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With the number of COVID cases and hospitalizations surging in many parts of the country, health care systems and their staff are becoming further strained, including many areas in Arizona. In Phoenix, six hospitals are now diverting incoming emergency patients to other facilities. Dr. Quinn Snyder, an emergency physician in Mesa, Arizona, joins Amna Nawaz to discuss his view from the frontline.
With the number of COVID cases and hospitalizations surging in many parts of the country, health care systems and their staff are becoming further strained.
In Los Angeles, paramedics are declining to take less-than-critically-ill patients to hospitals. And, in Phoenix, six area hospitals are diverting incoming emergency patients to other facilities.
Dr. Quinn Snyder is an emergency physician in Mesa, Arizona. He has been experiencing the surge first-hand, and he joins me now.
Dr. Snyder, welcome to the "NewsHour," and thanks for making the time.
I want to start with that surge we're hearing so much about. What does it look like, what does it feel like inside the hospitals right now?
It feels overwhelming, truthfully. We're literally watching the health care system overflow as we speak.
The kinds of things we're seeing, our ICU nurses are being stretched to the limit. They're having three or even four patients per nurse. The industry standard is usually 2-1. And to be at 3-1 or 4-1 represents just how catastrophic things have come.
Also, physicians like myself are starting to work well outside their scope of practice. I have personally been working in an ICU intubating patients and helping to do procedures, as well as helping in code patients who are, frankly, potentially in the process of dying.
These kinds of things, I haven't — I haven't worked in ICU in over 10 years, since I was a resident. And this is just the tip of the iceberg. There are many emergency departments, many hospitals throughout the state which are clearly running out of space. Transfers are locking up everywhere. You can't transfer people very easily from one hospital to another.
And, frankly, it's just becoming more and more clear that we're starting to run out of space. And it's already been several days, if not weeks even, since we have run out of adequate qualified staff to take care of our patient populations.
When you look at a place like Los Angeles that has a lot of attention right now because they're making decisions about rationing care, right, they're laying out decision trees about who gets limited resources, are you worried it's going to get that bad where you are?
I am worried that we could be in a similar situation here in Arizona.
So, in Arizona, we have these crisis standards of care which have been implemented for several months now. However, we haven't taken that final step to engage in triage protocols, where we literally have to ration care, where we have to decide who gets care and who doesn't.
And that's a statewide decision. That will be a decision that is agreed upon between all the hospitals and all the hospital systems within the state. So, we're not quite there yet. But there are many people out there who are very worried that we could get there very soon.
So, California has extended their stay-at-home orders to try to address that spike, right?
What's being done in Arizona? What do you see outside the hospital?
Unfortunately, we're not engaging in the kind of behaviors that we need to get the pandemic under control. And the truth is, in July, our governor stepped in and created new restrictions, which included restrictions on indoor dining and bars in particular, which helped bring our spike under control.
However, unfortunately, we haven't had any of these restrictions put back into place, even though our hospital systems are now overflowing well beyond where they were in that peak in July. We have almost 30 percent — we're at about 130 percent — excuse me — of where we were in July with our COVID inpatient hospitalizations.
We're at about 110 percent of our inpatient ICU admissions. And it can be very frustrating to head out for a night shift on a Friday or Saturday night and be going by many bars or restaurants in my community, seeing people out and about. Places are packed everywhere.
And to reconcile that part of my life with what's going on in the emergency departments and within the hospital systems at large here in our state is impossible for us, as health care workers.
Dr. Snyder, what about the vaccine rollout? I understand you have received the vaccine so far. How is it going? Is it getting where it needs to go right now?
Oh, that's a great question.
Yes, I did get the vaccine. I had very minimal side effects. I'm extremely grateful to Pfizer and Moderna and the other companies who have helped put out these wonderful vaccines for us.
But the rollout here has been pretty choppy, frankly, in Maricopa County. It's obvious that there were some issues at the beginning, when they started collecting information from people as to who would be eligible for the vaccine and who would not.
And, frankly, I know certain nurses, respiratory therapists and providers who are still waiting to get their vaccine, even though they are working on the front lines. Meanwhile, there are other people who rarely, if ever see COVID patients, who have direct contact with COVID patients, who have already gotten their vaccinations.
And I think, in the end, what this merely shows is that, in this phase, where it was supposed to be relatively easy to determine who needed the vaccine and who didn't, and the fact that it's been distributed inequitably, I think, only is informative such that I believe, in the months ahead, future vaccine rollouts, the tiers that come after this are going to be very challenging, very unequal, and potentially, at times, even corrupt.
Dr. Quinn Snyder in Mesa, Arizona, with a sobering front-line view of what they're facing there in the pandemic.
Dr. Snyder, thank you for your time. And we wish you luck and good health ahead.
Thanks so much, Amna.
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