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Brexit may have begun but it is not over, indeed it may never be finished.

Hospitals in several states are full, and hospitals in other states are filling with the overflow


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When talking about how full hospitals and ICUs are, it’s always slightly deceptive. All those stories about how both rural hospitals have been closed and older urban facilities converted into either apartments or senior living facilities? That was done by the conglomerates that increasingly run the hospitals for a specific purpose: to make sure that there were just enough beds to fit the patient load. After all, an empty hospital bed can’t be billed … though somewhere, somehow, they’re bound to be working on it.

The result is that about 60% of hospital beds—closer to 75% in some regions—were full, on average, before anyone in the United States ever heard the name “Wuhan.” If they could only get the population of walking cash-generation units to have their auto accidents and kidney stones on a nice, consistent schedule, that number would be something like 90% all the time. It’s a health care system designed to maximize profit, whether or not that happens to correlate with having somewhere to park a human being when that human being needs critical care.

It is not a system designed to deal with a crisis in which tens of thousands of people need hospital care for a single disease every day. It’s especially not a system designed to deal with such a crisis for months on end. It’s not built for it. It’s not staffed for it. It’s not supplied for it.

Still ... here we are. And, in a headline that seems all too damn familiar, The New York Times is reporting that a quarter of all the ICUs in the nation are on the brink of simply being unable to deal with one more patient. That’s especially true across the south. In Alabama, for example, for the second week in a row, it’s very easy to describe how many open beds there are for patients in desperate need of care: None. There are none.

Alabama has not a single open ICU bed in the whole state. That means that dozens, if not hundreds of patients have already been shuffled out of state when possible, or had to make do with a lower standard of care than their condition deserved.

And these aren’t just COVID-19 patients. These are heart patients. Cancer patients. Critical prenatal and post-natal cases. There are people in Alabama who did everything absolutely right, took every possible precaution, and who now find themselves at risk of dying because every bed in the ICU is filled with someone whose lungs are full of 100% “I’ll just take hydroxychloroquine/ivermectin/[insert quick fix here] if they tell me I have COVID, which isn’t real to begin with.” There are breakthrough cases of COVID that are not getting attention, because people who never got vaccinated simply got sicker faster.

Alabama is not alone. Across Texas, 169 counties have only a handful of beds to spare. Fifty-three are simply full. That includes overflow tents built in the parking lot of Houston hospitals. What happens with those overflow tents as Hurricane Nicholas brings heavy rain and strong winds to the state is unclear, but it’s not good. Florida, naturally, is heavily dotted with hospitals at or near capacity, with 24 facilities reporting having more ICU patients than ICU beds.

But the problem is not just in the South. As The New York Times reported on Monday, anti-mask and anti-vaccine policies are generating full hospitals everywhere they occur. In the peak that hit near the end of 2020, that meant patients from South Dakota were being exported to hospitals in other states. Now it’s Idaho’s turn. The combination of a vaccine-resistant Republican population and miserable Republican governance is turning into a problem … for Washington State.

Surgeries to remove brain tumors have been postponed. Patients are backed up in the emergency room. Nurses are working brutal shifts. But at Providence Sacred Heart Medical Center in Spokane, Wash., the calls keep coming: Can Idaho send another patient across the border?

Idaho has a vaccination rate of just 40%. That’s one of the lowest in the nation. Lower than Florida. Lower than Texas. Lower even that Mississippi. The rate of new cases in Idaho is still going up rapidly.

Washington State has a vaccination rate of 61.3%, making it the sixth-most vaccinated state. Throughout the pandemic, it has managed to keep its rate of cases so low despite being one of the first states hit by the virus that it’s now No. 46 out of 50 in terms of cases per capita. While the vaccination rate in Washington State isn’t enough to prevent the community spread of COVID-19, it’s definitely enough to reduce the rate of spread and should mean that Washington’s hospitals are able to both deal with its own current surge of cases and still tend to people who have something other than COVID-19. Only they can’t. Because Idaho keeps begging them to take more, and the alternative is often literally allowing those patients to die. So Washington State takes them, and local citizens suffer.

What’s happening along the Washington/Idaho border isn’t just an example of how the lies and conspiracy theories passed around the right-wing media have led almost 40% of Republicans to turn down a lifesaving vaccine; it’s also a story that goes right back to that first paragraph of this article: how hospitals in the area were never designed or staffed to deal with any sort of prolonged crisis. Somewhere over the last 10 years, some hospital consultant in Idaho has almost certainly received a lot of pats on the back, and a hefty bonus, for how many times he’s said “lean” or “six sigma.” For how well they all cut that margin of empty beds to the bone. On that front, Washington State is no better. Both states are near the bottom of the charts when it comes to hospital beds per capita, with <2 beds available for every 1,000 residents.

Both states had essentially zero spare capacity in their health care systems. Idaho just added Republican leadership to that mix.

When the map is full of hospitals at 95% capacity, it’s easy to assume that these are facilities are close to crisis, but not actually in crisis. For the patients, that’s not true. Patients suffering from heart attacks or cancer have worse outcomes when the hospitals are merely crowded rather than full. That’s true for COVID-19 patients as well. The staff of the hospital doesn’t scale up or down as the number of occupied beds changes. When those beds fill up, those same people only have to take care of more people, giving less time and attention to every patient.

And, as CNN reports, some of those hospitals are about to face a declining number of people to help with a rising number of patients.

A Covid-19 surge in Kentucky has led to so many patients at St. Claire Regional Medical Center that the workers are unsure how they'll handle the growing numbers when a medical team sent by the federal government leaves Friday.

Gov. Andy Beshear has deployed 400 National Guard troops who will be deployed across 25 hospitals, but that number is dwarfed by the number of COVID-19 patients. St. Claire Regional is currently operating at 130% capacity.

Even with no more room for beds, and the deployment of a federal emergency team about to end, the hospital’s chief medical officer swore they were not going to turn anyone away.

"We're gonna have to... don't know what we're going to do.”