COVID-19 Hospitalizations Are on the Rise — What You Should Know (Part 2)

Hospital haves and have nots

Photo by camilo jimenez on Unsplash

This article belongs to a three-part series written for anyone that is looking to understand why experts are expressing concern about rising COVID-19 hospitalizations. Part one explains what the number of hospitalized patients actually means, part two explains why hospital bed distribution is important, and part three covers the nuances of hospital and ICU occupancy.

According to the latest figures from the American Hospital Association, there are 792,417 staffed beds in community hospitals serving the general public (i.e. excludes military, prison, and college infirmaries) — this includes beds in all kinds of intensive care units:

Number of intensive care beds in the United States by type. Medical-surgical and Cardiac intensive care provides patient care of a more intensive nature than the usual medical and surgical care to adults. Pediatric intensive care provides care to pediatric patients that is of a more intensive nature than that usually provided to pediatric patients. Neonatal intensive care is a unit that must be separate from the newborn nursery providing intensive care to all sick infants. Burn care is a unit that provides care to severely burned patients. Other intensive care is a specially staffed, specialty equipped, separate section of a hospital dedicated to the observation, care, and treatment of patients with life-threatening illnesses, injuries, or complications from which recovery is possible. Source: American Hospital Association Fast Facts 2020.

As a nation, the U.S. reached 60,000 COVID-19 hospitalizations on two separate occasions. There are currently 42,000 patients hospitalized with COVID-19 across the U.S.

The total number of patients in the United States hospitalized with COVID-19. Source: The COVID Tracking Project

On paper, it seems like the U.S. should have plenty of hospital beds to handle a major surge of COVID-19 cases but that’s not actually the case — why? There are two big reasons:

• Not all of the beds are actually available (we’ll explore this further in the next part in this series).
• There is a supply-and-demand mismatch: the beds are not always physically located where they are needed

We can visualize the mismatch by comparing two maps. Here’s a map showing the number of hospital beds per 1000 population. The darker the state, the more hospital beds there are available. We can see that Louisiana, Mississipi, West Virginia, Alabama, and the Dakotas are among the top 5 states in the country by this particular measure:

Source: Maptitude.

We can also see that Florida, New York, and Texas are in the top 3 nationally when we measure in terms of beds within a single hospital. In other words, these three states are home to the largest hospitals in the country. Note is that the two lists are very different.

Now, compare that to the geographic distribution of cases as of October 24:

Source: The COVID Tracking Project.

This simple comparison sheds light on the need for field hospitals in New York City (first wave) near Milwakee, Wisconsin (third wave). In both cases, the number of patients needing hospitalization for COVID-19 exceeded the number of available beds.

A state with a few massive hospitals isn’t necessarily better off than a state with many smaller hospitals — the inverse is also true. What matters most is that the hospitals are physically close to the people that need them.

Key takeaways

• Although the U.S. boasts nearly 800,000 hospital beds, neither the hospitals nor the beds are evenly distributed.
• When the number of COVID-19 patients needing hospitalization in a geographic area exceeds the number of available hospital beds: patients need to be moved to another hospital, the government needs to set up field hospitals, or both.

Another way to say it

To understand where COVID-19 threatens to strain medical resources, we need to know where COVID-19 cases are surging in relation to where hospital beds are physically located.

Next, we’ll go beyond raw numbers to discuss the % of beds occupied.