Thursday, November 05, 2020

Is Covid-19 a threat to Intensive Care Unit bed capacity?

I believe this question is rarely addressed by the daily deluge of alarmist news reports about Covid-19 pandemic. It was recently suggested to me that Covid-19 cases could easily overwhelm the existing capacity of ICU beds. Why? Really?

Since it seems not widely reported it poses at least following questions:
  1. Is there actually a sufficient and adaptable ICU bed capacity to deal with the pandemic?
  2. Is the overall capacity insufficient and this fact has been deliberately downplayed for several months as not to cause a panic etc.?
  3. How fast can new ICU units be created if necessary?
  4. Can Covid patients reasonably be transported to other regions where ICU beds are still available?
Thanks to the Arizona Department of Health Services we have actually some easy access to this kind of time series data for Arizona (I did not have the time to do further research):
ADHS - Data Dashboard (click on Hospital Bed Usage & Availability for this great  interactive chart)

Following can be possibly be learned from this interactive chart:
  1. Arizona hospitals can apparently handle changing admissions of non-Covid and Covid patients to ICU units very flexible and fast
  2. At no time was full capacity reached in Arizona
  3. The chart strongly suggests (see month of July) that for some reason a lot more non Covid patients are admitted to ICU units than necessary. Does this happen for precautionary or liability or revenue reasons or a combination thereof? In general, this would also suggest that health insurance companies are overcharged and the insured pay too much for health insurance
  4. It also suggests that probably in the first several months since March more Covid patients were admitted to ICU than necessary. This is understandable as nobody knew in the beginning of the outbreak how dangerous the virus would be. However, latest since about July, we know that this virus is fairly harmless. Thus, admissions to ICU units may not be required as much anymore or the stay in such units will be shorter etc.

Just to give the reader an idea about the ranges we are dealing with here:
  1. At the height of ICU admissions on 7/13, there were 970 Covid patients and only 528 non-Covid patients
  2. As of November, following what shapes up like a possible second wave, we have about 230-250 Covid-patients and about 1,100-1,200 non Covid patients
  3. Even on the worst day (7/2) there were still 9% or 145 ICU beds available






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