View from the ICU

摘要

"WE AS PHYSICIANS struggle to con-ceive of the idea of exponential growth," says Dan Runde, of the emergency medicine department at University of Iowa Hospitals and Clinics, in Iowa City. "There's so short a window. You go from barely handling things, to not at all. It's so fast." He recalls how Iowa had some 700 patients in hospital infected with covid-19 at the start of November. A few weeks later, he says, that tally had doubled. At times almost every ICU bed is filled. His hospital, like others, tried preparing for such a surge. In-patients, where possible, were sent home; a dozen new ICU beds were added; some elective surgeries were postponed. Then staff watched in alarm as nearly one in every two covid-19 tests run in Iowa turned out positive, foretelling a surge in hospitalisation-and deaths. His hospital, the state's best-equipped, takes in patients from far and wide when others can't cope. That already means an "aggressive triage process". "We're already getting to the line to be full. We have to start saying no. If you're not going to die in the next six to 12 hours, then you have to wait," he says.