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Why is the United States lagging behind other countries in coronavirus testing?
05:03 - Source: CNN
CNN  — 

As the coronavirus pandemic spreads throughout the United States, some health experts are warning that hospitals are not prepared to manage the anticipated number of patients, if there is a large spike in severe cases.

“If we have a large spike of cases – no, American hospitals are not going to be able to handle it,” said Dr. Ashish Jha, the director of the Harvard Global Health Institute.

It’s unclear exactly how many people might need to be hospitalized, but doctors are trying to figure that out as healthcare systems prepare for what could be a large influx of patients.

Doing the math

CNN obtained one estimate presented to the American Hospital Association by Dr. James Lawler, at the University of Nebraska Medical Center on March 5 predicting that over the next two months, 4.8 million patients will be admitted to hospital because of coronavirus, including 1.9 million stays in the intensive care unit.

“This estimation is just that, an estimation,” Lawler said in an emailed statement. “However it is based upon the best epidemiological modeling and opinion of experts in pandemics and respiratory viral disease. This estimation assumes no attempt to lessen the outbreak, so there is the potential for these numbers to be altered somewhat by following public health recommendations like social distancing, avoiding large gatherings and practicing good hand hygiene.”

Dr. Eric Toner, a senior scholar at Johns Hopkins Center for Health Security, believes the need could even be even greater. Toner has been encouraging hospitals to prepare for a potential wave of coronavirus patients using numbers from a more familiar outbreak, an influenza pandemic.

The coronavirus is much more deadly than the flu, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, testified Wednesday during a hearing before the House Oversight and Reform Committee.

But he said the surge in patients is something the country has had experience with in the health care system.

In the 2017 US Department of Health and Human Services Pandemic Influenza Plan, the government modeled what it thought could happen with a flu pandemic.

Using a hypothetical moderate to very severe influenza pandemic, the plan estimated that with a moderate pandemic, 40 million people would need medical care, 1 million would need to be hospitalized and 200,000 would need intensive care. If the pandemic was very severe, 40 million would need medical care, but 9.6 million would need to be hospitalized and 2.9 million would need to be treated in an intensive care unit.

Toner said hospitals should get ready for a scenario similar to that of the 1918 Spanish flu, which left an estimated 500,000 people dead in the United States.

“I don’t think that will happen everywhere. It probably won’t happen in most places, but it will happen in some parts of this country.”

Toner said no one really can predict where that may happen, but he said resources could be stretched in a way that may shock a lot of people where the cases spike.