You still are missing the point that you need hospitals close enough to accept those patients as well as the infrastructure to move.
You are talking about moving one patient. Would that volunteer group have been prepared to move dozens of patients all at the same time? Would that specialized hospital have been prepared to accept dozens of patients all at the same time? If either of those questions cannot be answered with an unequivocal YES, then your example is pretty much irrelevant to the situation we are discussing here.
461 miles in an hour isn’t helicopters; that’s a plane. However, most of the air ambulance services in the US are primarily helicopter-based. Yes, we do have a network of fixed-wing air ambulances, but the civilian network is based on occasionally moving patients by ones and twos, and the military mass transport system is based on large receiving hospitals with lots of capacity.
If you are going to do a mass transport, then you need a group of patients sufficiently stable to wait around for however much time it takes to assemble and fly the whole group, and a hospital or set of hospitals in close proximity who can receive them as a group. When they did some largish medical evacuations out of New Orleans in the aftermath of Katrina, e.g., there were hospitals in Houston and Baton Rouge and Dallas (among other cities) that could. (Typically, ICU occupancy is around 65-70%, so lots of larger hospitals had many dozens of ICU beds.) Right now, no hospital within several hundred miles of Houston does, because they are all approaching capacity with COVID patients.
Your earlier example of moving 28 patients from New York to Albany took resources from medical facilities in five states, most of which did NOT have any serious capacity problems of their own to deal with. Right now, there aren’t medical facilities within the same radius to Houston that don’t have problems of their own. You can’t use the helicopters normally assigned to Galveston or Corpus Christi to evacuate patients from Houston, because they are needed to evacuate patients Galveston and Corpus Christi somewhere else. You are stressing the system, needing to bring planes and choppers from places further afield, which means they’re not going to be available in the next hour or several hours to move your very urgent case anywhere.
If you have to move a bunch of seriously-ill patients from Houston to Indianapolis, or Chicago or Cincinnati or Denver, then you have to accept that you are going to lose some of them in the process. Some people will be so ill or so injured that they do not survive lengthy delays to obtain a flight and then a lengthy flight itself. THAT is the “alternative” we are facing.
How many beds, especially intensive care and other specialty beds, are currently available in any of those facilities to treat patients being brought from Texas? Have you actually investigated, or are you just hand-waving that “of course” they’ll be available?
Wait a second! What happened to the tent hospitals that were set up in NY by the US military plus that one faith based group? Did they lose their tents or something? Where did the hospital ship sail off to? Is that one still at anchor in LA? They look like they are next on the curve.
If you are going to proffer those beds in Ohio as available to evacuees from Houston, then yes, I’d like some evidence that they actually are available.
A single C-17 can haul quite a few people in one flight and multi-stop to airports at great distances. You’re asking a non-question. We wouldn’t even have to move a support ship if for some reason it spun out of control. No need to even waste the time moving the ship.
If the plane is making lots of stops at lots of locations, then you are not getting the patients to their destination in an hour. The longer a patient has to wait to reach their destination and the highest level of care, then the greater the likelihood that a patient will die en route. I’m not even sure why this would be controversial.
Back in April, some hospitals in New York closed down specialist units (such as the cardiac ICU at Mount Sinai Morningside that was converted into a COVID unit); well, what happens to the patient who needs ICU-level cardiac care when that unit is closed and the cardiologists are stretched thin trying to treat COVID patients? When less-experienced staff are covering, they’re more likely to make mistakes or overlook details; that’s why we have specialists in the first place. When the specialists are overworked and trying to treat too many patients, they don’t have the same time and attention to give to each patient, and again care starts to slip.
Taking proactive steps and preventing the hospitals from being overwhelmed in the first place?
Unfortunately, to do that you would have to look at things ahead of time, through testing and contact tracing, rather than just hospital emissions and deaths.
What happens when all the places that you want to transport patients to are already filled up.
Also, you actually didn’t answer the question. Would you transfer the Texas patients on to another hospital, or leave them in place and send the Cincinnatians off?
