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Is U.S. health system ready for COVID-19 surge? These experts say no

New analysis by Harvard University researchers indicates that hospital capacity in many parts of the U.S. will be overwhelmed as the novel coronavirus continues to spread. Now, health care systems are working to increase their readiness. Jeremy Konyndyk of the Center for Global Development and Dr. Bruce Siegel of America’s Essential Hospitals join Amna Nawaz to discuss how facilities can prepare.

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  • Judy Woodruff:

    A new analysis by researchers at Harvard University shows that the bed capacity of hospitals in many parts of the U.S. will be overwhelmed if the COVID-19 coronavirus continues to spread across the country.

    And, as Amna Nawaz reports, hospitals and health care systems are working to increase their readiness.

  • Amna Nawaz:

    Judy, the Harvard study indicates that, when spread over a 12-month period, even a moderate number of coronavirus cases will begin to fill some American hospitals to capacity, unless they free up already occupied beds.

    The faster the pace of infection, and the larger the numbers grow, the greater the shortfalls become.

    For what hospitals are doing to prepare themselves and what more needs to be done, I'm joined by two people who focus closely on preparedness.

    Jeremy Konyndyk is a senior policy fellow at the Center for Global Development whose research focuses on global outbreak preparedness, among other things. He joins us by Skype. And here in the studio, Dr. Bruce Siegel. He's the president and CEO of America's Essential Hospitals. That's an association of more than 300 hospitals and health care systems.

    And welcome to you both.

    Dr. Siegel, I want to start with you here. We know there will be a surge of patients. We know that's coming.

    You told my colleague earlier, our hospitals are moving quickly to prepare for that. What specifically are they doing right now? And are you confident they will be ready?

  • Bruce Siegel:

    So, the good news is that millions of health professionals in our hospitals are working hard to prepare.

    They are clearing out some of the elective surgery cases, things that don't have to be done right now, to get that space ready for a surge in patients.

    They are expanding their capacity, you know, bringing beds and floors back into use that were maybe not used, building tents for triage centers and testing in their parking lots to keep sick patients away from the rest of their patient population. There's a lot going on.

  • Amna Nawaz:

    How confident are you they are going to be ready to meet with the expected surge?

  • Bruce Siegel:

    I think that they will do a good job of meeting that surge.

    I think they will do a good job of meeting that surge. I think if we, as citizens, also try to make sure that surge as small as possible by distancing ourselves from each other, as we're doing right now, that will help a huge amount.

    My concern will be, will they have the resources for a sustained response? And that's going to be something that Congress is going to have to really think hard about and act on in the days ahead.

  • Amna Nawaz:

    Jeremy Konyndyk, let me ask you about this.

    Some people will look at the maps on this. And it's very alarming when you see how much of the country and how many of our hospitals could become overwhelmed. Those darker red portions, by the way, represent over 1000 percent capacity for some of those hospitals. And that's in a moderate scenario.

    Tell me how you're looking at this. Do you believe the health care system and the hospitals can get to the capacity they need to handle even a moderate surge?

  • Jeremy Konyndyk:

    I think it's going to be an enormous struggle.

    And it's complicated by the fact that we have already lost quite a bit of time. We should have begun the process of this as soon as we saw what was happening in Wuhan, China, in mid-January, the way that hospitals and modern hospitals there were overwhelmed very rapidly by this virus.

    We're going to face struggles with PPE. We're going to face struggles with health care workers becoming infected. We have lost a lot of time. I think there are measures that we can begin to take. Some of the things that the president announced today are positive.

    It would have been better if they'd been announced a month ago. So we're just kind of in catchup mode still.

  • Amna Nawaz:

    What did you hear today that was positive?

  • Jeremy Konyndyk:

    Well, I think the Defense Production Act, I think the moving of the hospital ships, all of those things help somewhat to relieve the pressure.

    But they're also — it's going to take a while. We learned after the announcement that one of the hospital ships won't be ready to leave port for a few more weeks. Obviously, Defense Production Act work, if you start telling a company now to start manufacturing ventilators or N95 masks, that's not going to show up in the supply chain for weeks or months.

  • Amna Nawaz:

    Dr. Siegel, the PPE that Jeremy mentioned — that is personal protective equipment — that is what your front-line health care workers need…

  • Bruce Siegel:

    Absolutely.

  • Amna Nawaz:

    … to be able to protect themselves when they're handling those patients.

  • Bruce Siegel:

    Yes.

  • Amna Nawaz:

    Are you close to having what you need? And how dependent are you on the federal government to get that supply?

  • Bruce Siegel:

    So, we are not close to having what we need.

