WEDNESDAY,DECEMBER 2 , 2020 .THEWASHINGTONPOST EZ RE A
and Prevention recommenda-
tions on immunization in the
United States and provideofficial
guidanceto stateofficials,who
are tryingto meetaFridaydead-
line for vaccinedistributionplan-
ning.
Thedecisionon the highest-
prioritygroupsisknownas Phase
1a. Residentsandemployeesof
long-term-carefacilitieswerepri-
oritizedbecausetheyaccountfor
nearly 40 percent of covid- 19
deaths. Health-care workers
are on the front lines of the
pandemic.
Thecommittee voted13 to 1to
prioritizethe twogroups. Helen
Talbot,an associate professorof
medicineat Vanderbilt Univer-
sity, was the sole dissentingvote.
Unease over the recommenda-
tionscenteredon the inclusionof
long-term-care residents,with
several panel members saying
there was insufficient vaccine
safety andefficacydatatosup-
portimmunizingthatpopulation
rightaway.
Talbotsaidsafety monitoring
of peoplewhohave receivedthe
shotsin thesesettingsis inad-
equate.
“Wehopeit works, and we
hopeit’s safe,” she saidof the
vaccine.
Othermemberssaid theywere
reassuredby the supportofthe
recommendation from special-
ists in geriatric medicine.
Even as hospitalizationsrise,
PresidentTrumpandfirstlady
MelaniaTrump plan to throw
morethantwodozenlarge, in-
doorholidayparties duringDe-
cember,according to White
House officialswithknowledgeof
the planning.
“Maskswillbe requiredand
available, socialdistancing en-
couraged while on the White
House grounds,and handsanitiz-
er stationsthroughoutthe State
Floor,” said StephanieGrisham,a
spokeswomanfor the firstlady.
“Guests will enjoyfoodindividu-
ally plated by chefs at plexiglass-
protected food stations.All
passedbeverages will be covered.
All servicestaffwillwear masks
andglovesto complywithfood
safety guidelines.Attendingthe
partieswillbe averypersonal
choice.”
[email protected]
[email protected]
[email protected]
[email protected]JoshDawsey,JacquelineDupreeand
IsaacStanley-Beckercontributedto
thisreport.reachedshockinglevels.Now, his
hospitalis “maxedout,”Moore
said,and it has stoppedtaking
transfersfromrural areasthat
routinelysenttheirmostcritical-
ly ill patientsto the city. Earlier
this year,Moore wasmanaging
40 to 50 patientsat atime.Today,
thatnumberis closerto 90.
Theburden hasbecome in-
creasingly visible. Moore de-
scribedanursein the intensive
careunitbreakingdowncrying
on arecentday. Other workers
are burnedout.
“We’reall at our breaking
points,”hesaid. “It’sunmanage-
able.”
And local officials, he said,
estimate thatthe numberof hos-
pitalizationswilldoublein the
next fewweeks. In Sedgwick
County, Kan.,whereWichitais
located, nearly 15,000 people
tested positivefor the virusin
November,according to Wash-
ington Post data.
“Weare doingour best, and
peopleare risingto the occasion,
but it becomesdifficult to do your
job the waythatyou wantto do it,
the wayyou’retrained to do it”
when the numbersare this high,
Moore said.
Sixteenstates and Puerto Rico
reported recordnumbersof hos-
pitalizationson Tuesday, andfour
states tied with their highest
days. Arizona,California,Maine,
NewHampshire, Pennsylvania
and West Virginiaeachreported
morethana25percentincrease
in the averagenumberof hospi-
talizations compared with one
weekago.
If the number of casesand
hospitalizations continues to
swell,hospitalsmaybeforcedto
offer less careto thosewithnu-
merousco-morbiditiesin favor of
treatingothers with abetter
chanceofsurviving,said Janis M.
Orlowsky, the chiefhealth-care
officer of the Association of
AmericanMedicalColleges.
NewYork City operated under
crisisstandardsof care for ashort
periodduringthe firstwaveofthe
pandemictherein April,but the
ideaof adoptingthemin many
placesacrossthe UnitedStates
simultaneouslymaybeunprec-
edented,Orlowskysaid.
CORONAVIRUSFROMA1 Whether crisis standards of
careare officiallyinvoked, the
extremestrain on medicalstaff
willinevitablyleadto reduced-
qualitycare for all patients,said
Jean Ross,the co-presidentof
NationalNursesUnited,which
represents more than 170,
nursesin 20 states. She said many
nursesacrossthe countrywere
alreadyspreadthinbeforethe
pandemic arrived, which she
blamedon hospitaladministra-
tors whoare ultimately drivenby
financialinterests.
