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Intensive care beds almost reach nationwide capacity, new data shows




Share of occupied ICU beds

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85%

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Source: New York Times analysis of US Department of Health and Human Services data.·Note: Displays the average number of patients over 7 days per service area of ​​the hospital.

In El Paso, hospitals reported that only 13 of 400 intensive care beds were unoccupied last week. In Fargo, ND, there were only three. In Albuquerque, there were none.

More than a third of Americans live in areas where hospitals are sorely lacking in intensive care beds, federal data shows, revealing a newly detailed picture of the nation’s hospital crisis in the deadliest week in the world. Covid-19 epidemic.

Hospitals serving more than 100 million Americans said they had less than 15% of intensive care beds still available last week, according to a Times analysis of data reported by hospitals and released by the Department of Health and Human Services .

Many areas are even worse off: One in 10 Americans – across much of the Midwest, South, and Southwest – lives in an area where intensive care beds are either completely full or less than 5% of beds are available. At these levels, experts say maintaining existing standards of care for the sickest patients can be difficult, if not impossible.

“Our primary care can’t offer a lot, especially when you arrive in these truly rural counties that are currently hit hard by the pandemic,” said Beth Blauer, director of the Centers for Civic Impact at Johns University. Hopkins.

A sharp increase in the number of patients with Covid-19 can overwhelm small hospitals, she said. “This disease progresses very quickly and can get very ugly very quickly. When you don’t have this ability, it means people will die. ”

The new data set, released on Monday, marks the first time the federal government has released detailed geographic information on Covid-19 patients in hospitals, which public health officials have long said would be crucial to respond to the epidemic and understand its impact.

Where hospitals are at full capacity

High population areas

All hospital service areas

Covid patients
for 100k ▼
Covid intensive care patients
for 100k
Hospital
occupation
ICU
occupation
National average 30 5 59% 72%
White Plains, New York 175 31 79% 79%
Troy, Michigan. 135 15 79% 87%
Abington, Pennsylvania. 132 30 77% 102%
Fort Thomas, Ky. 121 31 146% 82%
Amarillo, Texas 117 42 78% 94%
Saginaw, Mich. 117 23 98% 99%
Oak Lawn, Illinois. 112 23 71% 78%
Paterson, NJ 110 17 71% 50%
Jonesboro, Ark. 109 28 78% 94%
Altoona, Pennsylvania. 103 19 94% 94%

Note: The locations shown represent hospital service areas and national averages correspond to service areas for which data exists. Percentages greater than 100 can occur when hospitals report patients beyond their normal limits.

Hospitalization figures collected by the Covid Tracking Project show that the number of people hospitalized with the virus across the country has doubled since early November. But existing state-level figures have masked vast differences within states, making it difficult to recognize local hot spots.

The new data shows that some areas – like Amarillo, Texas, Coral Gables, Florida, and Troy, Michigan – are experiencing rates of severe illness caused by Covid-19 that are approaching levels seen in New York City during the worst weeks of spring. .



Covid-19 patients per 100,000 inhabitants

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Political leaders in many states are stepping up measures to try to slow the spread. Last week, California issued stay-at-home orders for areas where hospitals have exceeded 85% of intensive care occupancy rates. Governor Michelle Lujan Grisham of New Mexico, where intensive care units are full statewide, is expected to announce soon that hospitals can ration care based on who is most likely to survive.

Doctors and researchers said the shortages were already causing serious damage.

In North Dakota, which for weeks this fall had the nation’s worst per capita infection rate, the number of unoccupied intensive care beds statewide has occasionally dropped to single digits in early November. In the small town of Minot, the local hospital, Trinity Health, has dedicated more than an entire floor of its six-story hospital to patients with coronavirus.

Other North Dakota hospitals would normally accept transfers to help ease the burden, but when Chief Medical Officer Dr Jeffrey Sather called for help he found everywhere else to be full, too.

Patients kept arriving, piling up in his emergency room. “There is no place for them,” he said at the time.

Survival rates for the disease have improved as doctors have learned which treatments work. But hospital shortages could reverse those gains, risking death rates to rise again as patients cannot receive the level of care they need.

Thomas Tsai, assistant professor of health policy at Harvard University, said that when resources are severely limited, healthcare workers already facing burnout are forced to make emotionally wrenching decisions about who gets cares.

There is evidence that doctors are already limiting care, Dr Tsai said. In recent weeks, the rate at which Covid-19 patients go to hospital has started to decline. “This suggests that there are stricter rationing and triage criteria for those admitted, as hospitals remain full,” he said.

In California, where a shortage of hospital beds triggered a lockdown across much of the state by Monday, hospital workers are bracing for the next few months. More than 10,000 Covid-19 patients are now hospitalized in the state, more than 70% above levels from two weeks ago, and the effects of the Thanksgiving holiday may not have been fully felt yet.

At the University of California San Diego Medical Center, only nine intensive care beds were unoccupied Monday. The atmosphere at the hospital was one of resignation, said Dr Chris Longhurst, deputy chief medical officer. For months, health workers have seen much of the public ignore their advice to take precautions and avoid the spread of the virus, he said, and now, inevitably, they are seeing more and more people arrive sick at their doorstep.

“A lot of healthcare workers have worried about that, about the lack of compliance, and now we’re seeing it play out, and you kind of feel resigned,” he said. “You have to go to work every day and help people who need hospital care, but we want this to stop beforehand.”

So far, policymakers have relied heavily on test and case data to make policy decisions, especially whether schools and businesses should stay open. But the new, detailed hospital data can lead to a rapid change in what executives consider when making decisions, said Ms. Blauer, of Johns Hopkins.

“If you live in a place where there is no intensive care bed for 100 miles, you have to be extremely careful about the social interaction you allow the community to take,” she says.

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