Why is the U.S. Healthcare System Still Struggling with COVID-19?

Dr. Cindy M. Duke
4 min readJul 17, 2020

Allow me to be straightforward and begin with some important reminders.

Our initial conservative estimates were that without any restrictions or social distancing, 50% of the American population will be infected with the novel SARS-Cov-2 coronavirus, in the absence of strict nationwide exposure-reducing measures.

This was based on consistent numbers coming out of China where between 20–30% of adults who were infected developed serious coronavirus disease and required intensive hospitalization. We saw similar numbers from countries in the EU, with the healthcare system in Italy and Spain actually buckling under the unprecedented surge of coronavirus-related complications.

The United States has an adult population of more than 200 million. And because of the country’s high rates of chronic conditions, 11 million are considered to be at serious risk if infected with COVID-19.

We only have about 900 thousand hospital beds in the United States, fewer than Italy per capita.

So far, we are seeing that out of all confirmed cases of COVID-19, between 1% and 3.4% will die.

I’ve seen posts and comments saying that the COVID-19 mortality rate does not seem super high. The rationale behind this claim is mostly based on comparisons with other illnesses or accidents like annual drownings etc. For example, the flu has caused an estimated 38 million illnesses, 390,000 hospitalizations and 23,000 deaths in the U.S. this past flu season alone. As of this writing, the United States have recorded 3,697,318 confirmed cases and 141,143 deaths tied to COVID-19. However, to conclude that the novel coronavirus is less of a threat than influenza is still ill-informed at best and deathly perilous at worst.

Regrettably, those who have tried to downplay its significance and possible implications have not only added to the noise, but are also hampering the collective effort of those among us who see it for what it is and are actively seeking ways to avoid the worst-case scenario.

A closer look at the numbers would tell us that although the COVID-19 mortality rate is anywhere between 1% and 3.4%, those 20–30% of infected adults who develop severe symptoms need serious and long term medical care. Medical care which entails hospital beds, intensive care units, ventilators and other essential medical equipment and staff, of which we continue to be in short supply!

For those speaking from an uninformed and inexperienced position i.e. armchair experts outside the medical community, it really is not just that experts and healthcare practitioners are freaking out because 3.4% of the infected are dying. We are actually rightfully alarmed by the fact that if we continue to ignore the continuing rise in numbers as we prematurely relax restrictions or shirk recommendations to wear a mask, 25–70% of our populations are infected and millions more people could need healthcare intervention and medical facilities all while we are already severely nearing capacity!

We simply do not have anything close to that number of hospital beds or medical personnel!

Don’t even get me started on the number of healthcare personnel who will be needed to tend to the rapid surge of infections that comes with an outbreak. Even if we take a more conservative approach and say that only 10% of infected people will need hospitalization, we are still talking about hundreds of thousands to millions of people in need of hospital beds and serious medical attention in an already stressed and stretched healthcare system.

Not only do we have fewer than a million total hospital beds in the United States — we have patients who are not infected with COVID-19 but will otherwise need to be in the hospital too!

The point is, WE ARE STILL ILL-EQUIPPED!!!

The success of the US healthcare system is dependent on the vast majority of its population being relatively healthy. Unfortunately, a pandemic changes all of that. Basic math now tells us that people are not just being irrational and alarmist. Our reactions are justified, and we have every right to call for more effective ways of flattening the curve until an effective vaccine and treatment are found. That starts with everyone ceasing to politicize the wearing of masks and continuing to wash hands while also practicing social distancing.

We should all be concerned and do everything in our power to reduce our exposure and chance of infection. We’ve long needed more hospital beds and personnel in the US but ‘fiscally’, we’ve been told it doesn’t make sense. So, for right now, all we can do is strive to continue to keep the rate of infection as low as possible.

For those obsessing over the conspiracy theories, politicized arguments against masks or ‘fake news’ claims, STOP! Just help to flatten the curve by wearing a mask correctly and heeding the warnings. I promise you that there will be plenty of time to argue over the conspiracies after this virus is truly contained. Until then, We are nowhere near close to being back to life as normal!

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Dr. Cindy M. Duke

Dr. Cindy Duke is a Hopkins & Yale trained Physician, Virologist, Blogger, Influencer & Clinical Assistant Professor. fertilitynevada.com, drcindyduke.com