Not much Comfort: Navy hospital ship only has 20 patients

Symbolic of Donald Trump's entire Presidency:

On top of its strict rules preventing people infected with the virus from coming on board, the Navy is also refusing to treat a host of other conditions. Guidelines disseminated to hospitals included a list of 49 medical conditions that would exclude a patient from admittance to the ship.

Ambulances cannot take patients directly to the Comfort; they must first deliver patients to a city hospital for a lengthy evaluation — including a test for the virus — and then pick them up again for transport to the ship.

I must be getting slow in my old age. I had assumed the ship was going to New York to help with the overflow of COVID 19 cases, but that is apparently not the case. I'm trying to find a list of those other 49 medical conditions the ship is refusing to treat, but we may have to wait until somebody leaks it, because the Navy isn't releasing that info. It may (or may not) surprise you to find out the same damn thing happened when it "came to the rescue" of Puerto Rico:

Following public debate over the Trump administration’s initial reluctance to deploy it, the Comfort arrived two weeks into the disaster, after some of the medical urgency had abated. Its mission and capabilities were opaque to many doctors on the island. It lacked the ability to treat some important areas of need, and the complex referral procedures made little sense on a battered island with scant power or telephone service.

“They were prepared for anything other than the reality of Puerto Rico,” said José Vargas Vidot, a doctor and independent senator in the Puerto Rican Senate whose charitable organization, Iniciativa Comunitaria, supported the post-hurricane medical clinic directed by Dr. Rosado. “It was like a vision in the harbor. Everybody was looking at the Comfort, like trying to build hope. But in the reality it was very frustrating to get access.”

A mid-November visit to the ship found dozens of people waiting to see doctors in the tents set up outside, but inside most of the beds were empty. Only a handful of patients were on board, and most of the doctors were milling about.

In Haiti after the 2010 earthquake, the Comfort provided much-needed surgical care, but communication with referring doctors and with family members was problematic. Some patients died during laborious, multistep transfers, and some doctors felt the ship left too soon.

Back to New York, where doctors are frantically trying to contain the virus:

Mr. Dowling said he has had to tear his hospitals apart, retrofitting any unused space, including lobbies and conference rooms, into hospital wards. His facilities now house 2,800 so-called Covid patients, up from 100 on March 20, he said. About 25 percent of those are in serious conditions in intensive care units.

Across the city, hospitals are overrun. Patients have died in hallways before they could even be hooked up to one of the few available ventilators in New York. Doctors and nurses, who have had to use the same protective gear again and again, are getting sick. So many people are dying that the city is running low on body bags.

Back when I was in the Army we had a saying: "The Mission Dictates." You have to adapt to the conditions on the ground, and that may include going against regulations from time to time, because completing the Mission is everything. Right now the Mission is defeating COVID 19, and if that means the Comfort reduces its bed capacity to 500 to adequately deal with virus patients, then do it. And that bullshit about requiring a "referral" from hospitals that are already overwhelmed? That's just moronic.



Personal anecdote time...

Back in 1983 we went on a joint training mission to Tunisia. We taught them airmobile operations (helicopters), and they taught us how to operate and survive in the Sahara Desert. When we first arrived at the desert outpost, my buddy who was a medic (close to getting his Physician's Assistant qualification) wanted to set up a walk-in clinic for the local Bedouin community.

The first day was slow, only about 20 folks (men) showed up. The next morning there were over 100 people lined up. 18 hour days for about a week, treating pretty much everything you can think of, even pulling teeth. I lost count of the IVs I inserted (yes, Bedouin can get dehydrated). Most of those folks hadn't seen a doctor in years (if ever).

Shortly after the stream of patients slowed to a manageable level and my buddy gave me a day off, I contracted dysentery. Not from the patients, but from the water. About 70 of my fellow soldiers were also stricken, and we were laid out for 8 days. Won't go into details, but it was horrific. I actually had to drink an IV to hydrate me enough that my buddy could find a vein to poke for more fluids.

I'm sure there's a moral in that story somewhere, but I need more coffee to figure it out...

The only thing in their actions that makes sense...

is not taking on Covid-19 patients. I'm sure that even though it is a hospital ship, it probably lacks the kind of isolation capability that would be needed for a highly infectious virus like SARS-CoV-2. So restricting themselves to treating other types of patients makes sense...and that's where things run off the rails. They should have set up an off-ship triage area (i.e., a tent hospital) on shore and used that for patient testing/screening to prevent Covid-19 cases from being admitted. Everyone else should be brought onboard and treated, period. This complex process of sending patients to the hospitals first is idiotic. The mystery list of things they won't treat is even more idiotic. Neither of these provisions is going to get patients who don't have Covid-19 separated from those who do, but will rather run them through the very hospitals that need to not have them show up where they'll be at risk of infection from already admitted patients. The whole thing only works if the patients who aren't infected are kept away. That's the only way they're going to effectively relieve the burden on NYC hospitals.