Understand how we got here — and how to move forward.


December 10, 2020

Is your county critically short on hospital beds? Here's how to find out.

Daily Briefing

    The United States on Wednesday once again reported record-high numbers of new deaths and hospitalizations linked to the novel coronavirus, and new data shows that hospitals throughout the country are running critically low on ICU capacity.

    US coronavirus cases top 15.4m

    U.S. officials on Wednesday reported about 218,667 new cases of the novel coronavirus, according to data compiled by the New York Times. As of Thursday morning, U.S. officials had reported a total of about 15.4 million cases of the virus since America's epidemic began—up from about 15.2 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 209,862—which is up by 19% when compared with the average from two weeks ago.

    As of Thursday morning, data from the Times showed that the rates of newly reported coronavirus cases were "staying high" in Puerto Rico; Washington, D.C.; and 40 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, Idaho, Indiana, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Mississippi, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington, and West Virginia.

    According to Axios' "Vitals," reported cases of the new coronavirus in recent weeks have continued to spike in the Midwest and Great Plains. Over the past week, for instance, Indiana, South Dakota, and Utah each reported an average of at least 100 new cases of the virus per day for every 100,000 residents. Rhode Island also reported an average of at least 100 new cases per 100,000 residents per day over the past week, and 16 other states reported daily averages of between 75 and 100 new cases of the virus per 100,000 residents, "Vitals" reports.

    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 nine states that had been seeing comparatively higher rates of coronavirus transmission. Those states are Illinois, Iowa, Minnesota, Montana, New Mexico, North Dakota, South Dakota, Wisconsin, and Wyoming.

    The U.S. Virgin Islands has had comparatively low case rates, but it was seeing those rates "going up" as of Thursday morning, according to the Times. In the Guam and Hawaii, meanwhile, rates of newly reported coronavirus cases were "staying low" as of Thursday morning, the Times' data showed.

    Many US hospitals are running low on ICU beds

    Meanwhile, U.S. hospitalizations for Covid-19, the disease caused by the novel coronavirus, grew to a new high for the 12th consecutive day on Wednesday, according to data from The Atlantic's COVID Tracking Project. The data showed that 106,688 Americans with Covid-19 were hospitalized for treatment on Wednesday, including 20,903 who were receiving care in an ICU and 7,621 who were on a ventilator.

    On Monday, HHS released new data on Covid-19 patient counts and capacity at individual hospitals throughout the country, offering the most detailed public look yet at how the epidemic is straining the U.S. health care system. On Wednesday, NPR launched a launched a tool based on an analysis of the new federal data by the University of Minnesota's Covid-19 Hospitalization Tracking Project that allows users to view how many hospital beds in their areas are filled with Covid-19 patients, both at the local-hospital level and on average by county.

    According to NPR, the ratio of Covid-19 hospitalizations to total beds serves as an indicator of a hospital's level of strain. NPR reports that although there's no clear threshold for a hospital's strain level, hospital experts said it's concerning when a hospital's ratio of Covid-19 hospitalizations to total beds increases above 10%.

    According to a framework developed by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, any ratio above 20% represents "extreme stress" for a hospital, NPR reports. And when the ratio approaches 50% or higher, the level of stress on a hospital "is immense," according to NPR.

    "It means the hospital is overloaded. It means other services in that hospital are being delayed. The hospital becomes a nightmare," IHME's Ali Mokdad explained.

    A separate analysis of the new federal data by the Times showed that more than 33% of Americans live in regions of the United States where hospitals are running critically low on ICU beds. Specifically, the analysis showed hospitals serving more than 100 million Americans reported having fewer than 15% of ICU beds available last week.

    And many hospitals throughout the United States have even fewer ICU beds available, the analysis showed. According to the Times' analysis, 10% of Americans live in an area across the Midwest, South, and Southwest where hospitals had fewer than 5% of ICU beds available or had no ICU beds available last week.

    Experts say low levels of ICU capacity throughout the United States will make it difficult or nearly impossible for health care providers to maintain existing standards of care for their sickest patients, the Times reports.

    "There's only so much our frontline care can offer, particularly when you get to these really rural counties which are being hit hard by the pandemic right now," Beth Blauer, director of the Centers for Civic Impact at Johns Hopkins University, said.

    Jeffrey Sather, Trinity Health's chief of medical staff, said his hospital in the small city of Minot, North Dakota, could normally transfer patients to other hospitals in the state, but it hasn't been able to do so in recent weeks because every hospital in the state seems to be overwhelmed with patients.

    As a result, Sather said patients keep piling up in Trinity Health's ED. "There's no place for them to go," he said.

    Experts fear the increased strain on hospitals also will reverse earlier progress in improving Covid-19 survival rates, the Times reports.

    Thomas Tsai, an assistant professor of health policy at Harvard University, said there's already evidence suggesting hospitals are limiting the care they provide to Covid-19 patients, which could ultimately affect survival rates. According to Tsai, the rate at which Covid-19 patients are being hospitalized been declining over the past few weeks, which "suggests that there's some rationing and stricter triage criteria about who gets admitted as hospitals remain full."

    US reports record-high number of coronavirus deaths in a single day

    As the United States' number of Covid-19 hospitalizations has grown, so too has the country's daily number of newly reported deaths linked to the virus.

    On Wednesday, U.S. officials reported about 3,055 new deaths tied to the novel coronavirus, breaking the country's previous record of 2,885 deaths newly reported coronavirus deaths in a single day, which U.S. officials reported last week.

    As of Thursday morning, U.S. officials had reported a total of about 289,531 U.S. deaths linked to the virus since the country's epidemic began, up from about 286,443 deaths reported as of Wednesday morning.

    (Owens, "Vitals," Axios, 12/10; Leatherby et al., New York Times, 12/9; McMinn/Carlsen, NPR, 12/9; New York Times, 12/9; Sullivan, The Hill, 12/9; New York Times, 12/10; "The COVID Tracking Project," The Atlantic, accessed 12/10).

    Have a Question?


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