A federal government survey of the experience of hospitals in responding to the coronavirus pandemic paints a desperate picture of equipment shortages, overworked staff, and insufficient tests.
Three quarters of hospitals are already treating patients with confirmed or suspected cases of Covid-19.
The report, released on Monday by the Department of Health and Human Services (HHS), warns that the problems experienced by hospitals that are already being overwhelmed with patients, particularly in terms of supplies, are feeding off each other in a vicious cycle — insufficient equipment leads to more potential infections, further draining supplies.
In direct contrast to the report, during Saturday’s White House Coronavirus Task Force briefing, President Donald Trump claimed that hospital administrators “even in the really hot spots … are communicating directly with us that their level of supplies are meeting essential needs. And at the current time, they’re really thrilled to be where they are.”
The administration’s own report says that hospital administrators describe shortages of basic equipment such as thermometers, and insufficient deliveries of personal protective equipment (PPE) from federal and state sources that “won’t even last a day.”
Shockingly, a hospital reported receiving a shipment of 2,300 N95 masks from a state strategic reserve, that were unusable because the elastic bands had dry-rotted. Another reported that the last two shipments it had received from a federal agency contained PPE that expired in 2010. The shipment also contained construction masks that did not contain a true N95 seal.
Another health system received a delivery of 1,000 masks when it was expecting far more, only to discover that 500 of them were for children and therefore unusable by hospital staff.
Hospitals also report shortages of critical supplies, materials and logistical support, from IV poles to linen, toilet paper and food, as well as thermometers and disinfectant. The shortage of thermometers completely undermines the ability to take temperatures of both staff and patients — one of the key indicators of the virus.
Severe shortages of testing supplies and extended waits for results, sometimes as long as eight days, mean patients are spending longer periods in hospitals causing further strain and depleting limited resources.
The massive anticipated shortage of full-feature ventilators has led to the use of alternatives, and poses potentially difficult ethical decisions. Though at the time of the survey no hospital reported limiting ventilator use.
Health systems are also having difficulties maintaining staffing levels through overwork and the emotional toll on both medical and support staff.
A further day-to-day challenge is also the changing and sometimes inconsistent guidance from federal, state, and local authorities, which confuses both hospitals and the public, and increases workload.
Longer term, hospitals are concerned about their financial viability as the drop in elective procedures has decreased revenues as costs have increased.
Before the release of the report, the American Hospital Association said officials are worried about shortages of critical medical supplies, including medication for patients and PPE for staff.
In a statement to NPR, Alicia Mitchell, the group’s senior vice president of communications, said: “Not a day goes by where we don’t hear from hospitals and health systems across the country that are concerned about shortages of PPE for their heroic frontline caregivers.”
She added: “The AHA continues to urge that all levers be used by both the government and private sector to ensure those on the front lines have the resources and support they need to care for their patients and communities.”
The findings of the report were based on phone interviews with administrators at 324 hospitals conducted between 23 March and 27 March.