September 16, 2021

The steep price of 'preventable' Covid-19 hospitalizations, according to a new study

Daily Briefing

    Covid-19 cases in the United States have risen to their highest levels in nearly a year—and the resulting surge in vaccine-preventable hospitalizations has carried a steep cost to the nation's health care system, according to new research from the Kaiser Family Foundation.

    How much worse will the 'delta surge' get? Watch these 7 factors.

    Rising cases and declining hospital capacity

    With children back in school, lax mask restrictions, and stagnant vaccination rates due to vaccine resistance, Covid-19 cases have increased—wiping out months of progress and placing hospitals in a "dire situation," particularly in the South, Associated Press/Modern Healthcare reports.

    According to a New York Times analysis of recent HHS data, one in four hospitals across the nation are approaching capacity—with more than 95% of ICU beds occupied. These numbers have increased from a reported one in five hospitals near capacity last month, and fewer than one in ten reported in June. 

    For instance, hospitals in Washington state and Utah have had to cancel certain scheduled procedures, while hospitals in Tennessee are reporting bed shortages and Texas ICUs are at or over capacity, AP/Modern Healthcare reports.

    In fact, according to AP/Modern Healthcare, the United States is currently seeing the highest Covid-19 mortality and case rates since early March and late January respectively, averaging over 1,800 Covid-19 deaths and 170,000 new cases per day. Moreover, the nation is dispensing only around 900,000 Covid-19 vaccinations per day, a considerable drop from the peak of 3.4 million vaccinations a day in mid-April.

    Widespread staffing shortages

    Around the nation, states reporting lower vaccination rates are placing a critical strain on hospitals with high ICU occupancy rates, AP/Modern Healthcare reports. After experiencing sustained fatigue and burnout for more than a year, many health care workers have reached their breaking point and quit their jobs during the latest Covid-19 surge, exacerbating the situation at already strained hospitals. 

    Emphasizing the severity of this crisis, Doug Griffin, VP and medical officer for Sanford Health, explained that for his organization, "[i]t's really all about staffing. That's the issue. It's day-by-day."

    According to Griffin, Sanford's hospitals in Fargo alone could use about 300 additional nurses to handle the influx of Covid-19 cases, although the organization's facilities are short-staffed across the board. He added that the health system is ramping up incentives to try to encourage new hires, including signing bonuses. Sanford is also delaying certain scheduled procedures, Griffin said.

    Similarly, Steven Stack, the public health commissioner in Kentucky, said his state was facing a similar situation, with about 70% of the state's hospitals reporting critical staff shortages. "Our hospitals are at the brink of collapse in many communities," he said.

    Similarly, as Colorado's hospitals reached their highest capacity since the start of the pandemic, Scott Bookman, Colorado Department of Public Health and Environment's Covid-19 incident commander, said, "I cannot stress enough the state that our hospitals are currently in today—the stress they are feeling, the impact that this wave is having on them, and the absolute importance of getting vaccinated to end this pandemic."

    Vaccine resistance and 'preventable' hospitalization

    President Joe Biden earlier this week said the nation at this point is living in "a pandemic of the unvaccinated."

    According to CDC's Sept. 10 Morbidity and Mortality Weekly Report, individuals who are unvaccinated and infected with Covid-19 are 10 times more likely to be hospitalized and 11 times more likely to die from the disease when compared with vaccinated individuals.

    Meanwhile, a new Kaiser Family Foundation study found that approximately 287,000 unvaccinated Americans were hospitalized from June through August, which cost the U.S. health care system roughly $5.7 billion. According to the study, which looked at data from CMS and other health reports, an estimated 84% of those Covid-19 hospitalizations could have been prevented through vaccination.

    For instance, according to Griffin, 123 of the 141 Covid-19 cases across 22 hospitals in the Sanford system are unvaccinated, including 44 of the 48 patients in the ICUs and 28 of the 30 people on ventilators.

    "The vaccines are a personal responsibility to help our communities and our country get through this pandemic," Griffin said. He added that while he respects that others may have different opinions, he remains "frustrated" by the lack of vaccine uptake.

    And although the mortality rate is arguably the most important metric, Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, pointed out that "it is a worthwhile exercise to try to get a handle on the financial magnitude of what we are doing to ourselves. It is staggering to think that we incurred $5.7 billion in largely preventable hospital costs in just three months, and that number is almost certainly a lowball."

    As infection rates and deaths continue to rise, so does frustration among medical professionals, AP/Modern Healthcare reports.

    In fact, Ryan Stanton, an ED physician in Kentucky, said at this point in the pandemic, continued vaccine uptake may be dependent on personal tragedy. "The problem now is we have been trying to educate based on science, but I think most of the education that is happening now is based on tragedy, personal tragedy," he said. (Masson, Becker's Hospital Review, 9/14; AP/Modern Healthcare, 9/14 [1]; AP/Modern Healthcare, 9/14 [2]; AP/Modern Healthcare, 9/14 [3]) 

    How much worse will the 'delta surge' get? Watch these 7 factors.

    looking aheadJust how worried should you be about the delta variant? Advisory Board's Yulan Egan takes a deep dive into this question, detailing seven factors you should watch closely (and two to ignore) to determine just how deadly and disruptive the variant will prove to be.

    Read the latest take

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