Becker's Hospital Review

37 FINANCE CMO / CARE DELIVERY Dr. Atul Gawande: Why COVID-19 vaccinations will test American society By Molly Gamble T he distribution of COVID-19 vaccines in America will test a deeply divided society, and not just because of mistrust in vaccinations, Atul Gawande, MD, told New Yorker Editor David Remnick. Dr. Gawande, longtime contributor to the New Yorker and member of President-Elect Joe Biden's COVID-19 task force, described the distribution of COVID-19 vaccines as the most challenging undertaking of 2020. "We have deployed north of 120 million coronavirus tests in the course of eight months. is is going to be 330 million vaccinations, done twice, and hoping to accomplish it in the course of six months or less," said Dr. Gawande, who is also a surgeon at Boston-based Brigham and Women's Hospital and a professor at Boston-based Harvard Medical School. Clear challenges lie in vaccine production, FDA ap- proval and the supply chain. But there is something larger at bay, too: e intensity of people clamoring for themselves and their families to be vaccinated as soon as possible will likely exceed the intensity of oth- er divisions formed in 2020, such as those over lock- downs or face masks. Fierce public demand matched with a relatively subjective prioritization process runs the risk of people seeing the Great American Vacci- nation as rigged. To prove otherwise — that vaccines are distributed fairly and rationally — is the ultimate opportunity for leaders in healthcare, public health and government. "ink about it. e bus drivers never came before the bankers before," said Dr. Gawande. "You're going to have Zoom workers who want to go back to normal, and I cannot blame the number of people who will say, 'You know, thank God I can finally not be in fear. Let me get the vaccine. What do you mean, I have to wait five months?'" "I can imagine a million ways [of jumping the line], people paying someone $2,500 to get your work I.D. tag. is is all about rallying people together. It can't just be about the rules. It has to be about how we all understand this and work together to say, 'ese are the folks most at risk. ey make our subways work. ey make our buses work. ey get our food supply to us. ey make it possible for me to go grocery shop- ping, and I'll just have to wait three or four months for my turn." n Hospitals saw drop in some HAIs: 4 CDC findings By Gabrielle Masson U .S. hospitals saw improvement fighting bloodstream and urinary tract infections rates in 2019, according to the CDC's 2019 National and State HAI Progress Report released in December. The report uses 2018-19 data from more than 36,000 hospitals, nurs- ing homes and other healthcare facilities to analyze rates of central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated events, surgical site infections, methicillin-resistant Staphylococcus aureus bloodstream events and Clostridioides difficile events. Four national report findings for acute care hospitals: 1. Overall, U.S. hospitals reported a 7 percent decrease in central line-as- sociated bloodstream infections from 2018 to 2019, with the largest de- crease — 13 percent — in neonatal intensive care units. 2. Catheter-associated urinary tract infections dropped by 8 percent, with the largest decrease — 12 percent — reported by ICUs 3. Ventilator-associated events increased by 2 percent, with the highest increase observed in ICUs. 4. There was no significant change in surgical site infections. n COVID-19 surge forces Indiana hospital to divert ambulances for 2nd time in 20 years By Mackenzie Bean E lkhart (Ind.) General Hospital was forced to divert ambulances in November 2020 for only the second time in 20 years amid a surge in COVID-19 patients, reported NBC News. The hospital went on diversion for seven hours Nov. 10, after surpassing its 144-bed capacity with 206 patients. Elkhart General houses one of only two emergency rooms in Indiana's Elkhart County. Goshen (Ind.) Hospital houses the second, which is about a 30-minute drive away. "That's not something we take lightly, and we rarely have had to do that," Michelle Bache, MD, vice president of medical affairs at Elkhart General, told NBC News of the diversion. The situation at Elkhart General is not unique — the nationwide surge in COVID-19 cases has forced many other hospitals to divert ambulances, according to the American Hospital Association. "As COVID-19 cases and hospitalizations rise across the country, we have seen and heard anecdotal reports of hospitals having greater diffi- culty transferring patients and having to go on diversion due to capacity and staffing issues," an AHA spokesperson told NBC News. n

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