars.

Those who purchased an insurance plan from a private company will most likely have to pay out of their own pocket. On average, it costs $ 440 a month for one person and $ 1,168 for a family. Typically, the company covers about 80 percent of medical expenses, but not immediately.

Americans living below the poverty line are only entitled to basic government health insurance. But many hospitals that provide care to the least protected segments of the population are not ready to work in the face of a pandemic. There are no isolation cells, no special protective suits, and masks for medical staff. As a result, doctors are in the same dangerous situation as patients.