Thread by @ashishkjha

Looking at hospital data, there's something concerning happening in America's ICUs

There are 27,000 COVID patients in ICUs right now

On October 2, there were 7,000

And in order to accommodate the increase, hospitals are reducing access of non-COVID patients to ICU care

Thread

So let’s talk data, hospitalizations, & rationing

Think like a hospital leader facing a surge of COVID patients

What do you do?

First, as # of COVID patients starts to spike, you expand capacity

You convert ORs and anesthesia units to ICUs

You open up field hospitals

2/10

But what if surge continues?

At some point you can’t expand further – you're running out of staff

So you tell your doctors & nurses: Hey, ICU is full

Implicit message: slow down ICU admissions

As ICUs fill w COVID pts, ability of non-COVID pts to get ICU care diminishes

3/10

So let’s look at data from HHS Protect.

Graph shows

Weekly ICU capacity (blue)
Weekly census of COVID patients (gray)
Weekly census of non-COVID pts (orange)

Why focus on ICU? Because obviously where sickest patients are

And failing to get ICU care when you need it is bad

On October 2, we had in US:

78K ICU beds
8K COVID ICU patients
48K non-COVID ICU pts

As COVID pts rise through October, hospitals add capacity

In Nov/Dec, COVID pts in ICUs more than double

Hospitals add just a few more beds (hitting capacity constraints)

4/10

So how do hospitals manage? By reducing Non-COVID pts

By January 1, we have

86K ICU beds (up from 78K)

27K COVID pts in ICU (up from 8K)

39K non-COVID pts in ICU (down from 48K)

Imagine a patient with moderate to severe lung disease or stroke

5/10

In October, they would have gone to the ICU

By December, many such patients aren’t getting ICU care

But let’s be clear, they would be better in the ICU

But ICUs are full. So hospitals forced to ration

But let's look at some states where picture clearer

Here’s Arizona

From October 2 --> January 1:

ICU capacity up 50%

COVID patients in ICU up 1250% (75 to 1011)

Non-COVID patients down 14%

By January 1, more COVID patients than non-COVID pts in ICUs

And California

October 2 --> January 1:

ICU capacity up 22%

COVID patients in ICU up 829% (from 492 to 4569)

Non-COVID patients down 30%

More COVID pts in ICUs than non-COVID patients

And a few more so I'm not just cherry picking

Georgia -- similar picture

And Texas

Where again, about half of all ICU beds are occupied with COVID patients

And # of non-COVID patients has fallen about 20% to accommodate surge of COVID patients

So that’s where we are

When you hear disinformation spreaders say hospitals have plenty of room...they don’t

If they had plenty of room, they wouldn’t cut back on ICU care for non-COVID patients

Reduced access to ICU care for non-COVID pts despite increased capacity

10/11

Bottom line is this

COVID is directly killing 3K-4K people every day

It is also filling up ICUs across the nation, particularly in hot spots

This appears to be reducing access to ICU care for sick non-COVID patients

11/12

Years from now, careful analysis will likely find that during this time, sick people without COVID in hot spots died at much higher rates

That's what happens when hospitals become strained

Their deaths won’t count as a COVID-related deaths

But may be, it should

Fin