Detroit hospitals warn many “extremely sick” patients will be denied lifesaving treatment
27 March 2020
As COVID-19 cases throughout the metro Detroit area soared, the Henry Ford Health system warned patients that “because of shortages,” patients who are “extremely sick” may be “ineligible for ICU or ventilator care.”
In a letter to patients and families shared widely on social media, the hospital chain stated:
“We currently have a public health emergency that is making our supply of some medical resources hard to find. Because of shortages, we will need to be careful with resources. Patients who have the best chance of getting better are our first priority. Patients will be evaluated for the best plan for care and dying patients will be provided comfort care.”
It continues, “[I]f you (or a family member) becomes ill and your doctor believes you need extra care in an Intensive Care Unit (ICU) or Mechanical Ventilation (breathing machine), you will be assessed for eligibility based only on your specific condition.
“Some patients will be extremely sick and very unlikely to survive their illness even with critical treatment. Treating these patients would take away resources for patients who might survive.”
The Michigan Department of Health and Human Services reported that the number of confirmed cases of coronavirus in the city of Detroit rose to 851 on Thursday afternoon, 146 people more than the previous day, or an increase of 21 percent. Fifteen Detroit residents have died from COVID-19, the disease caused by the novel coronavirus.
Driven by the increase in confirmed cases in the city, the number of people with coronavirus in Wayne County, where Detroit is located, has among the most rapidly rising infection rate of any county in the US outside of New York City and New Orleans. The number of cases in Wayne County went up by 239 people on Thursday, up to a total of 1,389, or an increase of 24 percent.
Local hospitals are already being overwhelmed by the number of cases, with nurses reporting that they are running out of critical supplies and that patients are dying before their test results come back positive for COVID-19.
The dramatic spread of COVID-19 cases in Detroit and Wayne County is so stark that it was taken note of by Dr. Deborah Birx of the White House Coronavirus Task Force during the press briefing on Thursday. Showing that the White House is very well aware of the developing crisis in Detroit, Birx said, “We are concerned about certain counties that look like they are having a more rapid increase,” adding that Wayne County is among the “hot spots” in “urban areas or communities that serve that urban area.”
Neither Dr. Birx nor anyone else from the Trump administration said anything about what precisely the White House is doing about the situation in Detroit and Wayne County. She said only, “We have integrated all of our information to not only look at where the cases are today, but how they’re moving so we can alert FEMA to where we think the next potential hot spot is.”
On Thursday morning in Lansing, Michigan Governor Gretchen Whitmer issued a formal disaster declaration requesting the intervention of the Federal Emergency Management Agency (FEMA). The appeal to the Trump administration for federal intervention was also combined with statements about how Michigan residents need to “stop communicating the disease” by following her “Stay Home, Stay Safe” executive order on Monday.
The eruption of the coronavirus pandemic in Detroit and surrounding communities is directly tied to the conditions of poverty that have existed in the city for decades and across generations. Detroit is the poorest big city in the US. According to data published recently by the Detroit Partnership on Economic Mobility, the city has a poverty rate of 35 percent, three times the national average.
Child poverty in Detroit is more than 50 percent, which is three-and-a-half times the national average. Poor children in the city, who had been able to stay on the food program with a “grab and go” breakfast and lunch at 58 schools after the closure of the school system earlier this month, are now getting food distributed to them only twice a week and at only 17 schools due to staffing issues related to the virus.
With official unemployment in Detroit at 8.8 percent, more than double the statewide average, and median income for workers in the city at $29,000 annually, it is very difficult for working class people to conform to the governor’s executive order, which states that Michigan residents must stay at home for the next three weeks.
Another cause of the spread of the virus and rising death toll in Detroit is the overall health of the population. Detroit and Wayne County residents age 21 and older have extremely high rates of obesity, diabetes, respiratory conditions and other underlying health conditions that make them vulnerable to getting the infection and also becoming fatally ill once they have it.
As reported yesterday on the WSWS, the hospital systems in the city are being overwhelmed with coronavirus patients, and this situation continued to intensify on Thursday.
Nurses working at Sinai-Grace Hospital in Detroit reported to Click-On Detroit that health care workers are not able to keep up with the influx of coronavirus patients. The report noted, “According to one nurse, some patients are so sick that they die before the coronavirus test comes back. She said she has to speak up for her patients—some are waiting on test results and are sharing rooms with people who have coronavirus.
“If you have a patient who is positive and 40 years old and a patient who is 80 that doesn’t have coronavirus, that patient doesn’t have a chance at life. This is ridiculous.”
As the hospitals are filling up, hotels and college dormitories—which have been closed by government directives—are being readied as temporary medical facilities to accommodate the expanding number of patients with the coronavirus.
An emergency room nurse working for Ascension Healthcare, Mary Macdonald, posted a video on Instagram to explain what is happening at the hospitals in Metro Detroit. She said, “I have been inspired by my friends and family to make a video in regard to the coronavirus and what is really going on in the front lines... If you would have asked me 10-plus days ago if I thought that this was going to get as bad as it is, I would have told you no. You have heard the rumors, you have seen the trends, but until you see it first-hand you just have no idea what it’s going to be like and it’s truly frightening...
“The numbers are starting to double and triple in regard to the number of people coming in. Most people are not getting tested, especially if you are walking well you are being sent home to quarantine. Coming into the hospital is not going to benefit you unless you are having respiratory distress...
“My boss texted me and said, ‘hey, they really need help in Southfield in the emergency room. Everybody is sick and they are intubating everybody, and all these patients need help.’ So, of course, I got up without any sleep and worked a night shift until 7:30 this morning with some of the bravest coworkers I’ve ever met in my life.
“It’s getting to the point now where we are going to be just like Italy. From 10:00 p.m. last night until this morning we intubated two patients within a half-hour, and I would say upwards of 10 patients were put on ventilators. My patient took the last ventilator in the hospital at 7:00 a.m.
“So, what does that mean going forward? Resources are very slim. We have no medications to keep these patients even ventilated, let alone ventilators. Medications like fentanyl that would keep a patient sedated while they’re intubated, we’re out of. We’re out of Tylenol...
“So, we’re going to start making life-or-death decisions in regard to people’s care. So, you’re going to come in, and you’re going to get tagged whether you are deemed necessary to get intubated or whether you’re going to be sent home to die. This is truly scary.”
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