The report is the first public federal critique of the capacity of the nation’s hospitals to cope with the flood of infected patients in coronavirus hot spots — an inundation likely to arrive elsewhere soon. In substantiating complaints about inadequate equipment, it essentially counters assertions by President Trump that hospitals and state officials advocating for them are being greedy.
“Hospitals across the country reported facing similar challenges, regardless of which stage of the process they were in — treating patients with [the virus], testing patients who were potentially infected, or preparing to treat covid-19 patients in the near future,” the report says.
The report’s findings are based on a survey of 343 hospitals spanning 46 states. It was conducted during five days at the end of March.
Released Friday, the report says the findings are “not a review of HHS response to the covid-19 pandemic” but are intended “as an aid to HHS as it continues to lead efforts to address the public health emergency.”
Its central findings include “severe shortages” of testing kits and delays in test results, and “widespread shortages” of personal protective equipment needed to help keep staff safe. Hospitals also reported that they cannot always maintain enough staff on duty and that the pandemic is “taking an emotional toll” on doctors and other medical workers.
The findings buttress dire descriptions of hospital conditions from physicians, nurses and health-care workers who have spoken out from wards overwhelmed with coronavirus patients, many fighting for their lives.
Many governors have been pleading for supplies at news conferences, as well as in direct communications with federal officials all the way up to the president. New York Gov. Andrew M. Cuomo (D), whose state has tallied more than 4,700 deaths and is home to the nation’s largest virus epicenter in New York City, frequently chronicles the shortage of ventilators for patients with the most severe breathing difficulties.
Trump has repeatedly warned states not to complain about insufficient respirators and other medical supplies from a federal stockpile, managed by the Federal Emergency Management Administration. Just over a week ago, Trump said at a White House news briefing that he had instructed Vice President Pence not to speak with governors critical of the administration’s response to the pandemic. “I want them to be appreciative,” the president said.
But the inspector general’s report documents that the concerns of governors, hospital executives and health-care workers are not simply naysaying from disgruntled political adversaries, as the president has suggested.
Asked about the report at Monday’s White House coronavirus briefing, Trump said repeatedly, “It’s wrong.” He demanded to know the name of the report’s author and when that person was appointed. The main author, Christi Grimm, has worked in the HHS inspector general’s office since 1999 and became the principal deputy inspector general in January, according to her biography.
Her tenure means she joined the office while Bill Clinton was president. Trump accused reporters at the briefing of having withheld the fact she worked in the adminstration of President Barack Obama. “We are doing a better job [at testing] than anybody else in the world,” Trump said.
Brett Giroir, an assistant HHS secretary who was put in charge of the government’s testing efforts in mid-March, said at the briefing that the hospital survery was conducted “quite a long time ago” during “several days of backlogs” in major diagnostic labs “that has been taken care of.”
The survey was conducted mainly by phone between March 23 and March 27 with one or more administrators at 323 hospitals — 85 percent of 380 hospitals surveyors tried to reach.
Of the hospitals that responded — in 46 states, plus Puerto Rico and the District of Columbia — 117 reported treating patients confirmed to have covid-19; 130 said they were treating suspected cases; and 32 said they had no cases. An additional 44 did not respond about their caseload.
To reduce the number of patients coming to emergency departments, some hospitals have created triage systems by phone or by relying on community clinics, the survey found.
Still, the findings point to the complexities facing the U.S. health-care system as it struggles to cope with the pandemic while the case count rises rapidly.
For instance, the report notes that even when covid-19 patients get well enough to leave a hospital, freeing up a sorely needed bed, hospitals sometimes cannot send them promptly to rehabilitation facilities to continue their recovery. Rehab facilities are insisting on proof that people have tested negative before they will accept them.
Hospitals reported an array of adaptations to cope with shortages of protective gear. They included buying masks from retailers including paint stores, auto-body supply shops and beauty salons. Some hospitals said they were using masks intended for other kinds of workers, from veterinarians to nail salon technicians.
The survey found that some hospitals were using sandwich bags as thermometer covers. Some hospitals reported that they needed more poles for intravenous therapy, bed linens, toilet paper and food.
“Isolated and smaller hospitals faced special challenges” keeping supplies on hand and restocking, the report says.
To conserve scarce supplies of protective equipment, some hospitals were reusing masks, face shields and gowns that are supposed to be discarded after a single use, restricting the use of such materials to patients and staff in intensive care units, or telling staff to interact with infected patients less often.
To lower hospital workers’ stress, some hospitals were helping employees find child care, grocery and laundry services — and putting them up in hotels so they don’t expose vulnerable relatives.