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  • Writer's picturemichelledangmd

Flatten The Curve

I’m going to keep on posting about this because educating the public is important during this time. For those of you who think this is just like the cold or flu, or that you’re healthy and you likely will only have mild symptoms, that may be the case for you, but it may not be the case for others who may require a much higher level of care. The reason why many physicians and healthcare providers keep talking about #SocialDistancingNow in order to #FlattenTheCurve is to not overtax our healthcare resources. I’ll do my best to summarize this information for you: 5,256 American Hospital Association (AHA) registered community hospitals 534,964 acute care beds, which includes 96,596 ICU beds. 68,558 are adult beds AHA does not have information on negative pressure rooms, which are meant to decrease spread of the virus and which are strongly recommended for a very contagious disease like COVID-19 You hear us talk about mechanical ventilators a lot. These are machines that help the lungs to breathe when patients go into respiratory distress or failure. The reason why we talk about this a lot is because the most common reason for COVID-19 patients to be in the ICU is due to respiratory failure. These patients may need to be intubated (have a breathing tube inserted into their trachea) and have their lungs ventilated by a machine. The machines have specific settings for oxygen level, volume, pressure, and respiratory rate (how fast the lungs are ventilated) among various other settings. 62,000 full featured mechanical ventilators with 98.738 older models that may or may not have all the capabilities needed and an additional 8.900 for emergency use; therefore, the total number is estimated to be around 200,000 Not all physicians manage these types of ventilators. In fact, AHA data in 2015 shows that there are approximately 28,808 intensivists (or critical care physicians). As a side note, in order to practice critical care medicine, there are various paths, but critical care medicine is a recognized subspecialty – meaning after a physician completes his/her residency training in fields like internal medicine, anesthesiology, surgery, emergency medicine etc they will then complete additional fellowship training in critical care medicine. Therefore, it is on average 5+ years of training after completion of medical school (4 years). There are approximately 34,000 critical care advanced practice providers (APPs) that can also provide care. Other physicians that have had training in critical care may also help (pulmonologists, surgeons, anesthesiologists). All other ICU staff will be needed and can potentially be in short supply. “Without these key members of the ICU team, critical care cannot be adequately delivered. Moreover, an indeterminate number of experienced ICU staff may become ill, further straining the system as need and capacity surge.” I urge you at home who think that you’re healthy and no one around you is affected by it to think twice after reading the above. The numbers are there. The United States as a nation is spread out but even a big city like where I am will be stretched thin when cases continue to pop up that require critical care. We just do not have enough resources. And to continue going on about our lives exposing others is frankly socially irresponsible, and I have a moral and ethical duty to educate you on why this is important. Your actions affect others. Stay the F home.

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