The coronavirus situation in Texas has deteriorated to the point where one county’s health authority has implemented a triage committee for the purpose of determining which COVID-19 patients the county’s single hospital will treat, and which patients will be sent home to die, according to the McAllen, Texas, affiliate WSYR.
In a stunning admission of how dire the COVID-19 situation is in South Texas, the health authority for one border county on Tuesday announced the formation of an ethics committee that will screen all patients for survival potential and will send home those with low probabilities.
Starr County Health Authority Dr. Jose Vazquez said Starr County Memorial Hospital, the county’s only hospital, on Tuesday implemented an ethics committee and a triage committee to review all coronavirus patients as they come in to determine what type of life-saving equipment and treatment they would likely require and whether they would likely survive. Those deemed too fragile or sick or elderly will be advised to go home to loved ones, he said.
As noted in the WSYR report, rural Starr county, located south of San Antonio, has only one hospital to serve 70,000 residents. Shortly after Republican Gov. Greg Abbott implemented statewide reopenings on May 1, that hospital became inundated with COVID-19 patients.
A county judge interviewed for the WSYR article attributes the spike in those infected to residents failing to adhere to social distancing practices, including “continuing to gather in groups for weddings, quinceañeras, and pachanga parties where he said communal spread of the novel virus is being propagated.”
According to the Health Authority, the county simply has no other choice but to implement this policy as neighboring county hospitals have no more intensive care unit (ICU) space to spare.
As explained by Dr. Vazquez, “We do not have specialty services, we are just […] a rural health hospital.” The institution of these real-life “death panels” is being implemented as a last resort.
The committees will consist of a patient’s primary care physician, the emergency room doctor or the hospital doctor taking care of the patient, a social worker, and one of the hospital administrators.
“That team will be responsible to talk with patients and family, especially in the cases where we are dealing with elderly patients with multiple comorbidities” and have moderate to severe COVID-19 symptoms, Vazquez said.
“Science tells us that those patients do not do well,” he said. “That most of those patients will never make it out of a ventilator.”
As a practical matter, even if patients recover from the acute phase of infection, if they were to be discharged to home thereafter, they would still require oxygen, which the hospital is unable to provide. The consensus also appears to be that most patients unlikely to recover, who would for the most part be receiving hospice or palliative care until death, would prefer to die at home rather than at some facility 1,000 miles away.
“We are not gods or anybody to make a decision for who should live or who should die. However, when you have a mass-casualty situation there are guidelines that makes you work in a more efficient manner and to help save the maximum number of people,” said Vazquez, who added in his entire career as a physician he has never experienced such a desperate mass medical situation.
The Starr County Memorial Hospital has eight beds in its COVID-19 unit, but it now has 28 COVID-19 patients, including three on ventilators or other life support, according to WSYR.
For further information on Texas’ overwhelmed hospital capacity, see BlackSheep1’s post.