What happens in the 4th wave of the pandemic
CNN
April 1,2020
Editor’s note: Kent Sepkowitz is a CNN medical analyst and a physician and infection control expert at Memorial Sloan Kettering Cancer Center in New York City. The views expressed in this commentary are his own.
CNN
...That reality is the fourth wave of the US epidemic. It is now clear that the epidemic has found a foothold not just in coastal cities, but also in mid-sized cities and towns across the country. Albany, a town in the western part of Georgia, near nothing in particular, was the first to gain attention as the epidemic appeared, possibly spread by people at a funeral. To date, 462 people have been diagnosed in Dougherty County, where Albany is situated, and 18 have died... Shreveport, Louisiana, also is battling an outbreak, as is Bossier City across the Red River... Across the Mississippi River sits Jackson, Mississippi, a city of about 170,000 and the state capital.Though its governor waited until March 31 to issue a shelter-in-place order, Mississippi is in or near the top quarter of states in cases of diagnosed Covid-19 per capita. Indeed, the three counties that Jackson straddles (Hinds, Madison, and Rankin) have diagnosed 172 cases and dozens of new cases are now diagnosed there.
... The appearance of so many cases in so many towns points to the next crisis for health care delivery. Hospitals in rural areas generally provide basic emergency and medical-surgical care, then refer more complex patients or those needing higher-tech care to a large city, often one with a medical school. If the large city finds itself overmatched by a certain problem, it will in turn arrange transfer to a regional super-specialty medical center. This system is held together by ambulances, helicopters, airplanes, goodwill -- and the assumption that there will always be capacity at the next level hospital.
The Covid-19 pandemic has changed that. A hospital like Cleveland Area Hospital (Oklahoma) might soon reach out to a medical center in Oklahoma City or Tulsa to transfer a Covid-19 patient in need of ICU care. But the ICUs in those large medical centers will likely soon be full of patients with Covid-19 -- and their outreach to super-specialty institutions in Houston or Dallas will in short order produce the same problem of ICU gridlock.
This may mean that medical personnel at small community hospitals with nowhere else to turn will be left managing critically ill patients using equipment they are not familiar with, all the while worrying that they might catch the infection from the patient.
More here.
https://www.cnn.com/2020/04/01/opinions/what-happens-in-the-4th-wave-of-the-pandemic-sepkowitz/index.html
