January 7, 2021

'Care now has to be rationed': Hospitals are at the breaking point amid Covid-19 surge

Daily Briefing

    The United States is consistently setting new daily records for reported hospitalizations and deaths tied to the novel coronavirus—and as cases of severe Covid-19 continue to rise, hospitals in some areas are struggling to treat influxes in patients.

    Your top resources for Covid-19 response and resilience

    America grapples with persistently high rates of new coronavirus cases

    According to data compiled by the New York Times, U.S. officials as of Thursday morning had reported a total of about 21.4 million cases of the novel coronavirus since America's epidemic began—up from about 21.1 million cases reported as of Wednesday morning.

    According to the Times, the United States' average daily number of newly reported coronavirus cases over the past week was 230,609—which is up by 8% when compared with the average from two weeks ago. Public health officials expect to see spikes in new coronavirus cases over the next few weeks because of Americans gathering with others over the recent holidays.

    As of Thursday morning, data from the Times showed that the rates of newly reported coronavirus cases were "staying high" in Washington, D.C., and 43 states that have had a daily average of at least 15 newly reported cases per 100,000 people over the past week. Those states are Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Rhode Island, South Carolina, South Dakota, Texas, Utah, Vermont, Virginia, Washington, West Virginia, and Wisconsin.

    According to the Times, Arizona currently is reporting the highest rate of new coronavirus cases in the United States, with state officials over the past week reporting an average of more than 8,000 new cases per day, which is more than double the number of new cases the state reported during its previous peak in the summer. On Wednesday, Joshua LaBaer, director of Arizona State University's Biodesign Institute, said Arizona is "the hot spot of the world right now" for new cases of the virus.

    Meanwhile, the Times' data showed that, as of Thursday morning, the daily average number of newly reported cases over the past seven days was "going down" in Puerto Rico and six states that had been seeing comparatively higher rates of coronavirus transmission. Those states are Idaho, Montana, North Dakota, Pennsylvania, Tennessee, and Wyoming.

    In Guam, Hawaii, and the U.S. Virgin Islands, rates of newly reported coronavirus cases were "staying low" as of Thursday morning, the Times' data showed.

    Covid-19 hospitalizations, deaths hit new highs

    At the same time, the United States is consistently reporting new daily records for Covid-19 hospitalizations and deaths—with new highs recorded nearly every day, Axios' "Vitals" reports.

    According to the Times, U.S. officials on Wednesday reported about 3,964 new deaths tied to the coronavirus, setting a single-day record. As of Thursday morning, U.S. officials had reported a total of about 361,383 U.S. deaths linked to the novel coronavirus since the country's epidemic began, up from about 357,394 deaths reported as of Wednesday morning.

    Meanwhile, U.S. hospitalizations for Covid-19, the disease caused by the novel coronavirus, reached a another new high on Wednesday, according to data from The Atlantic's COVID Tracking Project. The data showed that 132,476 Americans with Covid-19 were hospitalized for treatment on Wednesday, including 23,707 who were receiving care in an ICU and 7,953 who were on a ventilator.

    According to "Vitals," Covid-19 deaths and hospitalizations serve as indicators of severe cases of Covid-19, because patients who are mildly ill with the disease generally do not die and are not hospitalized because of the illness—particularly now when many hospitals throughout the United States are struggling to keep up with an influx of Covid-19 patients.

    Influx of Covid-19 patients overwhelm US hospitals

    Throughout the United States, surges in new Covid-19 patients are overwhelming hospitals. In 34 states, Covid-19 patients occupy at least 10% of hospital beds, "Vitals" reports—but in some states, Covid-19 patients are filling larger shares of hospital beds. For instance, Arizona, California, and Nevada each have reported that more than 30% of their states' hospital beds are occupied by Covid-19 patients.

    In California, many hospitals are reporting staffing and capacity shortages. For example, Anish Mahajan, Harbor-UCLA Medical Center's CMO, said adequately staffing his hospital—which has stretched its ICU capacity to 150% of its normal limit—has become a persistent challenge, because many of his staffers have fallen ill with Covid-19 or have had to quarantine due to exposure to the coronavirus.

    "Somebody who wears their [personal protective equipment] perfectly and deals with high-risk patients doesn't get sick at work. ... When they get home, their teenager might give them [Covid-19]. We see that a lot," Mahajan explained. "We end up short-staffed in everything, from nurses to doctors to even the custodial staff that helps us turn over the rooms. And all of that makes it even more difficult to take an onslaught of more and more patients."

    According to the Los Angeles Times, in December, more than 2,200 hospital workers in Los Angeles County tested positive for the novel coronavirus.

    On Monday, Los Angeles County Board of Supervisors Chair Hilda Solis said hospitals in the county are now declaring internal disasters as a result of their influxes of Covid-19 patients. "We are pushing the limits of the hospital infrastructure," Solis said. "Care now has to be rationed."

    California officials on Tuesday issued a public health order directing hospitals with available space to accept patients from hospitals whose ICU beds are maxed out.

    "If we continue to see an alarming increase of Covid-19 patient admissions at hospitals statewide, some facilities may not be able to provide the critical and necessary care Californians need, whether those patients have Covid-19 or another medical condition," said Tomás Aragón, the state's public health officer.

    Officials elsewhere have warned that, without stringent adherence to public health measures intended to curb the coronavirus's spread, other states could find themselves in the same situation as California.

    Marjorie Bessel—chief clinical officer at Banner Health, a major hospital network in Arizona—said, "Most Americans don't want to know, don't want to acknowledge, don't really want to recognize, and certainly—even as it's descending upon us—do not appear to understand the dire circumstances that we are facing" (Tang, Associated Press, 1/6; Owens, "Vitals," Axios, 1/7; Caspani/Szekely, Reuters, 1/6; Nagourney, New York Times, 1/7; Karlamangla, Los Angeles Times, 1/6; Money et al., Los Angeles Times, 1/6; Associated Press/Modern Healthcare, 1/6; Hauck, USA Today, 1/5; New York Times, 1/7; "The COVID Tracking Project," The Atlantic, accessed 1/7).

    How Covid-19 is changing the future of the health care industry

    hospital

    Read on to get Advisory Board's take on how Covid-19 will reshape demand, purchaser strategies, the competitive landscape, and delivery models.

    Get our Take

    Have a Question?

    x

    Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.

    X
    Cookies help us improve your website experience. By using our website, you agree to our use of cookies.