IMHE predictive graph of case counts

If State Does Not Curb COVID Trend, Healthcare Workers Will Have to Start Making “Painful Choices,” Experts Warn

by Carolyn Bick

Already, Dr. Nathan Schlicher has lost a patient to a heart attack, due to the patient’s inability to get timely and appropriate care at the hospital. This delay was caused by the skyrocketing rate of COVID-19 cases — a rate Gov. Jay Inslee called “almost vertical” — and associated hospitalizations throughout the state, as hospitals begin to delay certain forms of care, in order to keep up with the increase.

Schlicher, a frontline emergency room doctor and President of the Washington State Medical Association, spoke briefly about this patient and delivered grim warnings in a press conference on Nov. 24 alongside Inslee, Washington State Department of Health (DOH) Health Officer Dr. Kathy Lofy, and SEIU 1199 Vice President and registered nurse Betsy Scott.

The DOH yesterday reported that, over a period of three days, Washington State saw a cumulative count of 6,277 new cases, which translates to roughly 2,000 new cases per day. This is more than double the amount of cases the state saw per day at the outset of the pandemic, and the DOH’s epidemiological curve chart, included below, shows that the pandemic is not slowing down.

The DOH’s epidemiological curve chart, current as of Nov. 23, 2020.

Hospitals are already delaying elective and non-emergent surgeries, just to keep up with the rate of hospitalizations. There is already overcrowding and long waits in the ER, Scott said, “with patients being cared for on gurneys in the hallways, as they wait for a bed to … open up in a hospital with too few staff.”

And this appears to be just the beginning. Schlicher said that his hospital and hospitals across the state are simply “buying space and buying time for Washingtonians to rally and do the right thing.”

“If we don’t do that, [the Institute for Health Metrics and Evaluation] IMHE and others predict that our peak isn’t until February,” Schlicher said. 

He didn’t indicate what this peak might be, but IMHE predictive graphs show a predicted peak of more than 9,600 new cases per day and nearly 54 deaths per day, if Washington continues along its current path and people don’t change their behaviors.

Schlicher also gave a bleak warning, saying that, if the state cannot curb the sharp rise in cases, healthcare workers will have to make painful choices, regarding who gets healthcare. This is a scenario that already played out in several European countries at the start of the pandemic.

“And it’s not just older folks. It can be those that may have the least likelihood of survival. And that becomes a very complex question about how do you decide — if you’ve only got ventilator left, one ICU bed left, one dose of a medication left — who gets it,” Schlicher said. “I don’t think any of us want to play God in this world, and have to make that decision.”

Schlicher said he himself has never had to “proactively” decide whether someone gets a ventilator or care, even though he has taken care of people in disaster situations. But such a world isn’t too far off, if Washingtonians continue their current behaviors.

“We are talking about things that will truly tear apart those who are going to be making those decisions,” Schlicher said.

Inslee also said that even though a vaccine may be available in December for some people, most Washingtonians won’t get the vaccine until well into 2021.

Carolyn Bick is a journalist and photographer based in South Seattle. You may reach them via Twitter, and check out their other work here and here.

Featured image is a screenshot of the IMHE’s graph of predicted COVID-19 cases in Washington State.