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October 19, 2020

Coronavirus case numbers are spiking again—and in many states, they're worse than ever

Daily Briefing

    Covid-19 hospitalizations are once again rising throughout most of the United States, and hospital and state officials are responding by launching field hospitals and taking other steps to increase their capacity to care for another influx of patients.

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

    US new coronavirus cases top 8.1M, deaths surpass 219K

    The new data comes as U.S. officials as of Monday morning reported a total of 8,190,900 cases of the novel coronavirus since the country's epidemic began—up from about 8,020,100 cases reported as of Friday morning.

    On Friday, U.S. officials reported more than 69,000 new coronavirus cases, which was the country's highest number of newly reported cases in a single day since July, the Wall Street Journal reports. According to the New York Times, the United States' average daily number of newly reported coronavirus cases over the past week was 56,615—which is up by 30% when compared with the average from two weeks ago.

    Data from the Times shows that the rates of newly reported coronavirus cases are "staying high" in Guam and 30 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, Arkansas, Colorado, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming.

    According to the Journal, rates of newly reported coronavirus cases have been particularly high in Midwestern states in recent weeks. For example, Indiana and Wisconsin each reported record-high increases in their numbers of newly reported coronavirus cases for a second day in a row on Friday.

    Meanwhile, the rate of newly reported cases over the past seven days is "going down" in Puerto Rico, which had previously seen elevated case rates.

    Washington, D.C., and 13 states that have had comparatively low case rates are now seeing those rates "going up," according to the Times. Those states are Arizona, Connecticut, Florida, Georgia, Louisiana, Michigan, New Hampshire, New Jersey, Oregon, Pennsylvania, Vermont, Virginia, and Washington.

    In the eight remaining U.S. states and territories, rates of newly reported coronavirus cases are "staying low," according to the Times' analysis.

    U.S. officials as of Monday morning also reported a total of 219,541 deaths linked to the coronavirus since the country's epidemic began—up from about 217,585 deaths reported as of Friday morning.

    Covid-19 hospitalizations are rising throughout most of US—and hospitals are feeling strained

    Along with increases in newly reported cases of the coronavirus, states throughout America also are reporting surges in their numbers of hospitalized patients with Covid-19, the disease caused by the virus.

    As of Wednesday, U.S. hospitals reported having more than 37,000 Covid-19 patients, which is the highest reported number of hospitalized Covid-19 patients that the country has seen in nearly two months. That number still is lower than the peak in hospitalized Covid-19 patients that the United States had reported in mid-April, however. Then, the country had reported having almost 60,000 hospitalized Covid-19 patients, according to data from The Atlantic's COVID Tracking Project, CNBC reports.

    Covid-19 hospitalizations currently are rising in 39 states—with 16 states reporting either having reached or nearing their highest hospitalization rates since the country's coronavirus epidemic began, Axios' "Vitals" reports. And as a result of those spikes, some hospitals are beginning to run low on staff, hospital beds, and ICU capacity.

    For example, Julie Willems Van Dijk, a deputy secretary at Wisconsin's Department of Health Services, said, "Many of our ICUs are strained. Every region of our state has one or more hospitals reporting current and imminent staff shortages."

    Similarly, Lindsay Weaver, CMO of Indiana's State Department of Health (ISDH), said Indiana is experiencing "critical ICU bed shortages along with personnel shortages." According to data from ISDH, fewer than one-third of the state's ICU beds are available.

    In Utah, Gov. Gary Herbert (R) last week said the state's "hospitals are getting overwhelmed," as "[t]he dramatic increase in [new coronavirus] infections has put the integrity of [Utah's] health care system at risk."

    For instance, the University of Utah Health System—which is one of Utah's largest health systems—reported that its ICU is 95% occupied, Politico reports.

    Elsewhere, data from Texas' Department of State Health Services shows the region near El Paso, Texas, has only 10 remaining ICU beds available. And in Oklahoma, a spokesperson for Integris, the state's largest health system, on Thursday said the health system had one ICU bed available—after having none available on Wednesday, according to Politico.

    How state, hospital officials are responding

    Hospital and state officials are taking several steps to address the new surges in Covid-19 patients and related shortages in capacity and personnel.

    For example, Wisconsin Gov. Tony Evers (D) on Wednesday opened a field hospital at Wisconsin's State Fair Park to care for certain Covid-19 patients, and Evers' administration has asked the Army Corps of Engineers to review plans for two additional field hospitals in the state.

    In Utah, Herbert said the National Guard is on standby to construct a field hospital in a convention center outside of Salt Lake City, Politico reports.

    On the provider level, some health systems have had to relocate patients to other facilities because of staffing and bed shortages—and in some instances, patients have had to seek care across state lines because of capacity issues, according to Politico.

    For instance, Renae Moch, director of Bismarck-Burleigh Public Health in North Dakota, said some people who live in rural areas of the state at times have had to travel to Montana and South Dakota to receive care, because hospitals in Bismarck reached had their bed capacity. The state also has struggled with shortages of health care providers, Moch said, and she's concerned the situation could get worse as the United States heads into flu season.

    "We have had a nursing shortage prior to the [epidemic], and so the additional workload and additional hospital capacity that's come with Covid has impacted and affected staffing," Moch explained. "For us, this is the worst that it's been," and "I think especially with the flu season coming up and the possible impacts of that as we move into the fall ... we need to get a handle on this before it gets any worse, and I'm sure it can get worse," she said.

    Allison Suttle—CMO of Sanford Health, which has hospitals throughout both South Dakota and North Dakota—said the health system has been adding beds to treat more patients. According to Suttle, Sanford Health was able to prepare for a fall surge in Covid-19 hospitalizations and to stock up on medical supplies, and she feels confident that the health system will be able to treat the influx in Covid-19 patients seeking care.

    However, Suttle noted that many patients delayed seeking care for other medical conditions amid the country's first Covid-19 surge in the spring, and those patients now are coming to the hospital in worse condition—right as the number of Covid-19 hospitalizations are starting to rise. 

    "What we're seeing as the hospitalizations of Covid-19 increase in direct correlation to the number of cases increasing in our communities, we're also seeing sicker patients [who] have delayed care in March and April [who] are now coming in with problems," Suttle said. "They require more intense care, longer hospital stays, so that all compounds" (Yu, Wall Street Journal, 10/17; Hellmann, The Hill, 10/17; Owens, "Vitals," Axios, 10/19; Higgins-Dunn et al., CNBC, 10/17; Walsh, Forbes, 10/15; Goldberg, Politico, 10/16; New York Times, 10/19).

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