“Peoplearen’tlistening.Weare
going to be overrun.We are. And
that’sdepressing,” she said.“And
at somepointyourmindand your
bodygiveout.Whenyoucan’t
humanlywork anymore,some
will fall by the wayside,and some
maybealready have. If Ihave
morepeopleassignedto me than
Ican safelytakecare of as anurse,
somebody’s goingtoget short
shrift. That’s justcommonsense.”
Orlowskycited somehospitals
in Utah thatcontinueto expand
theirintensive-care beds into
otherparts of the hospitaland
employdoctorsandotherstaff
memberswho lacktrainingin
criticalcarefor thosepatients.
“EveryCEO Italk to says ‘per-
sonnel,personnel, personnel,’”
she said.“The nursesare exhaust-
ed. Thedoctorsare exhausted.
Can Iget through the next
60 days withmy staff, withmy
tired,overworked, mentallyand
physicallyexhausted staff?’”
On Monday, NewYork state’s
Department of Health ordered
whatGov.AndrewM.Cuomo(D)
called“emergencyhospitalmea-
sures”to preparethe statefor an
anticipated surgeofadmissions
in the comingweeks.That in-
cludespreparingto increasebed
capacityby50percent;identify-
ing retirednursesanddoctors
who could be called back to
augmentstaff; preparingto open
and staffemergencyfield hospi-
tals;andconfirmingthe avail-
abilityofequipmentand supplies
in stockpiles.
Hospitalsystemswerealso di-
rected to beginbalancingpatient
loadsacrosstheirfacilities.Erie
Countyhospitalswereorderedto
suspendelective surgeriesto cre-
atemore spacefor coronavirus
patients.
Health-care teams report
untenable work situation
field hospitalbecauseof rising
demandfor beds,as residents
receivedan emergencyalerton
theirphoneswarningthemthat
hospitalswerefull.
Meanwhile,the WhiteHouse
on Tuesdaysteppedup its pres-
sureon the Food andDrugAd-
ministration to quicklyauthorize
Pfizer’s coronavirus vaccine.
WhiteHouse ChiefofStaffMark
MeadowssummonedFDACom-
missionerStephen Hahn to a
meeting and demandedan expla-
nationfor whythe agency was
not movingfaster on clearingthe
vaccine,according to asenior
administration official who spoke
on the conditionof anonymity
becausehe was not authorizedto
addressthe issue.
Hahn, in astatementissued
before the meeting,said: “We
wantto move quicklybecause
this is anationalemergency, but
we will makesure thatour scien-
tists takethe timetheyneed to
makeanappropriate decision.It
is our job to getthisrightand
makethe correctdecisionregard-
ing vaccinesafety and efficacy.”
Therecommendations from
the AdvisoryCommittee on Im-
munization Practiceswill be sent
to CDCDirector RobertRedfield,
who also informs Health and
HumanServicesSecretaryAlex
Azar.Ifthe recommendationsare
approved,theywillbecomeoffi-
cial Centersfor DiseaseControl“Wemustadaptto this reality
and have aplan in placethat
specificallyaddresses the chal-
lenges thatcomewithit,”Cuomo
said.
In California,Gov.Gavin
Newsom (D) warned thatthe
state’sICUswere already two-
thirdsfull and could reach
112 percentcapacitybymid-De-
cember.
In Ohio,hospitalizationshave
surged 200 percentsinceNov. 1,
saidRJ Sontag,the presidentof
the EmergencyMedicine Resi-
dents’Association.Sontag,aphy-
sicianwhoworksfor Mid-Ohio
EmergencyServices,said his hos-pitalhas beenreceivingpatients
fromotherhospitalsthathave
run out of room.
He saidit is onlyamatterof
timebeforehis hospitalis full,
too.
“It’sanabsolutelytragedy,and
it’s getting harderand harderto
cope,”hesaid.“Asthe months
drag on, it’s becomingmoreand
moredifficult to realizeyou are
the lastpersonyourpatientis
going to see beforetheygoona
ventilator and thatsomeof them
are not going to wakeup.”
This week,RhodeIslandbe-
camethe lateststate to begin
sendingpatientsto atemporary7-dayavg.April MayJuneJulyAug. Sept.Oct.7-dayavg.April MayJuneJulyAug. Sept.Oct.Asof8p.m.TuesdayDec. 1Dec. 113,701,269,7292,180,2k
1k150k100k50k3kNewcoronaviruscases and deaths 200k
in the U.S., by dayFeb. 29Feb. 29YesterdayTotalCASESTotalYesterdayDEATHSDAVIDGOLDMAN/ASSOCIATEDPRESS
Peoplevisitatestingsite operated by the Rhode IslandArmyNationalGuard in Providence on Tuesday.
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