醫(yī)院人擠人,，美國正面臨嚴(yán)峻就醫(yī)難題
Sy Mukherjee
2020-12-03
術(shù)語“非急需手術(shù)”一詞，常被誤解為諸如整容手術(shù)之類的無關(guān)緊要的手術(shù),。實際上,，這個詞包含了很多需要住院治療的手術(shù)項目，其中不乏切除癌癥腫瘤等嚴(yán)重病情,。
隨著美國新冠病例持續(xù)增加,，大量醫(yī)院不得不再次暫停非急需的手術(shù)及醫(yī)療程序，為新冠患者騰出空間,。一些其他專業(yè)的醫(yī)護被調(diào)去照顧新冠患者,，美國人常規(guī)的癌癥篩查及心臟檢查也將會被推遲。
美國新冠病例各項指標(biāo)變化情況（2020年3月1日至2020年11月21日）,。數(shù)據(jù)來源：實驗室數(shù)據(jù),、門診/急診、住院部門及死亡率數(shù)據(jù)
約翰斯·霍普金斯醫(yī)院（Johns Hopkins Medicine）指出：“非急需手術(shù)并不一定意味著可選性和隨意性,，只是這些手術(shù)可以提前安排罷了,。”
該醫(yī)院指出,，在某些情況下,，非急需手術(shù)也可能用于諸如癌癥等嚴(yán)重的病癥。此外,，還可能包括摘除痣,、疣，摘除腎結(jié)石等手術(shù),。在其他形式的治療方案不起作用時,，非急需手術(shù)也可能會被安排上。
目前,，美國新冠病例確診數(shù)已超1372萬例,，造成超過27萬人死亡——當(dāng)然，死亡是一個滯后指標(biāo),，是一條復(fù)雜醫(yī)療鏈的最后一步,。從接受檢測開始，到確診,、住院治療,，根據(jù)病情嚴(yán)重程度一步一步推進。
因此,，無論是在加州,、俄亥俄州還是紐約，衛(wèi)生系統(tǒng)都必然做出調(diào)整,。截至11月29日,，加州的病例已經(jīng)突破120萬大關(guān),。把視角拉至全美，新冠疫情追蹤項目的數(shù)據(jù)顯示,，目前全美國有超過93000名美國民眾因為感染新冠肺炎而住院——這是自疫情開始以來全國范圍內(nèi)現(xiàn)存病例數(shù)的最高點,。專家們擔(dān)心，感恩節(jié)前后大量旅客乘坐飛機出門旅行之后,，美國疫情在接下來的幾天至幾周內(nèi)可能變得更糟,。
ICU、醫(yī)院由此受到了巨大壓力,。11月30日,，紐約州的州長安德魯·庫莫表示，從12月4日開始,，水牛城所在的伊利縣將不再允許進行非急需手術(shù),。
“醫(yī)院的可容納病人量是現(xiàn)在國家最關(guān)心的問題?！彼f,。
除紐約州外，加州宣布或?qū)⒃谑転?zāi)最嚴(yán)重的地區(qū)對非急需醫(yī)療程序嚴(yán)加限制,。同時,，俄亥俄州東北部的Summa Health等大型連鎖醫(yī)院也從12月1日開始暫停非急需手術(shù)。
由于假期旅行和新冠肺炎存在潛伏期,，住院高峰預(yù)計要到1月中旬才會出現(xiàn),。Summa Health亞克朗院區(qū)院長大衛(wèi)·庫斯托迪奧博士在接受水牛城當(dāng)?shù)孛襟wWGRZ采訪時說：“很明顯，我們并沒有輕率地做出決定,。我們清楚它將帶來的后果,。”
“我希望我們能打包票,，在1月2日開始（非急需醫(yī)療程序）——但那樣是誤導(dǎo)民眾的做法,。我們不知道何時才能開始。得等待疫情軌跡和醫(yī)院接診能力來給出答案,?！彼赋觥＃ㄘ敻恢形木W(wǎng)）
編譯：楊二一
術(shù)語“非急需手術(shù)”一詞,，常被誤解為諸如整容手術(shù)之類的無關(guān)緊要的手術(shù)。實際上,，這個詞包含了很多需要住院治療的手術(shù)項目,，其中不乏切除癌癥腫瘤等嚴(yán)重病情。
隨著美國新冠病例持續(xù)增加,，大量醫(yī)院不得不再次暫停非急需的手術(shù)及醫(yī)療程序,，為新冠患者騰出空間,。一些其他專業(yè)的醫(yī)護被調(diào)去照顧新冠患者,，美國人常規(guī)的癌癥篩查及心臟檢查也將會被推遲,。
約翰斯·霍普金斯醫(yī)院（Johns Hopkins Medicine）指出：“非急需手術(shù)并不一定意味著可選性和隨意性，只是這些手術(shù)可以提前安排罷了,?！?/p>
該醫(yī)院指出，在某些情況下,，非急需手術(shù)也可能用于諸如癌癥等嚴(yán)重的病癥,。此外，還可能包括摘除痣,、疣,，摘除腎結(jié)石等手術(shù)。在其他形式的治療方案不起作用時,，非急需手術(shù)也可能會被安排上,。
目前，美國新冠病例確診數(shù)已超1372萬例,，造成超過27萬人死亡——當(dāng)然,，死亡是一個滯后指標(biāo)，是一條復(fù)雜醫(yī)療鏈的最后一步,。從接受檢測開始,，到確診、住院治療,，根據(jù)病情嚴(yán)重程度一步一步推進,。
因此，無論是在加州,、俄亥俄州還是紐約,，衛(wèi)生系統(tǒng)都必然做出調(diào)整。截至11月29日,，加州的病例已經(jīng)突破120萬大關(guān),。把視角拉至全美，新冠疫情追蹤項目的數(shù)據(jù)顯示,，目前全美國有超過93000名美國民眾因為感染新冠肺炎而住院——這是自疫情開始以來全國范圍內(nèi)現(xiàn)存病例數(shù)的最高點,。專家們擔(dān)心，感恩節(jié)前后大量旅客乘坐飛機出門旅行之后,，美國疫情在接下來的幾天至幾周內(nèi)可能變得更糟,。
ICU、醫(yī)院由此受到了巨大壓力。11月30日,，紐約州的州長安德魯·庫莫表示,，從12月4日開始，水牛城所在的伊利縣將不再允許進行非急需手術(shù),。
“醫(yī)院的可容納病人量是現(xiàn)在國家最關(guān)心的問題,。”他說,。
除紐約州外,，加州宣布或?qū)⒃谑転?zāi)最嚴(yán)重的地區(qū)對非急需醫(yī)療程序嚴(yán)加限制。同時,，俄亥俄州東北部的Summa Health等大型連鎖醫(yī)院也從12月1日開始暫停非急需手術(shù),。
由于假期旅行和新冠肺炎存在潛伏期，住院高峰預(yù)計要到1月中旬才會出現(xiàn),。Summa Health亞克朗院區(qū)院長大衛(wèi)·庫斯托迪奧博士在接受水牛城當(dāng)?shù)孛襟wWGRZ采訪時說：“很明顯,，我們并沒有輕率地做出決定,。我們清楚它將帶來的后果,。”
“我希望我們能打包票,，在1月2日開始（非急需醫(yī)療程序）——但那樣是誤導(dǎo)民眾的做法,。我們不知道何時才能開始。得等待疫情軌跡和醫(yī)院接診能力來給出答案,?！彼赋?。（財富中文網(wǎng)）
編譯：楊二一
