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Just finished listening to the briefing from StL hospitals that occurred this am. They are asking for a state-wide Safer At Home mandate IMMEDIATELY. /1
Safer At Home means people can go to school, work, shop for necessities otherwise stay home. Dr. Garza said that Parson’s health directive wasn’t enough. Given the high degree of virus in Missouri, no county in the state is safe rn. /2
Currently there are about *1000 COVID patients* in St. Louis hospitals and ICUs are at 90% capacity. If we continue on this trajectory, we could have as many as *3000 COVID patients* at our peak. /3
BJC is cancelling things like joint replacement or any surgery where the outcome will not be adversely affected with an 8-12 wk delay. However, in order to reserve capacity it may become necessary to delay things like cancer resections. /4
Hospitals are meeting to develop Crisis Standards of Care which will guide “clinicians when the reach a point of having to decide ethically how to do the most good for the most people”. These standards have not been implemented yet. /5
Once hospitals reach capacity, they will need to “make choices as to who can be helped with the limited resources available and make choices as to who can’t be helped”. /6
Death rate is starting to tick upwards again. Once hospitals reach capacity, we will not only see an increase in deaths from COVID but an increase in deaths from other treatable conditions as well. /7
Garza notes that this is like war except in war there are always reserves that can come in. In this war with the virus, our healthcare workers are our frontline AND our rear guard. /8
The task force is calling on everyone to do their part and support one another. Individuals, communities, government and the private sector needs to contribute. /9
Local hospitals are working with the state to increase capacity. Options include opening additional units (converting ORs or cath labs to ICU/COVID units) using auxiliary staff and/or opening a field hospital. /10
The area will run out of capacity. The question is for how long? The longer we continue to take no decisive action, the higher the peak becomes and the longer it takes to recover. If we follow the red curve, we’re still dealing with this until March ‘21
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The slides from today haven’t been posted but when they are, I’ll attach them here. The most important take-away is that this is no longer about individual counties having outbreaks. The entire state is an outbreak and it’s going to take state-wide action to get it under control.
