The Coronavirus Pandemic Exposes Frailties in the Medical Ecosystem

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The Coronavirus has been a cruel enemy, invisible, free to invade unchecked, with a strength any general would admire, unabated by traditional military might, the pandemic handicapped the world's economies and challenged every available medical resource.

Once the pandemic arrived in Europe and stunned the world with its vicious, prolonged attack on Italy, the United States, which defines itself as a superpower, underestimated the burden the virus would place on its own medical response infrastructure.

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Even with the lens of hindsight, as many want to believe the pandemic has cleared our shores and is heading home, to its place of origin, and yet the data driven facts present a sobering and different picture as those states determined to reopen have seen daily increases in infection rates.

No state suffered the impact felt in New York, known as the epicenter in the US. The term, "flattening the curve" can clearly be seen in the data. With 319,000 total cases, the past 24 hours has seen the infection rate drop even as 2,538 new cases have been reported. The death rate also dropped even as 226 more died in the last 24 hours bringing the total to 19,415.

Signs of controlling the pandemic in the area are appearing as several field hospitals have been closed or dismantled and the Navy Hospital ship, Comfort, has sailed, no longer needed.

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The early days of the attack on New York State, and as other similar metropolitan areas, cluster cities, those with dense populations tightly squeezed within narrow boundaries, Chicago, Detroit, San Francisco, also began to see a spike in cases which together began to expose the medical infrastructure system as inadequately prepared.

Superpower Shadowboxes the Invisible Enemy

Wikipedia defines the word superpower as "a state with a dominant position characterized by its extensive ability to exert influence or project power on a global scale. At the end of the Cold War and the dissolution of the Soviet Union in 1991, only the United States appeared to be a superpower."

Nobel laureate Paul A. Samuelson and economist William Nordhaus "liken the ability of GDP [Gross National Product] to give an overall picture of the state of the economy to that of a satellite in space that can survey the weather across an entire continent," Elvis Picardo wrote in Investopedia.

With staggering unemployment rates which eclipsed even the Great Depression of the 1930's, the gross domestic product which looks over all areas, has also been effected by the ongoing challenges of the coronavirus. No area, however, has been pushed to the brink as clearly as the nation's available medical resource.

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The coronavirus challenged every aspect of the medical community and it became clear the United States is not adequately prepared for even short-term medical crisis.

Medical Infrastructure and The Invisible Enemy

While many believe the worst is over, the data driven truth presents a much starker picture. The expectation of infection rates will continue to rise especially in those states who have insisted on either premature reopening's or failed to initiate any statewide shutdown guidance.

On March 4, 2020, NBCNews ran a report on Boston's Mass General's Pandemic warehouse, a secret supply of PPE, Personal Protective Equipment, and other medical supplies labeled "pandemic product." Three weeks later, on March 21, 2020, the hospital had moved beyond its reserves and into the secret warehouse.

"Almost everything in this outbreak has come faster than we were expecting," Dr. Paul Biddinger, Mass General's chief of emergency preparedness, told NBC News on Monday. We have best-case and worst-case scenarios," Biddinger said. "I would say this is following our worst-case scenario in terms of how fast this is evolving. ... And that's not good," NBC News reported.

Hope, as many know can be dangerous when determining the cessation of the pandemic. Hoping it will go away, only leaves communities open to cluster spreads.

With data from the, the virus which had originally seen a projected end of infection rates by June 15, 2020. The data has been revised and have posted a cone projection that see continued stress on the medical infrastructure system with an expectation of more than 134, 475 total deaths and a range as high as 250,000 deaths continuing past August 1, 2020.

The graphs also represent startling truths into the continued needs of hospitalizations, ICU's and ventilators still in demand beyond August 1, 2020.

Without reinforced efforts to maintain the boundaries we have become accustomed to using over the past two months, including social distancing and masks, the spike outlined in the cones will become a reality.

Maybe Midway

If midway reports are accurate, the medical surplus is empty. The PPE supply ran out sometime ago and if it weren't for the innovation, ingenuity and willingness of states and the wealthiest citizens to purchase PPE supplies from foreign countries and provide transportation back to the United States, the emergency rooms and hospital war zones would be facing far worse conditions then they already have endured.

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Even at this midway point, the review of the first three months of Coronavirus outbreak in the US, it is clear the warehouses or surplus centers were dramatically unprepared.

It was not until the coronavirus health crisis that the federal government and other hospitals, even those who had secret pandemic warehouses of supplies recognized the gross lack of preparedness of the medical resources needed across the medical ecosystem to handle the surge in new patients.

This unpreparedness included the range of existing and unexpected patient and critical care emergencies to caregivers, first responders, emergency room critical care teams, nurses, doctors, staff and many others that make the hospitals run at maximum efficiency.

Reports run daily of infection and death to the frontline workers exposed to the coronavirus due to lack of personal protective equipment. Many have been pushed beyond their mental limits, to breaking points that have resulted in suicide.

Other than PPE, ventilators became the second most in demand item of the outbreak and even as great strides were made, the production scale necessary was never met.

For the small manufacturer Ventec Life Systems, and prior to the outbreak an innovator and leader in the market, producing critical care ventilators nearly lost its edge has it became apparent the plant could not scale his operations to meet the need.

Even with the President invoking the Defense Production Act and calling on Ford Motor Company and General Electric to assist in the mass production of ventilators, the critical need for ventilators exposed a frailty in the critical care ecosystem.

After General Electric and Ford Motor company announced a recent $336 million contract with the federal government which will produce 50,000 ventilators. It was also announced "In less than a month, Ventec, GM’s supply chain and its manufacturing, logistics, legal, and talent acquisition teams were able to marshal support to deliver a 30,000-unit order from the U.S. Department of Health and Human Services."

Production has begun and at some future date the surplus will be met, all states restocked, and global contracts filled.

Hospitals ICU and bed space are sorely lacking in the United States. With a nation so rich with scientific research and advanced medical practices, the thought that the United States would lack space and intensive care professionals and critical care units to meet a challenge such as this would prove a flaw in thought, planning or strategy at the highest levels.

As the US, a formidable military superpower, begins to prematurely review its post-pandemic battle strategies, the system, which was stressed, and many would say broken, needs to be overhauled. Now is the time to reinforce the medical ecosystem, to review both strengths and weaknesses, determine a workable strategy that considers the significant losses and works to an end that will never again strain the medical community and infrastructure to a breaking point.

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