WHO WILL DOCTORS SAVE?
AS THE TOLL OF THE CORONAVIRUS pandemic rises, Americans confront with increasing distress the idea of rationing health care. Choosing to deny care to people in desperate need is anathema; it feels unAmerican, even. But it happens all the time: when Congress allocates money for Medicare and Medicaid; when insurance companies reject claims; when the Trump administration decides to shut down the Federal marketplace for the Affordable Care Act.
Rationing is also what happens when governments whittle down their budgets for preparing for deadly pandemics, as they did over the last decade. That goes some way to explaining why the U.S. now has the steepest trajectory of COVID-19 cases of any nation so far, including China and Italy, and is experiencing a critical-care crisis in hospitals across the land. As the first wave of the SARS-CoV-2 outbreak begins to crest over the nation during April and early May, it is sending patients in respiratory distress to hospitals en masse, where many of them may die for lack of treatment.
The problem is how to keep these patients alive long enough for their immune systems to ward off the disease. That too-often requires intubating them with a breathing tube attached to a ventilator, which pumps oxygen into the lungs in rhythm with a patient’s natural breathing, for as long as two weeks. As intensive care wards fill up with patients needing ventilators, hospitals expect to see a shortfall. U.S. hospitals have about 160,000 ventilators, according to an analysis in the New England Journal of Medicine, plus another 8,900 in the Strategic National Stockpile. COVID-19 will hospitalize 2.4 million to 21 million people in the U.S., 10 to 25 percent of
