The well being care system has collapsed as a result of coronavirus.
Recently, a local Houston news station ran a story about a man who died waiting for a hospital bed. The story went viral.
Daniel Wilkinson, a 46-year-old veteran who served two missions in Afghanistan, presented himself at a community hospital a few doors down from his home in Bellville, Texas, a small town on the outskirts of Houston. He felt ill and was eventually diagnosed with gallstone pancreatitis.
In countries with modern health systems, gallstone pancreatitis is a dangerous but treatable diagnosis – it often requires an emergency interventional procedure that can be performed in most major referral hospitals (including many in the Houston area), followed by a short stay in hospital the intensive care unit. But with the COVID-19 pandemic raging across Texas and much of the larger area, finding an ICU bed is no easy task these days. Wilkinson had to wait more than seven hours to finally open a bed in a VA hospital in Houston. But by then, gas bubbles had formed in Wilkinson’s pancreas, suggesting that the failing organ was spreading an infection throughout his body. After waiting too long to undergo this procedure, Daniel Wilkinson died.
For the past year or so we’ve been told that the American healthcare system is on the verge of collapse. Last month the term was used to describe the plight of hospitals in Oklahoma, Louisiana, Alabama, and Alaska; last winter it was used to describe health systems in California and Idaho. A recent New York essay observed that the Mississippi health system was nearing national failure, while a Politico headline at the start of the pandemic saw New York hospitals quickly reaching a breaking point. Descriptions of health systems at the extreme limit of functionality count among other COVID clichés like new normal and in these troubled times.
But to say that our health system is on the verge of collapse is glossing over it. The story of a veteran who dies near a town known for some of the best hospitals in the world – and of a very treatable disease – shows that our healthcare system has already collapsed.
The Daniel Wikinson story feels shocking and almost typical at the same time at this point in the pandemic. As a resident doctor who was only trained in times of COVID – I was asked to consider graduating from school in early April 2020 in order to help with medical staff shortages – my time as a doctor was shaped by working in a system that had already collapsed. The American healthcare system I work in has been characterized by limited personal protective equipment, a lack of oxygen, and the construction of field hospitals in convention centers and parking garages. Last winter, many hospitals across the country introduced crisis standards of care that were forced to ration health services according to criteria that few people would imagine would be used outside of a mass accident like a terrorist attack. Nowadays, much of the country’s hospitals are full and patients in need of an intensive care unit are flown thousands of miles in search of an occupied bed. These are not characteristics of a health system that is on the verge of failure. These are features of a spectacularly collapsed health system that is forcing doctors and patients to climb through the rubble in search of help.
There is no textbook definition of “collapsed health system”. But it can be framed by a related concept of global health defined by the World Health Organization: the resilience of health systems. Conceived as a bulwark against collapse, resilience describes the ability of a health system to absorb shocks and adapt while it is performing core services. That is, during a major disaster, a functioning health system can care for the wounded as well as patients with a wide variety of health emergencies that arise in normal life, as well as those in need of routine preventive care. In terms of resilience, our system failed the requirements last year. Over the past year, it quickly became clear that we had no contingency plan for a lengthy disaster like a pandemic. In the first year of the pandemic, routine preventative measures – like childhood vaccinations and colon cancer screening – collapsed while our health system was overwhelmed by COVID. Almost half of all patients went without medical care after the pandemic began, according to data from a large survey, almost half of all patients abandoned health care unless there was an emergency (although hospitals have proven to be an unlikely location for COVID . to get ). The number of additional deaths during the pandemic in the United States is estimated at more than 900,000. If, in normal times, the American healthcare system was too expensive for many and difficult to trust for some, the pandemic has made things worse. Healthcare workers who lack the support to function at such a grueling pace for so long are voting with their feet. Nurses tired of working in a dysfunctional system are quitting their jobs in droves as a surge in doctors retires or follows other health workers to the exits.
I don’t blame the media and public health voices for backing up their descriptions of where our health systems stood during the pandemic. COVID was unpredictable. Nobody wants to cry or be wrong. Nonetheless, edge and hedging words like this – peak, limit, threshold – offer us a state of hovering revival between normality and a real crisis. Focusing so intensely on the language may seem pedantic. But there is power to just tell the truth. It validates the experiences of local health workers and people who are unable to receive adequate health care. In the future, the realization that our health system has collapsed under the weight of the COVID-19 will ultimately create the conditions for a comprehensive health reform. It runs counter to any revisionist story that might emerge in the years to come; It’s easy to imagine accounts that conveniently highlight the heroes of healthcare while waving away how flawed our healthcare system is. Unabashedly acknowledging our failure could lead us to build a more resilient system.
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Some healthcare executives begin to take an outspoken approach in their messages, hoping to accurately communicate the help that is needed at the moment. In Baton Rouge, Louisiana, Catherine O’Neal, physician and chief medical officer of Our Lady of the Lake Hospital, warned her ward in a recent press conference about what it means to run out of beds in her hospital. “We cannot tolerate it,” she said, and went on to explain that there are people waiting for a bed in emergency rooms because they risk health complications and even death. “We don’t have any more things in our pockets to open beds. They have to open our beds for us, ”O’Neal said, urging people to get vaccinated. The admission that the health system has collapsed shows the public the gravity of the situation. It increases the urgency of calls for people to get their shots and mask themselves in areas of significant community coverage. In countries that are severely affected by the Delta variant, vaccination rates have already risen.
To say we are on the verge of disaster gives hope that those responsible can take steps to keep us from falling into an abyss. It suggests that the situation is holdable, at least temporarily, that maybe you can keep crouching and do what you did and everything will be fine. But it’s not sustainable and it’s not okay. The health system is not approaching a cliff while it is still functioning – what is happening is killing people like Daniel Wilkinson. People who don’t have to die, die.