The term "elective surgery" is often misunderstood as a procedure like a face-lift or other forms of cosmetic surgery. But in fact, the term covers a wide range of hospitalizations, many of which are serious, such as removing a cancerous tumor.
And as coronavirus cases continue to surge across the U.S., many health systems have yet again had to place a hold on elective surgeries and procedures in order to make room for COVID patients. In some cases, doctors and nurses in certain specialties have been shifted to take care of coronavirus patients while Americans have had to put off routine cancer screenings or heart checkups.
"An elective surgery does not always mean it is optional. It simply means that the surgery can be scheduled in advance," according to Johns Hopkins Medicine.
"But in some cases it may be for a serious condition such as cancer. Examples of elective surgery include removing a mole or wart, and having kidney stones removed. It may also be done if other forms of treatment are not working."
There have now been more than 13.72 million confirmed COVID cases in the U.S. and nearly 270,669 deaths. Of course, deaths are a lagging indicator. They're the final step in a chain of complex medical logistics that begins with receiving a test and then may advance to hospitalization, depending on the severity of the illness.
Health systems from California to Ohio to New York have had to make adjustments given that reality. Cases in the Golden State have soared past 1.2 million as of Nov. 29, a record. Zooming out, nationally, there are currently more than 93,000 Americans hospitalized with COVID-19, according to the COVID Tracking Project. That's an all-time countrywide high since the pandemic began. And experts fear that a flurry of travelers flying during and after the Thanksgiving holiday will only make matters worse in the coming days and weeks.
The effects have put an enormous strain on ICUs and hospitals. New York Gov. Andrew Cuomo said on November 30 that there would be no elective surgeries in Erie County, which houses Buffalo, beginning on Dec. 4.
"Hospital capacity is now the state's top concern," he said.
California may also clamp down on elective procedures in the hardest hit regions. Meanwhile, major hospital chains across Northeastern Ohio, such as Summa Health System, will pause elective surgeries beginning on December 1.
Peak hospitalizations may not occur until mid-January given holiday travel and the coronavirus's incubation period. “Obviously, to make this decision, we didn’t do it lightly, and we understand the repercussions of that," Summa Health System Akron Campus president Dr. David Custodio told local Buffalo affiliate WGRZ.
“I wish we could say exactly we can start [elective procedures] on Jan. 2, but that would be misleading. We don’t know, and that really depends on the trajectory and the capacity,” he continued.
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