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This list of healthcare systems forced to ration care for COVID-19 patients during the COVID-19 pandemic , displayed in chronological order, includes a list of areas where the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has overwhelmed healthcare infrastructures, exceeding healthcare system capacity and requiring the use of triage in order to ration care for COVID-19 patients, such as not accepting certain patients or not providing certain care such as access to ventilators. Many governments and members of civil society took measures that aimed to flatten the curve, either by limiting spread or by increasing healthcare system capacity, and to thereby prevent such an outcome.
| Start | End | Country | Urban area | Shortages, comments and sources |
|---|---|---|---|---|
| Late January | Late February | China | Wuhan, Hubei | Turn away most patients due to health care facility capacity overwhelmed. [1] |
| February 2020 | Italy | Bergamo | Some patients could not be intubated in the hospital to which they had been admitted, so they had to be moved to another hospital where they were able to be intubated. [2] | |
| Late April 2020 | Brazil | Manaus | 3 times more deaths than usual. [3] | |
| 2020-04-23 | Brazil | São Paulo | [4] [5] [6] | |
| May 2020 | Peru | Loreto | Oxygen therapy shortage. [3] | |
| Early May 2020 | Mexico | Tijuana | Bed shortage [7] | |
| Early May 2020 | Mexico | Mexico City | Some hospitals were too busy to care for patients properly. [7] [8] | |
| Early May 2020 | India | Delhi | [9] | |
| 11 May 2020 | India | Mubai | [10] [11] | |
| Early May 2020 | Nigeria | [12] [13] | ||
| Early May 2020 | Somalia | Mogadishu | [12] [13] | |
| May 22, 2020 | USA-Mexico border | Southern California | 80-bed non-COVID temporary addition, many patients are US citizens residing in nearby Mexican towns who were turned away locally. [14] | |
| July, 2020 | Algeria | Patients sleeping on the floor, large parts of hospitals turned into COVID-19 services, suspicions that official numbers are large underestimates. [15] | ||
| August, 2020 | Turkey | [16] |
Elmhurst Hospital Center (EHC), also known as NYC Health + Hospitals/Elmhurst, is a 545-bed public hospital in the Elmhurst neighborhood of Queens in New York City. It is one of the 11 acute care hospitals of NYC Health + Hospitals, a public benefit corporation of the city.
The COVID‑19 pandemic, also known as the coronavirus pandemic, is an ongoing pandemic of coronavirus disease 2019 (COVID‑19) caused by severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). The disease was first identified in December 2019 in Wuhan, China. The World Health Organization declared the outbreak a Public Health Emergency of International Concern on 30 January 2020 and a pandemic on 11 March. As of 15 September 2020, more than 29.3 million cases have been reported in 188 countries and territories, resulting in over 930,000 deaths; more than 19.9 million people have recovered.
The COVID-19 pandemic in the United States is part of the worldwide pandemic of coronavirus disease 2019. As of September 2020, there were over 6,500,000 cases of COVID-19 and 190,000 COVID-19-related deaths in the U.S.
The first case of COVID-19 in the U.S. state of New York during the pandemic was confirmed on March 1, 2020, and the state quickly became an epicenter of the pandemic, with a record 12,274 new cases reported on April 4. By April 10, New York had more confirmed cases than any other country besides its own, but since then the outbreak has been mostly controlled in the state. As of September 15, 2020, the state has reported 9.2 million tests, with 445,714 positive cases, and 25,405 deaths.
Syra Madad is an American pathogen preparedness expert and infectious disease epidemiologist. Madad is the Senior Director of the System-wide Special Pathogens Program at NYC Health + Hospitals where she is part of the executive leadership team which oversees New York City's response to the Coronavirus disease 2019 pandemic in the city's 11 public hospitals. She was featured in the Netflix documentary series Pandemic: How to Prevent an Outbreak.
Flattening the curve is a public health strategy to slow down the spread of the SARS-CoV-2 virus during the COVID-19 pandemic. The curve being flattened is the epidemic curve, a visual representation of the number of infected people needing health care over time. During an epidemic, a health care system can break down when the number of people infected exceeds the capability of the health care system's ability to take care of them. Flattening the curve means slowing the spread of the epidemic so that the peak number of people requiring care at a time is reduced, and the health care system does not exceed its capacity. Flattening the curve relies on mitigation techniques such as social distancing.
The first presumptive case relating to the COVID-19 pandemic in Louisiana was announced on March 9, 2020. Since the first confirmed case, the outbreak grew particularly fast relative to other states and countries. As of June 14, 2020, there have been 46,619 confirmed cases in Louisiana, and of those 2,901 people have died. Confirmed cases have appeared in all 64 parishes, though the New Orleans metro area alone has seen the majority of positive tests and deaths. Governor Edwards closed schools statewide on March 16, 2020, restricted most businesses to takeout and delivery only, postponed presidential primaries, and placed limitations on large gatherings. On March 23, Edwards enacted a statewide stay-at-home order to encourage social distancing, and President Donald Trump issued a major disaster declaration, the fourth state to receive one.
The first case relating to the COVID-19 pandemic was confirmed in New York City in March 2020 by a woman who had recently traveled to New York City from Iran, a country already seriously affected by the pandemic at the time. Nearly a month later, the metropolitan area was the worst-affected area in the country, with its medical infrastructure overtaxed. By April, the city had more confirmed coronavirus cases than China, the U.K., or Iran, and by May, had more cases than any country other than the United States.