What you don’t seem to be understanding is that this is a process that is intended to move a small number of people who need specialized care in other places, not a process that is capable of shuffling massive numbers of people all over the country in and out of hospitals as they become overwhelmed.
I was hunting whitetail deer with this guy in 35 degree weather and it starting pouring rain. We huddled under a tree for shelter, and I asked what we would do when the tree soaked through. He said, don’t worry, we’ll just go under another tree. I don’t know why I was just reminded of that .
What you don’t seem to understand is that the system already in place is not designed or built to handle the situation now before us.
Let’s go back to the example you gave about the workmate with the seriously ill child transported 461 miles. Was that transport plane already sitting on the runway fueled and ready to go at the time the doctor said we need to transport kiddo to hospital X? If not, then how long did it take to arrange for the flight and get the plane set up? Did the originating hospital leave the child in ICU/PICU receiving specialist care while they set up the transport?
Now, if the hospitals get overrun (which is what we’re talking about), then they’re NOT going to have the patient in ICU awaiting transport, because there’s no room in ICU. The patient is going to be parked in a hallway somewhere receiving as adequate a care as can be provided by whichever non-specialist staff are available, which is not a good situation.
Would that volunteer pilot’s group have been prepared to transport 28 patients that day? (I’ve asked this question already and you did not answer.) If not, then who else is available to step and move that many. The New York example used resources from 5 states to move 28 patients 135 miles. Consider a situation where 28 patients need to be moved from Houston, and 28 more from Galveston, and 28 more from Corpus Christi, and 28 more from San Antonio, and 28 more from the lower Valley, and 28 more from Dallas, all of whom need to go at least several hundred miles, maybe 500 or more.
The US Air Force’s 375th Aeromedical Evacuation Squadron has 122 members; they are one of four active duty air ambulance units in the USAF (two of which are deployed overseas, in Germany and in Japan, and so are unlikely to be available here). In 2018, the 375th moved 354 patients around the US (cite). If the SHTF in Florida and Texas and Mississippi and Arizona, somebody is going to need to move possibly 300+ patients every couple of days.
Moving one patient from one not-overtaxed hospital to another hospital with the leisure to plan it is not even remotely the same situation as moving dozens or hundreds of patients from overtaxed facilities in constrained conditions. To a discussion about oranges and grapefruit, you are presenting examples of turnips, with no apparent grasp that you are not talking about the same situation.
No, the plane wasn’t sitting on the runway ready for to go. And yet as fast as they could move the child to the airport it was in position from another airport. That’s the whole point of the example. It was a complete unknown and went together smoothly. “I need your Falcon 20 at this airport and this FBO in in hour or less and I want it fueled to land at the following airport. Contracts will be on your fax machine in 5 minutes”. Charter company calls the pilots out to the plane if they’re not snoozing in the pilot’s lounge. FBO has plane towed from hanger and topped off if necessary. Pilots pick up the weather and flight plans and walk to the plane. engine opposite passenger door side is spun and they wait for the patient to arrive with medical air crew. They start the second engine as they taxi out.
The small charter industry is based on hurry up and wait. and yes, based on the New York example they were able to handle 28 patients. If you read the article it was because of an oxygen issue at one of the hospitals.
"Sorry, no can do, it just went off in the other direction with a different patient. We can put you on the waiting list, you’d be number 497. Oh, and if one more of our pilots comes down with it we’re going to have to ground our next-to-last plane.’
It took helicopters from five states and calling in a company based in Nebraska to handle those 28 patients.
If things go way south in Texas/Florida/Arizona, they’re not going to be handling 28 patients; they’re going to be handling hundreds of them, and they’re going to have to transport them much further than 135 miles. Scale matters; the system you keep describing isn’t built to scale up quickly. THAT is the point I’m trying to get across to you, and which you persist in ignoring.
The article about Russia is from May; the article about India is from early June; the articles about Columbia and Pakistan are from 3 weeks ago. It may be that we had excess ventilators; it may also be that we no longer do.