I've seen plenty of stories about being almost out of beds but I have yet to see one where anywhere in the world has run out of them and had to turn positive patients away from hospitals.
Has anyone seen stories about people being turned away?
In the United States at least The Emergency Medical Treatment and Labor Act (EMTALA) requires emergency departments to provide care to all those who present with a real emergency. From my understanding, that means if you show up at the ED with a legit COVID case, they gotta take you or the feds will go after the hospital.
They've handled it by throwing up some tents in the parking lot to handle overflow. So, they're gonna take you, but do you really want to be the COVID patient in a tent in the parking lot?
Not sure if there are similar laws in other countries?
I think “beds” is more a shorthand for overall capacity.
And some places have definitely run out of capacity. Northern Italy was very aggressively triaging patients that came in — too old? got diabetes or some other comorbidity? Never even going to see a doctor. They weren't turned away, but they were not really admitted to a hospital. They were just given somewhere to lay down and die.
The result was 50% of people admitted with COVID-19 were dying instead of the 10-15% other regions were seeing.
They stopped admitting accidents, strokes, and other life threatening conditions because they were no longer able to treat them. Those people were turned away. One ER literally just had a closed sign out front.
And that was after they’d already enlisted basically anyone with some medical training, handed them a pamphlet on airway management, and sent them to try and keep whoever they could alive, converted operating theaters into patient rooms, and done everything they could to try and increase capacity.
We’re not going to run out of things to physically lay people on. We’re going to run out of doctors, nurses, all the other infrastructure and equipment that makes a hospital room more than just a hotel room.
EDIT:
From Italy, in March:
> We’ve stopped all routine, all ORs have been converted to ITUs and they are now diverting or not treating all other emergencies like trauma or strokes. There are hundreds of pts with severe resp failure and many of them do not have access to anything above a reservoir mask.
> Patients above 65 or younger with comorbidities are not even assessed by ITU, I am not saying not tubed, I’m saying not assessed and no ITU staff attends when they arrest. Staff are working as much as they can but they are starting to get sick and are emotionally overwhelmed.
> My friends call me in tears because they see people dying in front of them and they con only offer some oxygen. Ortho and pathologists are being given a leaflet and sent to see patients on NIV.
Perhaps Arizona? I don't know if anyone was actually turned away. But I do remember reading about them instituting standards of care. Meaning doctors would have to decide which patients would be helped.
Has anyone seen stories about people being turned away?