    We're already seeing some spot shortages in some areas. And that could get worse, a lot worse, as the surge materializes. We are very dependent on the federal government for making this happen.

    And I'm glad that there are things happening now to start to get manufacturing up and to sort of divert resources to this sector. But my biggest concern is that we have stressed safety net hospitals in this country, stressed rural hospitals with maybe a week of cash on hand.

    As they lose their paying business, as they see a spike in uninsured patients coming in, as they have to spend millions and millions on treating sick coronavirus patients, they're going to run out of resources. They will literally could run out of money.

    And we're going to need Congress to make sure that we have that backstop to be there for these communities, given how sobering this is going to be.

  • Amna Nawaz:

    The other thing people hear a lot about are ventilators and the need for critical care in severe cases. Do you have the ventilators you need? Are you confident you will get the supply that you need?

  • Bruce Siegel:

    We are — we are working as hard as we can to make it happen. We need the government to step in. Are we sure we will have what we need? No, we're not. Let's be very clear about that.

    And I'm glad that we're preparing and moving all the things we need to in place, like the hospital ship. So, that's going to take longer than we expected. But we still have a long ways to go. And the decisions we make in the next few days around resources, around the stimulus bill are going to be absolutely critical, so we can really do this for the long haul, because this may go on longer than some of us would ever, ever like.

  • Amna Nawaz:

    Jeremy, you mentioned that Defense Production Act the president put into place today.

    To what degree do you think that will fill this gap Dr. Siegel is saying that we know we have right now? And what other levers of the federal government could we be pulling and using right now, if needed?

  • Jeremy Konyndyk:

    Yes.

    I think the Defense Production Act will — it basically forces companies to manufacture certain things. I think the companies would probably be inclined to manufacture those things anyway, if it keeps the factories running and if there's money behind it.

    So I think it's a helpful tool. It probably isn't a total game-changer.

    One of the things I'm still hearing about from a lot of the doctors I talk to in New York City and in Northern California is lack of testing. They are still struggling to get the testing that they need, both for their patients, but also for themselves. If they are exposed, it's quite important they be able to get a test quickly to determine whether they're infected or not, because, if they're infected, they have to go into quarantine.

    If they're not, they can stay at work. Right now, if you can't tell, you have to take the precaution, and you lose them from the work force.

  • Amna Nawaz:

    Jeremy, when you see the president speaking now, you see a number of different officials from different agencies working together and working behind him.

    Are you confident that every single element, every single resource at the government's disposal, is being used right now? Or are there other steps they could be taking right now?

  • Jeremy Konyndyk:

    I'm not confident. And I think that that — I think they have made some headway, but they're still not where they need to be.

    We were in a sort of inactive mode for about the first month-and-a-half of this, where we were really not moving out in an expeditious way on preparing the homeland for the arrival of this virus. I think we have now moved into reactive mode, but we're still not in proactive mode.

    So, yes, they're starting to get some things in motion, but they're still playing catchup. And I think it's hard to have confidence in the overall management of this, given what we have seen so far. But I hope it will…

  • Amna Nawaz:

    Dr. Siegel, when we see some of the projections, obviously, as Jeremy said, there's a lot we don't know.

  • Bruce Siegel:

    Right.

  • Amna Nawaz:

    We don't know how long it will take. We don't know when the surges will happen, when those viruses will peak.

    How do hospitals prepare for this? Do they go for the worst-case scenario? Or do they hope for a mild outbreak?

  • Bruce Siegel:

    Oh, you have to think about the worst-case scenario.

    So our hospitals are really thinking about, how bad could this get, and realizing that make a bed in one community now, and maybe it'll get worse in another community some weeks later. But they have to be prepared for the worst, or at least do their best to get to that point.

    We can't be optimistic or — hope is not a policy here. We have got to really — and I'm confident they are — our hospital leaders and nurses and doctors prepare for how bad this could be, even though we hope to avoid it by doing the things we're trying to do right now.

  • Amna Nawaz:

    We all hope those plans will come together.

    Dr. Bruce Siegel and Jeremy Konyndyk, thank you very much for your time.

  • Bruce Siegel:

    Thank you.

  • Jeremy Konyndyk:

    Pleasure.

  • Judy Woodruff:

    And please join us tomorrow, when we are hosting a virtual town hall, "Confronting Coronavirus," at 8:00 p.m. Eastern, 7:00 Central, on all PBS stations and streaming on the PBS app and on the "PBS NewsHour" social channels, including YouTube, Facebook and Twitter.

    Please watch to hear some of your questions answered by people who are on the front lines of the crisis.

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