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As coronavirus cases soar in North Texas, the number of available hospital beds continues to shrink.

Thursday, Dallas County’s health department reported a record-high number of COVID-19 hospitalizations for the fourth day in a row, along with 2,590 new cases and 20 deaths. The region is now poised to undergo crises like those endured by other major cities.

For instance, ABC7 reported this week that Los Angeles first responders must refrain from bringing patients to the hospital who have little chance of survival, such as car accident victims who couldn’t be revived at the scene.

Some people don’t think about the fact that non-COVID patients may be denied medical attention, said Dr. Erin Carlson, an associate clinical professor in the College of Nursing and Health Innovation at the University of Texas at Arlington.

“This isn’t only about COVID patients,” Carlson said. “This is also about the impact it has on patients with other conditions and both current and future patients.”

As of Thursday, there were 17 ICU beds left in Dallas County, said Dr. Philip Huang, director of the county’s health department. Coronavirus cases and hospitalizations are already at a record-high and they keep getting worse.

It’s not just an issue of how many ICU beds are available, Carlson said; space can always be made for more. Rather, overwhelmed hospitals will lead to overwhelmed health care staff, who have already been stretched thin over the past several months.

Dallas County Judge Clay Jenkins echoed that fear.

“What we can’t create or find right now are more nurses, doctors and respiratory therapists because there’s a national shortage and everybody wants those,” he said.

If hospital systems are bottlenecked, a delay in care will follow, Carlson said. Doctors and nurses will be tasked with tending to a greater number of patients, so some may not receive the same level of care that they normally would for treatment of heart attacks and strokes.

Also, since elective surgeries have been suspended, those in need of life-changing procedures such as back surgery must endure a lower quality of life, she said.

When ICU staff runs out, Carlson said some hospitals have to recruit health care providers who aren’t necessarily trained in or accustomed to critical care. For instance, she’s heard of cases where a dermatologist was enlisted to work in the ICU, or an OB-GYN was drafted for pulmonary care.

On top of that, many providers are exhausted, which could mean that despite best efforts, they’re more prone to making errors, she said.

“They’re drained, they’re emotionally spent and now they might be put into a position to have to make serious decisions about who gets care and who doesn’t, or who gets resources and who doesn’t,” Carlson said.

North Texans have done well at abiding by coronavirus guidelines, Jenkins said, but more people have been gathering than normal on account of the recent holidays. The region is now seeing the ramifications of those get-togethers.

Everyone should keep in mind that cases are much higher than they were in the spring, so chances of catching the virus are also greater, Jenkins said. People need to make smart decisions ahead of what will be the region’s toughest months.

“We’ve heard that saying, ‘it’s darkest before the dawn,’” he said. “Well, when it comes to hospitalization and the spread of COVID, our darkest months should be January and February.”

Last month, vaccine distribution began in the region, so things may start looking brighter in March, Jenkins added.

But even after getting vaccinated, people should continue social distancing and wearing masks, Huang said. It takes a week or two after the second dose to fully kick in, and no one has hit that point yet. Even then, recently inoculated people could be vulnerable to getting COVID, and there hasn’t been enough time to see how the vaccine affects transmission.

Aside from the obvious effect COVID-19 has on patients, there’s another major human cost when hospitals reach capacity, Carlson said: Some health care providers may have to decide who gets care and who doesn’t. To be sure, medical workers have protocols to consult about who gets preferred treatment, but it would be terrible to have to enact them.

When people are careless in coronavirus prevention measures, they put health care staff in the position to make such life and death calls, Carlson said.

“Nobody should be put into that position if it can be prevented,” she said. “And it can be prevented in these situations.”

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