Across the country, this scenario will continue to play out. Some cities will burst into hotspots while others nearby will wait at best. To save lives, we must all share the burden. The federal government must lead the way by asking hospitals to report open beds and by calling on the US military, with its fleet of trucks and helicopters, to help transfer patients.
To be clear, sending equipment and staff to hospitals in crisis is vitally important. It will be so. But by complementing these efforts with the transfer of patients between hospitals, patient demand and the supply of health care will be better adapted. To save lives, it is better to have more hospitals operating at full capacity than a few supporting the largest. Shouldn’t we mobilize existing capacity in places like Johns Hopkins Hospital – which is already staffed and equipped for this type of care – before relying on makeshift hospitals in places like the Javits Center?
Of course, transferring a sick patient requires thoughtful and deliberate planning. If the patient is critically ill, the challenge is even greater, often requiring transportation by helicopter and paramedics. Efforts could begin with coronavirus-negative patients – such as people with acute or chronic heart failure or drug overdoses – while the difficult task of transferring contagious patients is better coordinated. Once these patients have been transferred, I.C.U. beds should be opened for patients with coronavirus.
For the transfers to significantly complement the local response, they would need to be large – perhaps in thousands of patients. They can occur by land or air, since most large hospitals have a helipad.
It may seem difficult to keep Covid-19 patients away from family and friends. But many hospitals have already closed their doors to visitors, so that communication between patients and their loved ones is now done by phone or the Internet.
Some would say that hospitals should manage transfers between them. However, as hospitals crouch, it is unlikely that they will offer their beds. After all, they have their own patients, employees, public image and bottom line to manage. Naturally, the well-being of patients in other hospitals is not their primary concern. These incentives and realities require government leadership, and when transfers cross states, federal action will be required.
Others will say that doing this on a large scale is dangerous and prohibitively expensive. But these critics, like those of 1948, underestimate our potential. Our country’s armed forces have the necessary combination of expertise, resources and authority to oversee and carry out transfers. And let’s not forget that the federal leadership in moving patients in times of crisis is not without precedent. When Hurricane Katrina hit New Orleans in 2005, thousands of patients were flown from flooded areas to nearby facilities. The error was then a delay in action. We must learn from this error.
If we are to succeed, Mr. Trump must lead like Truman, New York must become our new Berlin, and the airlift must be ordered immediately. If we do it, again, countless lives will be saved. And an inspired world.
Michael Rose is a medical resident in internal medicine and pediatrics at Johns Hopkins Hospital in Baltimore. Sumit Agarwal is an internist at Brigham and Women’s Hospital and Harvard Medical School in Boston.
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