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ICU/Ventilators nearing capacity as tidal wave of cases peaks

Louisiana’s COVID-19 case count soared by nearly 2,000 Monday as an avalanche of test results flooded in. The state posted 1,857 new cases and 35 more deaths since Sunday. The trajectory of Louisiana’s death count appears to have leveled off, now at 512 reported deaths Monday, but, “It’s going to be the hardest, saddest week for Americans,” warns U.S. Surgeon General Dr. Jerome Adams, citing total American deaths to top 10,000 this week. Louisiana continues to lead in per capita death rate with St. John the Baptist Parish at nearly 30 per 100,000 residents. Orleans Parish has 25. The death rate in New York, by comparison, is 21. Put another way, sparsely-populated St. John Parish has three deaths for every two in America’s most densely populated county with 123,000 cases. This weekend, Louisiana matched New York with a 17 percent increase in deaths.

That number is likely to rise as hundreds more test results push Louisiana patients to flood hospitals. Most of the state’s ICU bed space and ventilators are now approaching 75 percent capacity before what’s estimated to be a surge in cases this week. Monday, East Baton Rouge Coroner Dr. Beau Clark announced 27 Baton Rouge residents have died of COVID-19 including a 1-day-old infant whose mother tested positive for the virus. Ouachita Parish still posts one death out of 230 confirmed cases of the virus. Tensas remains the only parish in north Louisiana with no confirmed cases. The other is Cameron Parish south of Lake Charles. Overall, Louisiana averages 10 deaths per 100,000.

But medical officials say equipment and staffing are at chokepoints. They estimate 70,000 full-service ventilators are in service in the entire United States with about another 100,000 of lesser capacity used in milder respiratory cases. The American Hospital Association estimates that if Coronavirus patients inundate medical facilities in the next two weeks, as many as 900,000 patients could need ventilators at once. Ford and General Motors are slowing car assemblies to manufacture 60,000 ventilators but that could take another month or more. Each ventilator contains 700 parts supplied by more than 100 vendors.

Staffing is approaching crisis levels as well. The country has one million physicians and 3.8 million nurses. Many recently-retired physicians and nurses are on call but New York Mayor Bill DeBlasio last week pleaded that the federal government should institute a draft of doctors and rush them to his city. “We need 45,000 healthcare workers right now,” he said. But every state is in critical condition. “As much as I love New York,” responded Louisiana Governor John Bel Edwards, “we need our doctors and nurses to stay here for the not-too-distant surge.”

Former Chief Medical Officer of Baton Rouge’s 1,000-bed Our Lady of the Lake Medical Center, 80-year-old retired Dr. Ron Radzikowski, says drafting retired physicians won’t be easy. First, most retired doctors and nurses fall into more vulnerable age groups but, “I’m not afraid of dying,” Radzikowski says. “My certification lapsed years ago and I wouldn’t begin to know current procedures, medicine or dosages, and the last thing a chronically sick person wants is somebody training on them.”

Assisted living and nursing homes have become epicenters, too, with clusters of COVID patients reported at 61 elder-care facilities with 60 deaths. Most are in the New Orleans area. In northeast Louisiana where fewer Coronavirus cases have been reported, East and West Carroll parishes report only one case each and no deaths. Holly Smith Madden, assistant director of nursing at Shady Lake Nursing Home in Lake Providence, which currently has no COVID patients, says they’re protecting their residents but can’t ward off the psychological toll. By not allowing family members to visit loved ones, her staff is faced with dramatically increased patient depression. “Our biggest struggle is keeping them entertained and upbeat because many don’t understand why their family has stopped coming. You can’t imagine how lonely they are. We have to put on silly suits and try to keep them laughing,” Madden says. “Now, CDC has ordered us to isolate all residents in their rooms, make patients wear homemade masks and staffers must now wear surgical masks that they must keep locked in their lockers.” Madden says the 22-facility network for which she works is speeding up recruitment of medical workers from vocational-technical schools. “Also, every time medical staff starts their shifts,” Madden says, “we take their temperatures and each day they fill out a survey of whether they’ve been in any other facilities where COVID-19 cases have been reported. But depression is absolutely our biggest problem. It’s heartbreaking.”

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