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March 2, 2022

The omicron surge overwhelmed hospitals–why didn't federal data capture this?

Daily Briefing

    Hospitals across the country were overwhelmed with patients during the omicron surge, but federal data suggests otherwise—highlighting a potential oversight in the way hospital capacity data is collected, Jeremy Faust, an emergency medicine physician at Brigham and Women's Hospital, writes for Inside Medicine.

    Access our new omicron surge toolkit 

    The discrepancy between federal data and hospitals' experiences

    During the omicron surge, hospitals across the country, which were already catching up with a backlog of delayed care, such as elective surgeries, quickly became overwhelmed by rising Covid-19 hospitalization rates.

    According to Faust and his colleagues who operate the U.S. Hospital Circuit Breaker Dashboard, hospitals in thousands of U.S. counties were either over 100% capacity, or at least close to it, during the omicron surge. This led to some patients needing to be "flown across state lines to get care" or having their heart attacks "treated in beds lining hospital hallways, without basic cardiac monitoring," Faust writes.

    However, HHS data on hospital capacity suggests that few hospitals ever exceeded their capacity during the omicron surge—a discrepancy Faust argues is due to HHS' data collection methods.

    Since 2020, HHS has instructed hospitals to report the number of staffed beds they might be able to open in worst-case scenarios instead of the normal number of patients they can safely treat. "As a result, HHS['] public reporting on hospital capacity more closely resembles fire capacity than safe care capacity," Faust writes.

    Although Faust says it would be reasonable for a hospital to increase its maximum capacity by 10%, albeit temporarily, many hospitals around the country have been reporting significantly more beds than their maximum capacity for weeks and months at a time. In particular, data from the American Hospital Directory suggests that many hospitals have been reporting 25% more potential beds compared with their pre-pandemic maximums.

    How to achieve a more accurate representation of hospital capacity

    According to Faust, having accurate hospital capacity data is important so state leaders and other authorities will be able to implement temporary mitigation measures during surges to prevent hospitals from being overwhelmed.

    To do this, Faust recommends federal officials change how they require hospitals to report their safe inpatient capacity to HHS. Specifically, hospitals should report both their normal safe staffed bed capacity and their surge capacity. "Currently, hospitals report these numbers combined as one number," Faust writes, so "[t]easing this out should be easy."

    So far, Faust says he has spoken to "several well-placed federal officials" about the current issues with hospital data, and they have "indicated that they understood the problem and recognized the importance of fixing it."

    "Our hospital system was not sufficiently protected during the [o]micron surge," Faust concludes. "We owe it to our communities to do better next time." (Faust, Inside Medicine, 2/27; Gamble, Becker's Hospital Review, 2/28)

    Learn more: Check out our new omicron surge toolkit

    We've collected our best resources and insights for creating capacity, supporting staff, communicating with patients, and more. This page will be a consistent work in progress as we compile the newest and most helpful resources. Check out all the resources, including:

    Access the toolkit

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