US hospitals are unprepared for the spread of coronavirus. Here’s what they need to do.
This piece by ACCESS Health Chair and President William A. Haseltine originally appeared in the Los Angeles Times.
When the new coronavirus COVID-19 first broke out, China’s health care system was unprepared. Hospital waiting rooms were so packed with prospective patients that hundreds more had no choice but to line up outside. Many waited several hours, only to be turned away and urged to self-quarantine. More troubling, experts say, is the fact that the chaos of this initial surge likely did more to spread the disease than stop it.
The same fate awaits us here if the new virus becomes a global pandemic.
Hospitals in the United States are already so overburdened, and their staffs so overworked, that one bad flu season is enough to push them over capacity. Just two years ago, during a particularly bad season in California, patients seeking treatment for the flu instead found themselves in “war zones.” Hospitals turned away ambulances, imported nurses from elsewhere and erected parking lot tents when they ran out of beds. Surgeries had to be cancelled and hospitals ran out of supplies.
If the new coronavirus gains momentum here, infecting thousands, the outlook would be even grimmer. To be sure, we are better prepared than we were for the last coronavirus outbreak in 2009. Our hospitals now have pandemic plans to ensure that enough equipment, protective gear, and administrative controls are available to deal with a surge of new patients.
But, on their own, these measures are not enough.
First, we must do more to make sure that if an outbreak occurs, we can keep and treat people where they are safest — in their homes. That will require leveraging or boosting the telehealth capabilities of local clinics to enable remote diagnosis of emergent coronavirus cases. Such virtual consultations would divert pressure away from hospitals and limit the transmission of infections in crowded waiting rooms.
Second, we must ensure that any added costs of protection and prevention are covered for patients. Currently, payment by insurance companies for virtual urgent care is not federally mandated, and many plans don’t cover it. Without a guarantee that their costs will be covered, patients may still head to hospitals to avoid the fees.
Finally, we must prepare our hospitals and our health systems now for future crises even greater than the one we may face with COVID-19. This latest coronavirus is, by all appearances so far, more benign than some previous ones. Though it is highly transmissible, it has a low mortality rate, with the vast majority of those infected surviving whether they are treated at home or in a hospital.
But there will come a time when a coronavirus outbreak or other biothreat emerges that is more lethal and widespread than anything previously seen. Our hospital-centric health system isn’t equipped to handle such a crisis. We must forge a new path toward a health system of distributed care, where patients receive care where they need it most—not just in hospitals, but in the home and community.
The United States is home to some of the world’s best health providers and technological innovations. But we still hold to an antiquated notion that advanced healthcare is best delivered in hospitals. Countries like Singapore have shown that distributed care can be achieved on a national scale, and if they can do it, so can we.