Spread of the coronavirus outbreak is overwhelming the healthcare systems of heavily affected countries like China and South Korea. The continued rise in infected patients in those countries has reportedly overflowed hospital beds and long delays in care for other health conditions.
In the U.S., the situation is not as stark. Providers say they have experienced little disruption to operations due to date.
"There are a lot of folks presenting in our ED [emergency department] settings right now, and probably more PUIs [patients under investigation] than we can count," said Becca Bartles, executive director for system infection preventions at Providence St. Joseph Health.
On Jan. 20, Providence Regional Medical Center Everett received the very first patient in the U.S. diagnosed with COVID-19. Since then, Washington has been one of the nation's hotspots for coronavirus cases. The state has had a total of 70 confirmed cases as of Thursday, according to the Washington State Department of Health.
Most of the cases have occurred within King County, where nine of the 11 coronavirus deaths that have been reported. Approximately 231 people are currently being monitored and are suspected to have been exposed to the virus.
Bartles said Providence hospitals within the most affected areas have had "more than a handful" of patients who have tested positive for the virus. Still, she said as of Wednesday morning the increase in patients coming to their facilities due to coronavirus has not caused significantly longer wait times. Patients had also not yet canceled or delayed any scheduled elective surgeries or routine appointments.
Likewise, Dr. Paul Nee, an infectious disease specialist with Nuvance Health in New York, said the 22 cases in the state have yet to impact the system's day-to-day care delivery operations. There have been no cancellations in elective surgeries or appointments that can be attributed to coronavirus, he said.
Nee is counting on communication within their network to play a key role in preventing any disruption to care services.
Hospitals throughout the country are trying to assure patients that for now, care services are still running as usual.
On Thursday, the Association of American Medical Colleges announced clinicians from the nation's 155 medical schools and 1,100 teaching hospitals were mobilizing to respond to the COVID-19 virus outbreak similar to how they addressed the Ebola outbreak in 2014. During that outbreak many academic medical centers served as designated care sites to transfer patients that were suspected of being at risk of exposure.
One of those designated facilities, Rush University Medical Center in Chicago, has sent emails telling patients they are ready to handle any infectious disease threat and urging patients to keep appointments, procedures, and elective surgeries
Not even major destinations for international medical tourism have seen a hit, according to officials.
Mayo Clinic, which every year sees patients from more than 130 countries, reported no disruptions.
A Cleveland Clinic spokeswoman reported the system has seen a slight decline in surgeries for international patients as a result of the outbreak, with expectations of additional impact as travel restrictions continue. Domestically, she said the health system has not canceled elective surgeries due to the virus.
"While we have not heard of a disruption in services yet, if there were to be a widespread outbreak the public should know that the hospital might take steps such as rescheduling their elected surgeries in order to make sure we can appropriately continue to care for those who are most ill at that moment," said Nancy Foster, vice president of quality and patient safety policy for the American Hospital Association.
But hospitals are not the only point of care that could get overburdened in a major epidemic.
Retail health clinics and urgent care centers have grown in number recently and have become often a preferred first point of contact for patients seeking quick care.
Before going to the hospital, the first COVID-19 patient in Washington reportedly visited a local urgent care center.
"There's been a lot of worried people calling up about their symptoms and wondering where they get tested," said Dr. Lane Tassin, chief medical officer for FastMed Urgent Care, which owns and operates more than 100 clinics across Arizona, North Carolina and Texas.
Tassin said so far, the outbreak has not resulted in an uptick in patient visits. However, doctors have reported spending more time on the phone educating patients about COVID-19.
Urgent care centers are not testing patients for the virus.
Tassin said the clinics would conduct patient screenings and notify anyone at risk to local health officials based on their symptoms and if they were in contact with travelers from high-risk countries.
"That's our role in the grand scheme right now," Tassin said.
So far, the federal government hasn't specifically marked emergency funding for hospitals and other providers. The Senate on Thursday passed an $8.3 billion aid package, sending the bill to President Donald Trump's desk.
The package provides $2.2 billion to support federal and local state health agencies, including $950 million for state and local governments to conduct testing and other response activities. Lawmakers set aside $500 million for purchasing medical supplies, an unspecified amount for increasing medical surge capacity, and $100 million in grants for community health centers.
Other large providers not in the thick of things are preparing themselves nevertheless.
On Thursday, Scripps Health in San Diego put in place temporary visitor restrictions to all its hospitals and set up a screening station outside all main entrances.
Staff were told to inform visitors coming to a hospital for an appointment to expect a delay in entering the building due those screenings, and that anyone showing symptoms would be barred from entering the hospital.
"We need to be prepared to protect the care team so they will be able to care for our patients as we always do,"said Chris Van Gorder, president and CEO of Scripps Health in a statement. "We are developing additional stages of response which will include expansion of telemedicine use, call centers and if needed, consolidation of resources if our workforce is impacted. But we are not in any kind of panic—on the contrary, we are taking a very methodical approach to our planning and the development of our COVID-19 staged response."
