I’m a medical doctor. Day to day, I focus on the practice of emergency medicine. I’ve never considered myself an alarmist. Actually, I’ve been trained to be calm in the face of tragedy. Many of my friends in business are concerned that the medical community and politicians are overreacting to the novel coronavirus. They are worried that the economy is being sacrificed to save a few people. Comparisons to yearly flu deaths are made frequently.
1. We do everything we can for flu patients every year. This includes widespread public vaccination campaigns and mandatory vaccinations of health care providers. Physicians and hospitals are aware of the flu season. They generally have capacity for those patients. If a single hospital doesn’t, their partner hospitals do. There will be deaths related to the flu each year, but our system is not generally overloaded by flu season. Influenza patients will become ill and require hospitalizations, and they will receive great care even if the final result is unavoidable death.
2. Hospitals run near capacity as a general rule. The goal of a hospital administrator is to run at 99.9 percent capacity. This maximizes the use of resources of the hospital, and therefore maximizes billing and revenue. At times, the census will be 80 percent and at times it will be 101 percent. I’ve been told that profit margins in health care are thin compared to most other businesses. When a hospital is near or at capacity most of the time, it’s more likely to be able to retain staff and pursue capital projects.
3. The novel coronavirus is just that: novel. This is a new entity causing the need for hospitalizations and significant resource utilization wherever it has spread. Other countries that were affected before the U.S. have not had the resources to meet demand. The countries affected are not all third world nations. Projections by the U.S. and international epidemiologists conclude that without significant, but temporary societal sacrifices, many patients will become quite ill in any country affected by this virus. This would include hospitalization, intensive care needs, and deaths. The U.S. is not immune.
Regular illnesses and injuries will not pause to allow for resources to be mobilized to care for these new patients. There is no reason to believe that fewer people will have heart attacks, strokes, gastrointestinal bleeding, or other medical problems that we see every day. Even influenza illnesses haven’t paused to give room for coronavirus patients. All of the things required to care for people that are ill from the novel coronavirus will be in addition to the usual needs. These additional patients will be on top of the 80 to 101 percent capacity that a hospital usually carries.
4. Your business colleagues in health care administration aren’t willing to throw away money on a whim. Recently, hospitals have made significant changes to prepare to care for novel coronavirus patients. For instance, they have all canceled elective surgeries. In general, elective surgeries are money makers for hospitals. They have spent money on isolation tents, ventilators, personal protective equipment and any resource they can get their hands on. They aren’t blowing money to garner political favor or as a publicity stunt. They aren’t blowing money because they think only a few people will die or because this is health care business as usual. Your business colleagues in health care believe the epidemiologists.
5. There are many articles in the medical and lay press describing predictions and recommendations of epidemiologists and health care experts in regards to novel coronavirus. I don’t absolutely agree with every assumption or recommendation in those articles. But, too many similar warnings have been given by experts, and too much devastation has occurred in other countries to ignore.
I am not an entrepreneur or business professional. But, I understand that the economy has and will continue to take a significant hit due to the restrictions imposed by the government. However, the experience of every other country affected and the expert opinion of every epidemiologist I’ve read has led me to believe that our health care system will collapse if substantial restrictions are not employed and followed. If significant measures aren’t taken and taken quickly, it won’t only be a few deaths from novel coronavirus, and it won’t only affect those infected with it either. Once the health care industry has survived by using our knowledge, experience, innovation, and hard work, I’ll rely on my business friends to use the same characteristics to resuscitate their companies.
Benjamin J. Ricke is an emergency physician.
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