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September 25, 2021

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Sisolak: State doesn’t have enough ventilators in fight against virus

Ventilators at Sunrise Hospital

Steve Marcus

Medical ventilators are displayed outside Sunrise Hospital and Medical Center Thursday, March 19, 2020. The hospital has 120 ICU ventilators as well as transport ventilators and other machines that can be used as ventilators, said Rob Smith II, associate chief medical officer at Sunrise Hospital.

Ventilators at Sunrise Hospital

Ryan Hamblin, director of respiratory at Sunrise Hospital and Medical Center, displays medical ventilators at Sunrise Hospital Thursday, March 19, 2020. The hospital has 120 ICU ventilators as well as transport ventilators and other machines that can be used as ventilators, said Rob Smith II, associate chief medical officer. Launch slideshow »

Patients are placed on a ventilator if they are having trouble breathing or can’t breathe on their own, including those under general anesthesia for surgery. It’s also critical life-support equipment for those with COVID-19, the disease caused by coronavirus.

But in Nevada, there’s a shortage of ventilators and other medical supplies needed to combat the virus, and there doesn’t appear to be any help in sight from the federal government, Gov. Steve Sisolak said Friday. As it stands now, the state will be overwhelmed if more than a few hundred cases of coronavirus require ventilators — meaning hospitals won’t have them available for anyone, for any purpose.

Statewide, there are 718 ventilators at acute-care and critical-care hospitals, such as University Medical Center in Las Vegas, the Nevada Hospital Association reports. Of those, 232 machines, or 32%, are already in use by patients with a variety of ailments.

When asked Friday by the Sun about the state’s ventilator capacity, Sisolak bluntly responded: “We don’t have enough. We don’t have enough in any of our hospitals.”

Nevada has fewer than 5,000 acute-care beds and of those, fewer than 700 are intensive care beds better equipped to handle severe cases of COVID-19, Sisolak said.

“Right now, more than 80% of all those beds are occupied with a mix of COVID-19 and other patients,” the governor said. “That means, we have only 20% (140) of beds available. We have similar limits when it comes to ventilators.”

Of all the ventilators statewide, some 536 are in Southern Nevada, and 195 of those are already in use, according to the hospital association.

Sunrise Hospital and Medical Center said it has 150 ventilators, and MountainView Hospital reported 50. University Medical Center didn’t respond to a request for information, but the Nevada Current reported that UMC has 115 ventilators.

A spokesperson for Dignity Health, parent company of St. Rose Dominican hospitals, said in an email message that “those type of figures I can’t share with you right now.”

The first case of the coronavirus in Clark County was reported March 5. As of Friday, there were 126 cases and two deaths, according to the Southern Nevada Health District.

At that pace, the number of infected people in the Las Vegas area will soon be in the multiple hundreds and put a strain on the valley’s health care system — everything from available hospital beds, face masks for medical workers and, most notably, ventilators.

The American Hospital Association estimates 960,000 Americans could need mechanical help breathing during the coronavirus pandemic. But the nation has only about 200,000 of the machines, according to the association, and about half are older models that may not be ideal for the most critically ill patients.

Many ventilators are already being used for patients with other ailments. Add more than 10,000 coronavirus cases to the mix — the U.S. cleared that benchmark Thursday — and it’s a formula for disaster. Also, there are only enough respiratory therapists, specialist nurses and doctors with the ideal type of critical care training in the U.S. for about 135,000 patients to be put on ventilators at any one time, Society of Critical Care Medicine said.

The Trump administration says it is working to get hospitals more ventilators. Manufacturers are ramping up production, but whether they can turn out enough machines at a time nations around the world are clamoring for them, too, is unclear. On Friday, the president claimed non-medical companies were ramping up to manufacture ventilators, but when pressed to name them, he refused to do so other than to say General Motors was making some parts.

“The most important thing right now is to plan ahead and start mobilizing all the resources at hospitals in the city and at the state and national level ... to get ventilators to places that need them the most,” said Jacqueline Kruser, an intensive care physician and professor at Northwestern University’s medical school. “Waiting until a shortage occurs or appears imminent is going to be far too late.”

Dr. Robert Smith, associate chief medical officer at Sunrise Hospital and Medical Center and Sunrise Children’s Hospital, said the facility is prepared to deal with the virus, though he could not say how many, if any, COVID-19 patients are there because of privacy policies.

“This is what we do every day; we know how to identify and treat infectious diseases while minimizing risk to caregivers, just as we have done with seasonal flu and tuberculosis,” he said.

Dr. Brian Labus, an assistant professor with the UNLV School of Public Health and former senior epidemiologist with the Health District, said valley health officials have prepared and practiced for responding to a pandemic, “but to actually live it is a totally different experience.”

The health care system has a lot of “just-in-time delivery of critical items, which can easily be disrupted when demand spikes and everyone is clamoring for those same scarce supplies,” he said. “That is a challenge in any emergency. It all depends on how the disease spreads in our community.”

Sisolak said putting the brakes the spread of the disease is critical.

“Let me be clear, if we do not do everything we can to slow this virus, hospital beds will soon be completely filled with COVID-19 patients,” Sisolak said. “There will be no beds to set broken bones, treat heart attacks or use for other necessary medical procedures.”

Ray Brewer, Kelcie Grega, Emma Cauthorn and the Associated Press contributed to this report.