Medical materials and other goods shortages caused by the COVID-19 pandemic quickly became a major issue of the pandemic. The matter of pandemic-related shortage has been studied in the past and has been documented in recent events. On the medical side, shortages of personal protective equipment such as medical masks, gloves, face shields, gear, sanitising products, are also joined by potential shortage of more advanced devices such as hospital beds, ICU beds, oxygen therapy, ventilators and ECMO devices. Human resources, especially in terms of medical staff, may be drained by the overwhelming extent of the epidemic and associated workload, together with losses by contamination, isolation, sickness or mortality among health care workers. Territories are differently equipped to face the pandemic. Various emergency measures have been taken to ramp up equipment levels such as purchases, while calls for donations, local 3D makers, volunteer staffing, mandatory draft, or seizure of stocks and factory lines have also occurred. Bidding wars between different countries and states over these items are reported to be a major issue, with price increases, orders seized by local government, or cancelled by selling company to be redirected to higher bidder. In some cases, medical workers have been ordered to not speak about these shortages of resources.
Uché Blackstock is an American emergency physician and former Associate Professor of Emergency Medicine at the New York University School of Medicine. She is the Founder and CEO of Advancing Health Equity, which has a primary mission to engage with healthcare and related organizations around bias and racism in healthcare with the goal of mobilizing for health equity and eradicating racialized health inequities. During the COVID-19 pandemic Blackstock used social media to share her experiences and concerns as a physician working on the front lines and on racial health disparities and inequities exposed by the pandemic. She is best known for her work amplifying the message on racial health inequities and her media appearances speaking on the COVID-19 pandemic. She has been featured on Meet the Press, PBS NewsHour, Slate and Forbes among others. Blackstock became a Yahoo! News Medical Contributor in June 2020.
Allison McGeer is a Canadian infectious disease specialist in the Sinai Health System, a Professor at the Dalla Lana School of Public Health and a Senior Clinician Scientist at the Lunenfeld-Tanenbaum Research Institute. McGeer has led investigations into the severe acute respiratory syndrome outbreak in Toronto and worked alongside Donald Low. During the COVID-19 pandemic, McGeer has studied how SARS-CoV-2 survives in the air.
Planning and preparing for pandemics has happened in countries and international organizations. The World Health Organization writes recommendations and guidelines, though there is no sustained mechanism to review countries' preparedness for epidemics and their rapid response abilities. National action depends on national governments. In 2005–2006, prior to the 2009 swine flu pandemic and during the decade following it, the governments in the United States, France, UK and others managed strategic health equipment stocks, but often reduced stocks after the 2009 pandemic in order to reduce costs.
The COVID-19 pandemic has impacted long-term care facilities and nursing homes around the world. Thousands of residents of these facilities, who are a high-risk group, have died of the disease.
The COVID-19 pandemic has impacted crime and illicit economies such as organised crime, terrorism, street crime, online crime, illegal markets and smuggling, human and wildlife trafficking, slavery, robberies and burglaries.
The COVID-19 pandemic has impacted hospitals around the world. Many hospitals have scaled back or postponed non-emergency care. This has medical consequences for the people served by the hospitals, and it has financial consequences for the hospitals. Health and social systems across the globe are struggling to cope. The situation is especially challenging in humanitarian, fragile and low-income country contexts, where health and social systems are already weak. Health facilities in many places are closing or limiting services. Services to provide sexual and reproductive health care risk being sidelined, which will lead to higher maternal mortality and morbidity.
Lorna Breen was an American physician who was the emergency room director at NewYork–Presbyterian Hospital. She died by suicide in 2020, while taking a break with family in Charlottesville, Virginia during the coronavirus pandemic.
The Children's Hospital at Montefiore (CHAM) is a nationally ranked pediatric acute care children's teaching hospital located in the Bronx, New York. The hospital has 193 pediatric beds and is affiliated the Albert Einstein College of Medicine. The hospital is a member of the Montefiore health network and is the only children's hospital in the network. The hospital provides comprehensive pediatric specialties and subspecialties to infants, children, teens, and young adults aged 0–21 throughout the Bronx and New York state. Children's Hospital at Montefiore also sometimes treats adults that require pediatric care. While CHAM does have a pediatric emergency department, they do not have a pediatric trauma center and sends all pediatric trauma cases to the nearby Jacobi Medical Center's level II pediatric trauma center. The Children's Hospital at Montefiore is one of the largest providers of pediatric health services in New York state. The hospital is attached to Montefiore Medical Center and is affiliated with the Ronald McDonald House of New York.
Management of COVID-19 includes supportive care, which may include fluid therapy, oxygen support, and supporting other affected vital organs. The WHO is in the process of including dexamethasone in guidelines for treatment for hospitalized patients, and it is recommended for consideration in Australian guidelines for patients requiring oxygen. CDC recommends those who suspect they carry the virus wear a simple face mask. Extracorporeal membrane oxygenation (ECMO) has been used to address the issue of respiratory failure, but its benefits are still under consideration. Personal hygiene and a healthy lifestyle and diet have been recommended to improve immunity. Supportive treatments may be useful in those with mild symptoms at the early stage of infection. Nasal breathing is suggested as such a procedure based on several peer reviewed studies.
On 9 August 2020, a major fire broke out in early morning hours at a COVID-19 facility located at the Hotel Swarna Palace in the city of Vijayawada, in the state of Andhra Pradesh. The fire blaze killed 11 people and wounded a further 22. The hotel was used as a temporary COVID-19 facility as it was leased out by the private hospital Ramesh Hospitals Vijayawada for the purpose of treating infected COVID-19 patients. An electrical short circuit was described as the ultimate reason for the incident. The fire had been brought under control by the firefighters within a space of 30 minutes. The patients who survived from the fire blaze were transferred to another quarantine centre.
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