Overwhelmed hospitals are converting chapels, cafeterias, waiting rooms, hallways, even a parking garage into patient treatment areas. Staff members are desperately calling around to other medical centers in search of open beds. Fatigue and frustration are setting in among front-line workers.
Conditions inside the nation’s hospitals are deteriorating by the day as the coronavirus rages across the U.S. at an unrelenting pace and the confirmed death toll surpasses 250,000.
“We are depressed, disheartened and tired to the bone,” said Alison Johnson, director of critical care at Johnson City Medical Center in Tennessee, adding that she drives to and from work some days in tears.
The number of people in the hospital with COVID-19 in the U.S. has doubled in the past month and set new records every day this week. As of Tuesday, nearly 77,000 were hospitalized with the virus.
Newly confirmed infections per day in the U.S. have exploded more than 80% over the past two weeks to the highest levels on record, with the daily count running at close to 160,000 on average. Cases are on the rise in all 50 states. Deaths are averaging more than 1,155 per day, the highest in months.
The out-of-control surge is leading governors and mayors across the U.S. to grudgingly issue mask mandates, limit the size of private and public gatherings ahead of Thanksgiving, ban indoor restaurant dining, close gyms or restrict the hours and capacity of bars, stores and other businesses.
New York City’s school system — the nation’s largest, with more than 1 million students — suspended in-person classes Wednesday amid a mounting infection rate, a painful setback in a corner of the country that suffered mightily in the spring but had seemingly beaten back the virus months ago.
Texas is rushing thousands of additional medical staff to overworked hospitals as the number of hospitalized COVID-19 patients statewide accelerates toward 8,000 for the first time since a deadly summer outbreak.
In the worsening rural Panhandle, roughly half of the admitted patients in Lubbock’s two main hospitals had COVID-19, and a dozen people with the virus were waiting in the emergency room for beds to open up Tuesday night, said Dr. Ron Cook, the Lubbock County health authority. “We’re in trouble,” Cook said.
In the Texas border city of El Paso, overwhelmed morgues have begun paying jail inmates $2 an hour to help transport the bodies of virus victims. The crush of patients is forcing the city to send its non-COVID-19 cases to hospitals elsewhere in the state.
More than 5,400 extra medical personnel have been deployed around Texas by the state alone, said Lara Anton, a spokeswoman for the Texas Department of State Health Services. And that doesn’t include the help surging into Texas from the military and volunteer organizations.
“There are only so many medical personnel to go around. And I think what we’re seeing in places like El Paso is not sustainable in all or a large part of the state,” said Dr. Mark McClellan, a former head of the Food and Drug Administration.
Ballad Health system, which is located in the Appalachian mountains and includes the Tennessee hospital where Alison Johnson works, has warned that it and its workers are stretched so thin that without a change in course, its hospitals might have to turn patients away. Ballad reported having just 16 available ICU beds Wednesday and about 250 team members in isolation or quarantine. It is trying to recruit hundreds more nurses.
In Idaho, doctors warned that hospitals have almost reached the point where they need to ration care, unable to treat everyone because there aren’t enough beds or staffers to go around.
“Never in my career did I think we would even contemplate the idea of rationing care in the United States of America,” said Dr. Jim Souza, chief medical officer for St. Luke’s Health System.
In Reno, Nevada, Renown Regional Medical Center began moving some coronavirus patients into its parking garage.
Video of the converted garage before it opened to patients showed rows and rows of beds separated by moveable white screens set up on one level of the stark, cavernous garage, each section designated by letters and each bed space marked by a number on the ground. The garage unit currently houses 27 patients but at peak capacity will have enough beds to accommodate more than 1,400, said Dr. Paul Sierzenski, Renown’s chief medical officer for acute care.
The garage is heated, pressurized to ensure adequate airflow and set up for patients who don’t require long-term hospital care, Sierzenski said.
In Kansas, hospitals are converting spaces such as chapels and cafeterias for use by COVID-19 patients, said Cindy Samuelson, spokeswoman for the Kansas Hospital Association.
Stormont Vail Health in Topeka, Kansas, devoted an entire hospital floor to COVID-19 patients as their numbers swelled, hitting 90 on Wednesday. The hospital also converted two surgery waiting rooms for use by non-infected patients, spokesman Matt Lara said.
