美國醫(yī)院準(zhǔn)備迎接新冠病毒浪潮

美國醫(yī)院準(zhǔn)備迎接新冠病毒浪潮

As the coronavirus spreads in the U.S., public health agencies are starting to worry about hospital capacity.

隨著冠狀病毒在美國傳播，公共衛(wèi)生機構(gòu)開始擔(dān)心醫(yī)院的容量。

Overseas, China was forced to build two new hospitals on an emergency basis, and in South Korea earlier this week, the government said over two thousand people were waiting for hospital care.

在海外，中國被迫在緊急情況下新建兩所醫(yī)院。在韓國，政府電視臺本周早些時候說，有超過2000人在等待醫(yī)院治療。

The potential numbers in the U.S. are daunting. Richard Waldhorn is a pulmonary critical care physician who's studied hospital preparedness for the Johns Hopkins Center for Health Security. Last week, he co-wrote an article arguing that American hospitals should prepare for the possibility of too many patients.

美國的潛在數(shù)字令人生畏。理查德·瓦爾德霍恩是一名肺部危重癥護理醫(yī)師，他曾為約翰·霍普金斯衛(wèi)生安全中心研究醫(yī)院準(zhǔn)備工作。上周，他與人合寫了一篇文章，主張美國的醫(yī)院應(yīng)該為可能出現(xiàn)的病人過多做好準(zhǔn)備。

"The arithmetic suggests that we will outstrip hospital resources, particularly instensive care resources, in waves as the pandemic spreads," he says.

他說：“計算結(jié)果表明，隨著大流行的蔓延，我們將以一波又一波的速度超過醫(yī)院資源，特別是醫(yī)療資源。”。

He says government planning assumptions based on past flu pandemics suggest a surge in demand for intensive care that could range somewhere between 200.000 thousand and 2.9 million patients.

他說，政府根據(jù)以往流感大流行做出的規(guī)劃假設(shè)表明，對重癥監(jiān)護的需求可能會激增，可能在20萬到290萬病人之間。

The American Hospital Association says the total number of Intensive Care Unit beds is about 65.000.

美國醫(yī)院協(xié)會表示，重癥監(jiān)護病房的床位總數(shù)約為6.5萬張。

Waldhorn says hospitals can make more ICU beds available in a crisis, perhaps doubling the capacity, but there's still a chance it won't be enough.

瓦爾德霍恩說，醫(yī)院可以在緊急情況下提供更多的重癥監(jiān)護病房床位，可能會使床位增加一倍，但仍有可能不夠用。

"We're going to have to face the problem of how do we allocate limited health care resources in some sort of rational and ethical and organized way with the goal of doing the greatest good for the greatest number," he says.

他說：“我們將不得不面對這樣一個問題：我們?nèi)绾我阅撤N理性、道德和有組織的方式分配有限的醫(yī)療資源，以期為最大數(shù)量的人做出最大的貢獻。”。

He gives the example of "extracorporeal membrane oxygenation," a technique for oxygenating blood outside the body, in cases of respiratory failure. Chinese doctors reported some success using the procedure to keep COVID-19 patients alive, but it's not something that could be easily provided to hundreds or thousands of patients.

他舉了“體外膜肺氧合”的例子，這是一種在呼吸衰竭的情況下，在體外對血液氧合的技術(shù)。中國醫(yī)生報告說，使用這種方法維持COVID-19患者的生命取得了一些成功，但這并不是一種可以輕易提供給成百上千患者的方法。

In Washington State, things have not yet reached the stage of tough choices.

在華盛頓州，事情還沒有發(fā)展到艱難抉擇的階段。

EvergreenHealth hospital in Kirkland identified the country's first fatal case of COVID-19 last Friday, and since then it's borne the brunt of the most serious cases — and most of the country's deaths. Many stem from the outbreak at the nearby Life Care nursing facility.

基爾克蘭的常青健康醫(yī)院上周五發(fā)現(xiàn)了該國首例COVID-19致命病例，自那以后，它承受著最嚴(yán)重的病例的爆發(fā)，以及該國大部分死亡病例。很多是由附近的生命護理機構(gòu)爆發(fā)的。

One week later, the hospital has made plans to house even more of the patients, by taking steps such as converting more sections of its buildings into "negative pressure wards," in which HVAC systems keep germs from spreading. Still, they're feeling the strain.

一周后，醫(yī)院已經(jīng)制定了為更多病人提供住處的計劃，采取了一些措施，比如將更多的建筑改造成“負壓病房”，在這里，暖通空調(diào)系統(tǒng)可以防止細菌傳播。盡管如此，他們還是感到了壓力。

"Right now I know for certain, we have one critical care bed left," the CEO, Jeff Tomlin, said on Thursday night. "We're right now already talking to the other facilities to see what their capacity is."

該公司首席執(zhí)行官杰夫•湯姆林周四晚表示:“現(xiàn)在我可以肯定，我們還剩下一張重癥監(jiān)護床。”“我們現(xiàn)在已經(jīng)在與其他設(shè)施進行談判，看看它們的容量是多少。”