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US 'The threat is real': Miami hospital flooded with critical COVID patients

03:25  04 july  2020
03:25  04 july  2020 Source:   abcnews.go.com

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At Miami -Dade hospitals , what started as a slow but steady rise of COVID patients arriving two weeks after Memorial Day intensified over the last Daequan Wimberly, of Miami , died at Jackson Memorial Hospital on June 30 of COVID -19 pneumonia, according to the Miami -Dade Medical Examiner’s Office.

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Krystal Spaulding is almost out of breath as she sprints from one critically ill patient to another at Jackson Memorial Hospital in Miami. Coronavirus cases are increasing at an alarming rate and the hospital is seeing more and more patients every day, the nurse said.

a person standing on a chair: People wearing protective masks are seen outside Jackson Memorial Hospital, as Miami-Dade County eases some of the lockdown measures put in place during the coronavirus disease outbreak, in Miami, June 18, 2020. © Marco Bello/Reuters People wearing protective masks are seen outside Jackson Memorial Hospital, as Miami-Dade County eases some of the lockdown measures put in place during the coronavirus disease outbreak, in Miami, June 18, 2020.

"There's just a lot of running around with this current wave of [COVID-19] that we're experiencing here in Miami," Spaulding told ABC News. "The patients seem to be way more critical than the first wave."

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Its hospitals are now bracing for an onslaught of patients , setting up temporary wards and hoping advances South Africa's health minister, Dr. Zwelini Mkhize, issued a sobering warning recently about an expected flood of cases, especially Gauteng hospitals already have 3,000 COVID -19 patients

" The threat Covid -19 poses to our community right now is higher than it has been. 'We are having an explosion of Covid '. Some local officials and public health administrators are already reporting " That 's really our major concern," he told CNN, adding the hospitalized patients they're receiving on

Florida reported over 10,000 new coronavirus cases on Wednesday, the biggest one-day increase in the state since the pandemic started.

As the state continues to shatter records for coronavirus cases amid the reopening of the economy, hospitals in Florida -- like Jackson Memorial -- are seeing a rise in hospitalizations. And as a safety net hospital, it is seeing more minority populations being infected with COVID.

The state has seen an explosion of coronavirus cases since reopening the economy and Gov. Ron DeSantis, a Republican, has faced significant criticism for his handling of the pandemic since the outbreak began.

During the month of May, as Florida slowly began to reopen with restaurants and retailers allowed to operate with limited capacity, the state saw increases larger than 1,000 in a single day three times.

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At Brookdale University Hospital Medical Center in New York, the ICU is at capacity, patient beds line the hallways of the emergency department, and the morgue is overflowing.

As cases of COVID -19 increase across the state, Florida hospitals are bracing for a spike in patients that experts project will leave them scrambling for Although the outbreak is currently concentrated in Broward and Miami -Dade County, the greatest threat to hospital resources could be in different areas.

In June, after the majority of the state was in phase 2 of reopening, infections rose by 168% with over 95,000 new cases. The percentage of tests coming back positive has grown to 15% from 4% at the end of May. Miami-Dade County alone reported 2,046 new cases on Friday and a positivity rate of 20.8%.

a group of people standing around a bag of luggage: People wait for a health assessment check-in before entering Jackson Memorial Hospital, as Miami-Dade County eases some of the lockdown measures put in place during the coronavirus disease outbreak, in Miami, June 18, 2020. © Marco Bello/Reuters People wait for a health assessment check-in before entering Jackson Memorial Hospital, as Miami-Dade County eases some of the lockdown measures put in place during the coronavirus disease outbreak, in Miami, June 18, 2020.

Carlos Migoya, Jackson Memorial's CEO, said the "warning signs" came around June as people started changing their behaviors.

"What happened is that when somebody has been at home for six weeks, they get tired and they get really stir crazy," said Migoya. "So they're out in the streets. People are fighting the use of masks, social distancing and wanting to really get together."

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Many counties and cities across the state have now been forced to roll back reopening plans and implement stricter facial covering requirements following the record-setting pace of COVID-19 cases.

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Dr. Lilian Abbo, the head of infection prevention at the hospital, said people have not learned to follow the guidelines necessary to protect themselves and others.

"As a society, we have not learned enough from our mistakes, and we're making the same mistakes, which is causing this resurgence of cases," Abbo told ABC News. "I think it's human behavior. It is a false sense of security of 'this is not going to happen to me.'"

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Abbo and Spaulding both noted a common trend in the past few weeks: Younger people are getting sick. Both have seen an uptick in younger patients, a disproportionate impact on minority patients and more patients with preexisting conditions.

"Right now we have at least two people on our floor now with preexisting medical conditions in their 40s that are needing an extreme amount of oxygen," said Spaulding.

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Abbo added that younger patients tend to not take the virus seriously, which affects everyone when spread.

"Just because you might be in your 20s, 30s and 40s, you could still come down with some pretty serious symptoms that require a longer term hospitalization," Abbo added.

Abbo told ABC News that the coronavirus pandemic reminds her of another one -- the HIV crisis.

"This pandemic is like when HIV started when people didn't know and infecting others," said Abbo. "People were thinking, 'I don't have symptoms.' If we don't do something, this could have significant transmission."

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Jackson Memorial and other hospitals in Miami are seeing an increase in hospitalizations, causing them to reevaluate their ability to conduct elective surgeries.

"Elective surgeries were postponed based on what we are seeing through our predictive models," Abbo told ABC News. "We aren't going to put ourselves in a position where we are stressing capacity,"

Migoya doesn't believe the community is entirely to blame for the rise in cases, saying people in lower-income communities have no choice but to leave their homes to go to work.

"Not everybody gets unemployment ... not everyone gets time off," said Migoya. "If you look at the zip codes with the highest amount of infections [they] are the lower income, the ones that the people have to work or they don't eat."

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a group of people on a sidewalk: People wait for health assessment check-in before entering Jackson Memorial Hospital, as Miami-Dade County eases some of the lockdown measures put in place during the coronavirus disease outbreak, in Miami, June 18, 2020. © Marco Bello/Reuters People wait for health assessment check-in before entering Jackson Memorial Hospital, as Miami-Dade County eases some of the lockdown measures put in place during the coronavirus disease outbreak, in Miami, June 18, 2020.

Migoya also noted that since the hospital sees mostly patients who are minorities, predominantly Latinos, households with multigenerational family members are common, making it difficult to social distance.

"The young person gets infected, they come home and they infect the mother or the grandmother," said Migoya. "And that's where the challenges start coming."

Although hospitalizations at the hospital have tripled, Migoya said doctors have learned a lot since March and are better prepared to treat patients now.

"We're smarter now than we were in March in April. We were flying blind, we really did not know what was the right thing to do," said Migoya. "Our people understand better how to deal with these patients."

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To better serve critical patients, the hospital made the decision to suspend all elective surgeries and nonemergency procedures.

"We decided as a health system that our patient and our health care worker priority is safety," said Abbo. "We are not going to put anyone in a position of stressing the workforce if we don't have enough capacity."

"Please listen to the health care workers," said Abbo. "We're not making this up. This is real, the threat is real."

For Abbo, following social distancing guidelines and mask wearing requirements is key to limiting transmission of the spread, and ensuring resources are there for those who need it.

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"Let's work on this together," said Abbo. "It doesn't matter what political party you are from. This is public health."


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