Kansas health chief Dr. Lee Norman said a system that he likened to air traffic control for coronavirus patients is being put in place so nurses from rural hospitals can make a single call to find a larger hospital that can take their sickest patients.
In some cases, nurses and doctors in Kansas have been spending up to eight hours looking for a large hospital with an opening.
Maryland health officials similarly set up a centralized clearinghouse with information on available ICU beds so that hospitals need only make a single phone call. State authorities also issued an emergency order prohibiting most hospital visitors until further notice.
Public health experts say staying home is best to keep yourself and others safe from infection. But if you’re thinking about flying for the holidays, you should know what to expect.
Flights are getting more crowded and more airlines plan to stop blocking seats to accommodate the growing number of people taking to the skies again, reports AP.
Starting Dec. 1, Southwest will join United and American in allowing every seat on planes to be sold. JetBlue will scale back the number of blocked seats, and — along with Delta and Alaska — plans to drop all limits some time next year.
The airline industry says it’s safe to fly, pointing to a report it funded that found the risk of viral spread on planes very low if everyone wears a mask, since planes have good ventilation and strong air filters.
But the U.S. Centers for Disease Control and Prevention notes that sitting within 6 feet of others — sometimes for hours — can still increase your risk of getting infected. And though airlines are still requiring passengers to wear masks, there’s no guarantee everyone will comply. More than 1,000 people who refused to wear masks have been banned by U.S. airlines.
Remember that flying also means spending time in airport security lines and gate areas, where you might come into close contact with others.
In an October update on travel, the CDC emphasized the importance of wearing a mask and recommended checking whether infections are rising in the area you’re traveling to.
U.S. regulators on Tuesday allowed emergency use of the first rapid coronavirus test that can be performed entirely at home and delivers results in 30 minutes.
The announcement by the Food and Drug Administration represents an important step in U.S. efforts to expand testing options for COVID-19 beyond health care facilities and testing sites. However, the test will require a prescription, likely limiting its initial use.
The FDA granted emergency authorization to the single-use test kit from Lucira Health, a California manufacturer.
The company’s test allows users to swab themselves to collect a nasal sample. The sample is then swirled in a vial of laboratory solution that plugs into a portable device. Results are displayed as lights labeled positive or negative.
To date, the FDA has authorized nearly 300 tests for coronavirus. The vast majority require a nasal swab performed by a health professional and must be processed at laboratories using high-tech equipment. A handful of tests allow people to collect their own sample at home — a nasal swab or saliva — that’s then shipped to a lab, which usually means waiting days for results.
Health experts have called for options to allow people to test themselves at home, reducing turnaround times and the potential spread of the virus to others, including health care workers. Rapid test results are critical to quickly quarantining those who are infected and tracing their contacts. But for months, U.S. testing has been plagued by slow results due to bottlenecks as testing laboratories. There are other rapid tests but most require a small, special machine operated by a health professional to develop results
“Now, more Americans who may have COVID-19 will be able to take immediate action, based on their results, to protect themselves and those around them,” Dr. Jeff Shuren, director of the FDA’s devices center, said in a statement.
Lucira did not immediately respond to a request for additional details after business hours Tuesday.
The Lucira COVID-19 test grew out of research the company was doing to develop an at-home flu test, according to the company’s website. Lucira adapted its technology to detect COVID-19 after the outbreak.
The test uses technology similar to genetic laboratory-based tests that are the standard tool for COVID-19 screening. That’s different than most rapid tests currently used in the U.S., which look for viral proteins called antigens — not the virus itself.
Anyone that tests positive should isolate and seek care from a health professional, the FDA said in its release. Those who test negative but still have coronavirus symptoms should consult a doctor; a negative result does not rule out COVID-19 infection.
The FDA said Lucira’s test was also authorized for use in doctor’s offices and testing sites. Currently all U.S. testing sites must report results to state and federal health authorities tracking the pandemic. Doctors will be required to report the home test results.
“If the results are not reported back, it may be difficult to figure out what is happening in the community at large,” said Dr. Alberto Gutierrez, former head of the FDA’s testing office, in an interview before the announcement.
More than two dozen companies have been racing for months to develop the first, rapid home-based test for COVID-19. However, the FDA outlined a number of study requirements for manufacturers.
