EAU CLAIRE, Wis. — As the coronavirus pandemic swelled around the 160-bed Mayo Clinic hospital, the day was dawning auspiciously. Two precious beds for new patients had opened overnight. At the morning “bed meeting,” prospects for a third looked promising.
Better yet, by midmorning there were no patients in the Emergency Department. None. Even in normal times, a medium hospital like this can go many months without ever reaching zero.
Everyone knew better than to trust this good fortune. They were right.
From 9 a.m. to 10 a.m., seven patients arrived at the emergency room. Fourteen came the next hour, then 10 more the hour after that.
About a third had signs of COVID-19, the illness the novel coronavirus can cause, most with trouble breathing. But there was also the man who had smashed his fingers with a hammer. The unresponsive woman who had to be resuscitated. An injured elbow. Neck pain. Acute depression.
By 12:05 p.m., Mayo had put itself on “bypass,” sending all ambulances to the two other hospitals in town, a last-resort move rarely employed. By late afternoon, the emergency room was stashing patients in four beds erected in the ambulance garage — the first time it had adopted that tactic — and holding others for hours as they waited for places in the overflowing hospital.
With more than 91,000 COVID-19 patients in their beds, U.S. hospitals are in danger of buckling beneath the weight of the pandemic and the ongoing needs of other sick people. In small and medium facilities hit hardest by the outbreak, that means finding spots in ones and twos, rather than adding hundreds at a time as New York hospitals did when the coronavirus swept the Northeast in the spring.
“A bed is a gift right now,” said Jason Craig, regional chair for the Mayo Clinic Health System in northwestern Wisconsin. “I’ll take all of them.”
In Utah, some doctors acknowledge that they are informally rationing care, a euphemism for providing some patients a lower level of service than they should receive. In El Paso, Texas, the National Guard has been dispatched to handle the overwhelming number of COVID-19 corpses, many held in 10 refrigerated trailers outside the medical examiner’s office.
Such extreme measures are not widespread, but only because hospitals have spent months preparing for this catastrophe — one expected to grow worse in the weeks to come as the weather turns cold and Americans move indoors.
More challenging still is locating doctors, nurses, respiratory technicians and other staffers needed to provide care as the pandemic places unprecedented demand on the entire nation simultaneously. Even Mayo, one of the most prestigious and well-resourced systems in U.S. medicine, is supplementing its Wisconsin staff with nurses from its hospitals in Arizona, Florida and Minnesota, redeploying nurses from other parts of this hospital and hiring temporary travel nurses who sign on for short assignments.
With nearly 300 staffers infected or quarantined in northwestern Wisconsin, the system has turned to