CORONAVIRUS PANDEMIC UPDATE: RATIONING OF CARE AT THE HENRY FORD HEALTH SYSTEM, DETROIT

By Akin Ojumu

With a total number of cases standing at close to 86,000 and 1,300 deaths, the United States now has more confirmed cases of Coronavirus than anywhere else in the world. As the country sets record for the new cases of COVID-19, hospitals and healthcare facilities across the country are experiencing an acute shortage of medical supplies. Masks, gowns, gloves, PPEs, respirators, ventilators, etc. are in short supply. In addition, the healthcare workforce is overwhelmed and stretched thin, with some states allowing medical students to graduate early so that they can add to the workforce.

The response of one of the nation’s hospitals to the shortage of medical supplies is to institute plans to ration and prioritize care to patients who have the best chance to survive. One of such plans was outlined in a letter sent out to patients, families and the community by the Henry Ford Health System in Detroit.

The Henry Ford Health System letter reads,

To our patients, families and community:

Please know that we care deeply about you and your family's health and are doing our best to protect and serve you and our community. We currently have a public health emergency that is making our supply of some medical resources hard to find. Because of shortages, we will need to be careful with resources. Patients who have the best chance of getting better are our first priority. Patients will be evaluated for the best plan of care and dying patients will be provided comfort care.

What this means for you and your family:

1.    Alert staff during triage of any current medical conditions or if you have a Do Not Resuscitate (DNR)/Do Not Attempt Resuscitation (DNAR) or other important medical information.

2.   If you (or a family member) becomes ill and your medical doctor believes that you need extra care in an Intensive Care Unit (ICU) or Mechanical Ventilation (breathing machine) you will be assessed for eligibility based only on your specific condition.

3.   Some patients will be extremely sick and very unlikely to survive their illness even with critical treatment. Treating these patients would take away resources for patients who might survive.

4.   Patients who are not eligible for ICU or ventilator care will receive treatment for pain control and comfort measures. Some conditions that are likely to may make you not eligible include:

o   Severe heart, lung, kidney or liver failure
o   Terminal cancers
o   Severe trauma or burns

5.    Patients who have ventilator or ICU care withdrawn will receive pain control and comfort measures:

6.   Patients who are treated with a ventilator or ICU care may have these treatments stopped if they do not improve over time. If they do not improve this means that the patient has a poor chance of surviving the illness – even if the care was continued. This decision will be based on medical condition and likelihood of getting better. It will not be based on other reasons such as race, gender, health insurance status, ability to pay for care, sexual orientation, employment status or immigration status. All patients are evaluated for survival using the same measures.

7.    If the treatment team has determined that you or your family members does not meet criteria to receive critical care or that ICU treatments will be stopped, talk to your doctor. Your doctor can ask for a review by a team of medical experts (a Clinical Review Committee evaluation.)

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