These hurdles have less to do with COVID-19 specifically, and more to do with decades-long concerns about whether people without any medical training can accurately screen themselves and interpret the results.
The FDA has only ever approved one home test for an infectious disease — an HIV test. And even commonplace over-the-counter tests— such as home pregnancy kits — were subject to years of scrutiny before FDA allowed their use in the 1970s.
Experts say that careful approach is warranted for coronavirus.
“I think increased testing closer to patients, including in the home, is the way of the future,” said Dr. Robin Patel of the Mayo Clinic, in an interview before the announcement was made. “But there are considerations that have to be addressed to make sure that this is done in a safe and effective way.”
FDA regulators authorized the new test using their emergency powers to quickly speed the availability of experimental products during public health crises. In normal times, the FDA requires evidence of safety and effectiveness before clearing a new test. But during public health emergencies the agency can lower those standards.
The FDA release did not disclose the test’s accuracy or the study results that regulators used to make the decision.
An agreement announced Tuesday paves the way for the largest dam demolition in U.S. history, a project that promises to reopen hundreds of miles of waterway along the Oregon-California border to salmon that are critical to tribes but have dwindled to almost nothing in recent years.
If approved, the deal would revive plans to remove four massive hydroelectric dams on the lower Klamath River, creating the foundation for the most ambitious salmon restoration effort in history. The project on California’s second-largest river would be at the vanguard of a trend toward dam demolitions in the U.S. as the structures age and become less economically viable amid growing environmental concerns about the health of native fish.
Previous efforts to address problems in the Klamath Basin have fallen apart amid years of legal sparring that generated distrust among tribes, fishing groups, farmers and environmentalists, and the new agreement could face more legal challenges. Some state and federal lawmakers criticized it as a financially irresponsible overreach by leaders in Oregon and California.
“This dam removal is more than just a concrete project coming down. It’s a new day and a new era,” Yurok Tribe chairman Joseph James said. “To me, this is who we are, to have a free-flowing river just as those who have come before us. ... Our way of life will thrive with these dams being out.”
A half-dozen tribes across Oregon and California, fishing groups and environmentalists had hoped to see demolition work begin as soon as 2022. But those plans stalled in July, when U.S. regulators questioned whether the nonprofit entity formed to oversee the project could adequately respond to any cost overruns or accidents.
The new plan makes Oregon and California equal partners in the demolition with the nonprofit entity, called the Klamath River Renewal Corporation, and adds $45 million to the project’s $450 million budget to ease those concerns. Oregon, California and the utility PacifiCorp, which operates the hydroelectric dams and is owned by billionaire Warren Buffett’s company Berkshire Hathaway, will each provide one-third of the additional funds.
The Federal Energy Regulatory Commission must approve the deal. If accepted, it would allow PacifiCorp and Berkshire Hathaway to walk away from aging dams that are more of an albatross than a profit-generator, while addressing regulators’ concerns. Oregon, California and the nonprofit would jointly take over the hydroelectric license from PacifiCorp while the nonprofit will oversee the work.
Buffett said the reworked deal solves a “very complex challenge.”
“I recognize the importance of Klamath dam removal and river restoration for tribal people in the Klamath Basin,” Buffett said in a statement. “We appreciate and respect our tribal partners for their collaboration in forging an agreement that delivers an exceptional outcome for the river, as well as future generations.”
Removed would be the four southernmost dams in a string of six constructed in southern Oregon and far Northern California beginning in 1918.
They were built solely for power generation. They are not used for irrigation and not managed for flood control. The lowest dam on the river, the Iron Gate, has no “fish ladder,” or concrete chutes that fish can pass through.
That’s blocked hundreds of miles of potential fish habitat and spawning grounds, and fish populations have dropped precipitously in recent years. Salmon are at the heart of the culture, beliefs and diet of a half-dozen regional tribes, including the Yurok and Karuk — both parties to the agreement — and they have suffered deeply from that loss.
Coho salmon from the Klamath River are listed as threatened under federal and California law, and their population in the river has fallen anywhere from 52% to 95%. Spring chinook salmon, once the Klamath Basin’s largest run, has dwindled by 98%.
