美国医院准备迎接新冠病毒浪潮

美国医院准备迎接新冠病毒浪潮

As the coronavirus spreads in the U.S., public health agencies are starting to worry about hospital capacity.

随着冠状病毒在美国传播，公共卫生机构开始担心医院的容量。

Overseas, China was forced to build two new hospitals on an emergency basis, and in South Korea earlier this week, the government said over two thousand people were waiting for hospital care.

在海外，中国被迫在紧急情况下新建两所医院。在韩国，政府电视台本周早些时候说，有超过2000人在等待医院治疗。

The potential numbers in the U.S. are daunting. Richard Waldhorn is a pulmonary critical care physician who's studied hospital preparedness for the Johns Hopkins Center for Health Security. Last week, he co-wrote an article arguing that American hospitals should prepare for the possibility of too many patients.

美国的潜在数字令人生畏。理查德·瓦尔德霍恩是一名肺部危重症护理医师，他曾为约翰·霍普金斯卫生安全中心研究医院准备工作。上周，他与人合写了一篇文章，主张美国的医院应该为可能出现的病人过多做好准备。

"The arithmetic suggests that we will outstrip hospital resources, particularly instensive care resources, in waves as the pandemic spreads," he says.

他说：“计算结果表明，随着大流行的蔓延，我们将以一波又一波的速度超过医院资源，特别是医疗资源。”。

He says government planning assumptions based on past flu pandemics suggest a surge in demand for intensive care that could range somewhere between 200.000 thousand and 2.9 million patients.

他说，政府根据以往流感大流行做出的规划假设表明，对重症监护的需求可能会激增，可能在20万到290万病人之间。

The American Hospital Association says the total number of Intensive Care Unit beds is about 65.000.

美国医院协会表示，重症监护病房的床位总数约为6.5万张。

Waldhorn says hospitals can make more ICU beds available in a crisis, perhaps doubling the capacity, but there's still a chance it won't be enough.

瓦尔德霍恩说，医院可以在紧急情况下提供更多的重症监护病房床位，可能会使床位增加一倍，但仍有可能不够用。

"We're going to have to face the problem of how do we allocate limited health care resources in some sort of rational and ethical and organized way with the goal of doing the greatest good for the greatest number," he says.

他说：“我们将不得不面对这样一个问题：我们如何以某种理性、道德和有组织的方式分配有限的医疗资源，以期为最大数量的人做出最大的贡献。”。

He gives the example of "extracorporeal membrane oxygenation," a technique for oxygenating blood outside the body, in cases of respiratory failure. Chinese doctors reported some success using the procedure to keep COVID-19 patients alive, but it's not something that could be easily provided to hundreds or thousands of patients.

他举了“体外膜肺氧合”的例子，这是一种在呼吸衰竭的情况下，在体外对血液氧合的技术。中国医生报告说，使用这种方法维持COVID-19患者的生命取得了一些成功，但这并不是一种可以轻易提供给成百上千患者的方法。

In Washington State, things have not yet reached the stage of tough choices.

在华盛顿州，事情还没有发展到艰难抉择的阶段。

EvergreenHealth hospital in Kirkland identified the country's first fatal case of COVID-19 last Friday, and since then it's borne the brunt of the most serious cases — and most of the country's deaths. Many stem from the outbreak at the nearby Life Care nursing facility.

基尔克兰的常青健康医院上周五发现了该国首例COVID-19致命病例，自那以后，它承受着最严重的病例的爆发，以及该国大部分死亡病例。很多是由附近的生命护理机构爆发的。

One week later, the hospital has made plans to house even more of the patients, by taking steps such as converting more sections of its buildings into "negative pressure wards," in which HVAC systems keep germs from spreading. Still, they're feeling the strain.

一周后，医院已经制定了为更多病人提供住处的计划，采取了一些措施，比如将更多的建筑改造成“负压病房”，在这里，暖通空调系统可以防止细菌传播。尽管如此，他们还是感到了压力。

"Right now I know for certain, we have one critical care bed left," the CEO, Jeff Tomlin, said on Thursday night. "We're right now already talking to the other facilities to see what their capacity is."

该公司首席执行官杰夫•汤姆林周四晚表示:“现在我可以肯定，我们还剩下一张重症监护床。”“我们现在已经在与其他设施进行谈判，看看它们的容量是多少。”