Triage

The FDA’s formal approval of the Pfizer coronavirus vaccine will facilitate making the vaccine a requirement to participate in public life. Some schools in other parts of the country have already decided to mandate that faculty get the vaccine; some now require students to do so. Businesses will have more leverage to require it as well.

Although all Mississippians have been eligible for vaccination since March 16, fewer than half are fully vaccinated. Such foot dragging has allowed the Delta variant to run rampant through Mississippi and other states with similarly low vaccination rates. Accordingly, health care workers have been unable to offer adequate care for every person infected with Covid-19–not to mention people with injuries, or heart attacks, or strokes.

When hospitals experience shortages, whether those involve staffing or space, how should they prioritize care? Should they admit patients on a first come, first served basis? Allocate a certain percentage of their resources to pandemic patients? If so, what should those percentages look like, and will there be subcategories within that portion? At what point should they send patients to other facilities?

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9 Responses to Triage

  1. Jon Kiesel says:

    What if there were separate hospitals, a kind for general health, and another one that’s specialized in virus care? In terms of medical treatment facilities, we already do this kind of separation with dentists, optometrists, practitioners, psychologists, neurologists, and therapists, so why not with virologists? Now I could be living under a rock, but I haven’t seen as many buildings specifically for pandemic care as much as there are with the other subcategories of doctors.

  2. Kaylee Hall says:

    Hospitals should prioritize care based on space, supplies, and severe health needs. All patients are served on a first-come, first-served basis. That’s how most hospitals work. Patients arrive and their needs are attended to as fast as possible to make space for others. If there is a certain percentage for the pandemic patients, how long before it cuts into the other categories, subcategories? No matter how many levels, categories, spaces you create, there will always be a need for more. Vaccines can become mandatory, but bottom line is that there will still be COVID-19 risks. There’s still a risk after getting the vaccine. All hospitals can do is try their best with what they have and make it work. How they implement supplies and space is up to them.

  3. David Johnson says:

    I would the hospitals serve on a first come first serve basis but, if the hospitals are full then triage may be necessary, I would have them serve on the basis of maximum people saved.

  4. Nicholas Djedjos says:

    As we all are aware, the acute shortages of ICU beds, masks, ventilators, and medical personnel in the face of rising Covid-19 cases has put tremendous stress on the healthcare system in the United States. When the question ultimately changes from, ”When can we give you care?” to “Who do we give care to?” I believe the first criteria should be severity of disease. Under no circumstances, with a completely full hospital, should an optional procedure take place while other individuals are desperately waiting for a life saving procedure. To the best of my knowledge, this idea has been implemented throughout the Covid-19 pandemic already.

    In the case the Covid-19 outbreak begins to spiral out of control (full beds, patients cannot get care). Hospitals should only admit patients on a first come, first served basis if the patients have a life threatening disease and need immediate medical attention. All other procedures that can be postponed, should be postponed. With that said, saving lives in the now may result in higher chances for loss of life in later years, due to cancer and similar terminal disease screenings being postponed. Still, I’d rather save lives in the now than worry about the chance of saving lives down the road. I don’t think it will get to this point unless hospitals are heavily overwhelmed and understaffed, especially considering the high efficacy of the vaccine, though.

    As far as resource usage in a hospital, I believe preparing for the worst and hoping for the best is the best option. Hospitals should be prepared to allocate at least 30% of their existing beds (or be prepared to set up more beds) to COVID-19 patients. This allocation encompasses patients who test positive with COVID-19 and have complications. Hospitals also need to be creative with optimizing the resources they already have, such as converting single rooms to doubles when possible, training healthcare workers how to manage COVID-19 patients (to ensure healthcare workers do not bring COVID-19 home), and keeping a close inventory of crucial supplies like N95 masks to prevent shortages.Managing a large influx of COVID-19 patients isn’t just about space either: it’s about personnel. There needs to be an emergency response team of doctors, nurses, and epidemiologists ready to deal with severe COVID waves.

    I firmly believe that by at least attempting to implement these proposals, more lives will be saved.

  5. Gordon Welch says:

    First off, I feel as if hospitals should create a list of guidelines for people with Covid-19. For example, someone with minor symptoms or a low grade fever shouldn’t rush to the hospital to take up space. Next, they should base their supply on need or severity. If someone who has almost fully recovered from the Delta variant needs to give their ventilator to someone who is dying from a car crash, the hospital shouldn’t have to think twice about their decision. At all costs, hospitals could short-term hire more employees such as Nursing graduate students to help monitor and staff the hospital if it becomes over filled. Hopefully, the Pfizer vaccine being approved by the Fda gets people vaccinated and ends this crazy thing once and for all.

  6. Everett Mason, Jr says:

    I feel that hospitals should operate off on a first-come, first-served basis, but still prioritize the older generation if at all possible. It must also be understood as well that hospitals have limited supplies and space, so certain hospitals will not be able to accommodate large amounts of people at one time. In this case – especially in locations like my hometown where there is only one hospital in the county – triage might be necessary and efficient. Also, it might be useful to start designating wings or floors of hospitals to just simply virus care. Then they could designate a certain percentage of their medical supplies directly to dealing with Covid-19.

  7. Willem says:

    I believe they should continue doing first come first serve bias in hospitals. Everyone needs care and there shouldn’t be a discrimination to people who have covid to treat others first. People who are taking up emergency beds in hospitals because of covid are still in an emergency bed for a reason. If hospitals decide to split off virologists to help treat covid care only, there would still be a shortage in materials, staff, and emergency beds. Don’t let the entitlement to care ease your opinion of getting the vaccine though. Getting the vaccine won’t just have the opportunity to save your life and others through reducing covid, but reduce the chance of taking up the time, materials, and space in a hospital.

  8. Hong Zheng says:

    When in strict demands, hospitals should prioritize whichever case is most severe. For example, a ten-year-old with slight coughing should not be prioritized over a sick seventy-year-old with a fever. You could also switch that and say that an elder with a slight cough should not receive treatment first when a ten-year-old with a fever is rushed in. I think the idea of first come first serve is fair but can be unjust in some situations. For example, if two pandemic patients, both with severe symptoms came in, I think it’s only logical that the person who arrived first should receive treatment first. On the other hand, if a patient with little to no discomfort arrives before another patient in severe distress, the second patient should receive help first. I do not think distributing a certain percentage of resources to pandemic patients is necessary. Every patient’s health should be guaranteed with whatever is left. When resources do eventually deplete, patients should be sent to another facility.

  9. Aaron Sharp says:

    In a perfect world, we could prioritize the vaccinated in hospitals. The thought process behind this is; if the anti-vaxxers aren’t going to do everything they can to prevent getting the virus, then why should our at-risk healthcare workers do so? But, considering the country we actually live in, the course of action would probably be first come first serve. The severity of the case at hand should determine how long they stay in the hospital, but the best that we could hope for is first come first serve. I do, however, see the vaccine being mandatory in the future just like the flu shot is now. It is a necessary precaution to take in order to function in society.

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