Fall chinook, the last to persist in any significant numbers, have been so meager in the past few years that the Yurok canceled fishing for the first time in the tribe’s memory. In 2017, they bought fish at a grocery store for their annual salmon festival.
“It is bleak, but I want to have hope that with dam removal and with all the prayers that we’ve been sending up all these years, salmon could come back. If we just give them a chance, they will,” said Chook-Chook Hillman, a Karuk tribal member fighting for dam removal. “If you provide a good place for salmon, they’ll always come home.”
PacifiCorp has been operating the dams under an extension of its expired hydroelectric license for years. The license was originally granted before modern environmental laws and renewing it would mean costly renovations to install fish ladders. The utility has said energy generated by the dams no longer makes up a significant part of its portfolio.
In the original deal, PacifiCorp was to transfer its license and contribute $200 million to bow out of the removal project and avoid further costs and liability. An additional $250 million comes from a voter-approved California water bond.
U.S. regulators, however, agreed only on the condition that PacifiCorp remain a co-licensee along with the Klamath River Renewal Corporation — a nonstarter for the utility.
Residents have been caught in the middle. As tribes watched salmon dwindle, some homeowners around a huge reservoir created by one of the dams have sued to stop the demolition.
They say their waterfront property values have already fallen by half because of news coverage associated with demolition and they worry about losing a water source for fighting wildfires in an increasingly fire-prone landscape. Many also oppose the use of ratepayer funds for the project.
U.S. Rep. Doug LaMalfa, a California Republican, said the agreement puts taxpayers in the two states on the hook. Some state lawmakers in Oregon said Gov. Kate Brown violated her constitutional authority by authorizing the deal without legislative or voter approval.
Further upstream, farmers who rely on two other dams are watching carefully. The removal of the lower four dams won’t affect them directly, but they worry it could set a precedent for dam removal on the Klamath.
More than 1,720 dams have been dismantled around the U.S. since 2012, according to American Rivers, and 26 states undertook dam removal projects in 2019 alone. The Klamath River project would be the largest such project by far if it proceeds.
Looking for toilet paper? Good luck.
A surge of new coronavirus cases in the U.S. is sending people back to stores to stockpile again, leaving shelves bare and forcing retailers to put limits on purchases.
Walmart said Tuesday it’s having trouble keeping up with demand for cleaning supplies in some stores. Supermarket chains Kroger and Publix are limiting how much toilet paper and paper towels shoppers can buy after demand spiked recently. And Amazon is sold out of most disinfectant wipes and paper towels.
A similar scene played out back in March, when the pandemic first hit and people hunkered down in their homes.
But Geoff Freeman, president and CEO of the Consumer Brands Association, formerly the Grocery Manufacturers Association, said he doesn’t expect things to be as bad this go-around since lockdowns are being handled on a regional basis and everyone is better prepared.
“A more informed consumer combined with a more informed manufacturer and a more informed retailer should provide all of us with a greater sense of ease and ensure we can meet this growing demand, “ Freeman said.
The biggest supply issue seems to be paper products: 21% of shelves that stock paper towels and toilet paper are empty, the highest level in at least a month, according to market research company IRI. Cleaning supplies have remained level at 16%. Before the pandemic, 5% to 7% of consumer goods were typically out of stock, IRI said.
Contributing to the problem is the fact that roughly 10% of the workforce at manufacturing plants where the products are made are calling out sick, mainly because they’ve been in contact with others who were tested positive to COVID-19, Freeman said.
Kelly Anderson of Colorado Springs, Colorado, said she needs more supplies now that in-person school in her area was canceled earlier this month and her two children are at home more. She’s noticed others are stocking up, too: Safeway and Walmart were nearly wiped out of bottled water and disinfectant wipes during a recent visit, both of which had been easy to find since the summer.
It’s also been harder to find a time slot to get her groceries delivered. Anderson says she’s had to wait as many as two days instead of same-day delivery. But that’s still not as bad as earlier this year
“March seems like a million years ago, but I do remember freaking out,” she said. “I couldn’t get groceries delivered for a week.”
Walmart said while supplies are stressed in some areas, it thinks it will be able to handle any stockpiling now than earlier this year. Amazon said its working with manufacturers to get items such as disinfecting wipes, paper towels and hand sanitizer in stock.