Hospitals across the country are filling up, but ICUs are filling even faster

The New York Times has a new map showing the level of ICU occupancy across the nation. Some areas are surprisingly fine—like New Orleans, where ICUs are operating at a perfectly normal level of 61% capacity. This shows that southern Louisiana, though heavily battered in earlier phases of outbreak, has largely avoided the worst of the current surge. That’s likely because Gov. John Bel Edwards has kept the state under restrictions that include a mask mandate and limits on nonessential businesses. On the other hand, Texas is a hodgepodge of counties where hospitals are doing well and those that are are overrun. Pinning down a cause in any of these locations is difficult because Gov. Greg Abbott never issued a statewide mask order, and while some counties have done so, hospitals often pull patients from multiple counties.

Across the nation, some hospitals show ICU capacity well over 100%. These are often regional hubs in rural areas and smaller cities where the opportunities for transferring patients is restricted. As a result, the hospital at Fort Thomas, Kentucky, is operating at 146% of stated capacity. Nowhere else is quite that bad, but Henderson, Nevada, is showing 116% of overall capacity plus an absolutely full ICU.

Working out the impact of COVID-19 on the health system might be better done using a new interactive map from NPR, which shows the percentage of patients in each county who are hospitalized due to COVID-19. This reveals areas of the country where COVID-19 is absolutely saturating healthcare facilities. In Deaf Smith County, Texas, 93% of all hospital beds are occupied by a COVID-19 patient. That may sound bad until you hit Tioga County, Pennsylvania … where 125% of hospital beds are filled with coronavirus patients. The hospital has literally expanded into hallways and parking lots and still can’t keep up with the demand. It’s little wonder that rates of COVID-19 deaths are increasing, and also little wonder that deaths from other causes are also moving up.

But even when mapped out, not every situation is perfectly clear. For example, in Rapid City, South Dakota, every single ICU bed is occupied. However, at the same time the NPR map suggests that only about 30% of hospital beds are occupied by COVID-19 patients. How do the two things fit together?

Well, as The Denver Gazette noted last week, residents of that state are being overwhelmed … by COVID-19 patients coming in from neighboring states. 

… COVID-19 patients from Texas, New Mexico, Kansas, Wyoming and Montana have been transferred to Colorado hospitals. 

South Dakota isn’t on that list because South Dakota isn’t an adjoining state. And yet, as the Rapid City Argus Leader reports, patients from that state are in fact being flown to Colorado and housed in hospitals over 300 miles away. Colorado wasn’t the only state to be so gifted by Gov. Kristi Noem’s home.

South Dakota’s largest hospitals are at or above their capacity to care for critically ill COVID-19 patients, forcing some of the sickest patients to be flown out of state to receive care.

Between October and December, the national case fatality rate for COVID-19 plunged almost a full percentage point. However, that sharp decline was somewhat illusory because over that period the number of new cases surged and, sadly enough, death is a trailing indicator. Still, there’s absolutely no doubt that when every patient is given adequate care, the rate of death from COVID-19 can be considerably lower. Countries like South Korea, where careful testing and case tracking prevented hospitals from ever being seriously overrun, have maintained case fatality rates around 1.4%. That same rate is reflected in many U.S. states, including California. The United States has been slowly driving the national rate of deaths from COVID-19 down … until the last few days, when progress has been stalled by record levels of COVID-19 deaths. And by record levels of hospital overcrowding.

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