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What overwhelmed hospitals look like in the COVID era

Utah doctors are doing what they say is the equivalent of rationing care. Intensive care beds in Minnesota are nearly full. And the country overall continues to break hospitalization records — all as millions of Americans travel to spend Thanksgiving with friends and family.

Why it matters: America's health care workers are exhausted, and the sickest coronavirus patients aren't receiving the kind of care that could make the difference between living and dying.


The big picture: Some overwhelmed hospitals are sending patients away to receive care elsewhere, while others are reducing the quality of care that their patients receive — a byproduct of being short-staffed.

  • For example, 75% of counties in Kansas and Missouri don't have any ICU beds, so these patients are sent to city hospitals — some of which are starting to crack under the increased caseload, NPR reports.
  • "It's not just the rural health care infrastructure that becomes overwhelmed when there aren't enough hospital beds, it's also the surrounding neighborhoods, the suburbs, the urban hospital infrastructure starts to become overwhelmed as well," Shannon Monnat, a rural health researcher at Syracuse University, told NPR.

What they're saying: "There are things going on right now that wouldn't normally happen," Andy Pavia, chief of pediatric infectious disease at the University of Utah, told the Salt Lake Tribune.

  • "Patients from Idaho are not being accepted. People are staying in small community hospitals rather than coming to referral hospitals, where the greater [technical] sophistication is. It's just not the point where people are stacked up in the hallways with no bed."

The bottom line: One of the nation's most finite resources in our fight against COVID is health care workers. In too many places, they're reaching capacity.

Go deeper: U.S. coronavirus hospitalizations keep breaking records

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World coronavirus updates: Global cases top 16 million

Data: The Center for Systems Science and Engineering at Johns Hopkins; Map: Axios Visuals

The number of novel coronavirus cases surpassed 16 million globally early Sunday, per Johns Hopkins data.

By the numbers: More than 644,500 people have died from the virus worldwide, per Johns Hopkins data. Over 9.2 million have recovered.

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Trump says he will announce Supreme Court pick on Saturday

President Trump tweeted Tuesday that he plans to announce his Supreme Court pick on Saturday.

Why it matters: Republicans are moving fast to replace the late Justice Ruth Bader Ginsburg, which would tilt the balance of the high court in conservatives' favor and have lasting impact on climate policy, immigration and the Affordable Care Act. Judge Amy Coney Barrett, who met with the president this week, is a frontrunner for the job.

Billionaire philanthropist Robert Smith's tax fraud roils Vista Equity

Robert Smith's admission to tax fraud has done more than just cost him a whopping $140 million. It's also roiled Vista Equity Partners, the private equity firm he founded and leads, with some insiders and limited partners feeling they were misled (or left in the dark) about the extent of Smith's legal troubles.

Behind the scenes: Smith called a virtual meeting of Vista's managing directors and other top staffers on Wednesday, to discuss details of his settlement. A source says he called the overall experience "humbling" and that he regretted the "undue burden" that his actions had put on others, including some Vista colleagues.

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