I continue to hope our unusual President will slash enough red tape to balloon supplies of things like ventilators in time to do some good. In the meantime, we're getting a crash course in rationing by "triage officers" and in budget trade-offs.
I keep reading that the U.S. has fewer hospital beds per capita than many EU countries, even Italy. The more important metric, however, may be ICU beds, where we're not doing so badly: 3 times as many as Italy, 5 times as many as the UK. Nevertheless, New York is in for a rough ride, though I'm encouraged to see that they're whole-heartedly trying chloroquine and other promising antivirals, supplies of which so far appear to be holding up.
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GE Medical has negotiated an emergency contract extension with IAMAW Lodge 10 allowing them to produce ventilator at their Madison, WI plant for the next 6 months. The extension is renewable if necessary. (This is the old Ohmeda plant.)
They will be running 24/7 and using white-collar personnel in addition to the Union forces to increase production.
I think the 'hospital bed' figures are subject to a lot of interpretation. If you've ever dealt with a convalescing patient (my mom was in and out of various care facilities for about a year before she passed) the US has an insane number of classifications for determination of what insurance benefit actual pays for room and board, hospital vs swing bed vs skilled care, and probably others. I can easily see how the numbers could skew depending on what was counted as a hospital bed.
The other thing is we've been pretty aggressive at performing a lot of procedures with very minimal hospital stays which reduces the need for beds. Both my mom and dad wound up with MRSA (Methicillin-resistant Staphylococcus aureus) during hospital stays. When that bug started going around staying in the hospital for a prolonged period was just asking for a secondary infection with a long and uncomfortable treatment regiment, and the best way to avoid it is not stay in the hospital longer than absolutely necessary.
Theodore Dalrymple pointed out years ago that the NHS of Britain reduced its average time from presentation to hospital bed overnight by redefining a gurney in the corridor as a hospital bed. Their numbers are not our numbers. Also, there was a strong tendency in Romania when I used to be very attached to clinics and hospitals there in the late 1990s for people to convalesce in hospital beds for a length of time Americans would consider ridiculous. Women who had given birth would stay for two weeks, generally. That hasn't been true in America since the 1950s. Not even then, really.
I don't know how much that translates to hospitals in Italy and Europe in general, but I'll bet there's something, particularly in southern Europe.
On the other hand, if your usual practice is to let patients hang out for two weeks, you at least have some emergency capacity when you have to boot their butts home and put really sick people there. Of course, you're going to need a lot more medical attendants.
My understanding was that we had 3 or 4 times as many ICU beds as Italy *per capita*. And something like seven times the ventilators, which may be even more important.
Anecdotally, I've been hearing a *lot* of horror stories about Italian hospitals in the 21st c.
I mean, that's a country where I saw a man working at making Parmiggiano Reggiano cheese, stirring the milk in the cat, cigarette hanging out of his mouth. This speaks to both ideas of hygiene, and some of the underlying reasons why it's so bad there- which there are many. We are definitely not Italy, in so many ways.
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