Hospitalization data is used to claim that the pandemic is exaggerated.This is the reason why it is wrong

Immediately after the positive Omicron COVID-19 cases exploded nationwide, hospitalization continued.

Many states Highest level The number of COVID-19-related hospitalizations since the start of the pandemic almost two years ago.

However, unlike the previous surge, new data show that many patients with COVID-19 are coming to the hospital for other reasons. This is called an “accidental” case.

New York data released in early January most clearly reveal this dichotomy. The state changed the report on hospitalization with COVID-19 and asked the hospital to distinguish between those who were specially hospitalized for the virus and those who came to the hospital for other reasons but had it. As of January 17, approximately 42% of COVID-19-positive patients in New York hospitals did not list COVID-19 as a reason for admission. According to the state data. Hospital other state Has started I also do that.

But this new data is booming Problematic claims On social media, the number of hospitalizations is swelling, suggesting that the situation is not as dire as health officials think.

But people currently working in hospitals have told us that the situation is much more complicated than those claims suggest.

Dr. Jeremy Faust, MD, a physician in the emergency room at Brigham and Women’s Hospital, Massachusetts, said: “After all, it doesn’t matter if it’s accidental or not. The important thing is that the medical team is growing beyond its limits.”

The assumption is that the big picture cannot be evaluated and all accidental cases are the same. All patients with COVID-19 need more resources, such as personal protective equipment and isolated rooms, when the hospital is trying to operate with a serious staff shortage, regardless of the severity of the infection. ..

Dividing patients into these two categories-mainly hospitalized with COVID-19 or COVID-19-may be useful for epidemiological data, but not so much to show what is happening in the hospital today. The doctor said it was useless. For some, the infection is mild and the purpose of the visit is unrelated to the virus. However, some may come to the hospital to treat a health condition that has been caused or deteriorated by being infected with the virus. Everyone is in bed.

PolitiFact consulted with medical professionals and doctors in the emergency room to clarify what is happening in US hospitals among the highly contagious variants of Omicron. This is what we found.

Why are hospitalizations increasing with milder varieties?

The case number is large.

Even with the milder variants, the infectivity of Omicron resulted in twice the infection compared to previous variants. Such numbers will eventually send more people to the hospital.

“The original tension was like hitting a grand slam and knocking out someone from time to time,” Faust said. “At Omicron, singles go from single to single, and soon the bass fills up and runs.”

For example, in the first surge, the grandmother of a family of 10 could have been infected with the virus, while the other 9 relatives could have been fine. According to experts, with Omicron, all 10 people are much more likely to get sick.

Dr. Monica Gandhi, an infectious disease specialist at the University of California, said that there are many counties in the United States that do not yet have sufficient vaccination rates, and Omicron is a milder variant, but it makes unvaccinated adults sick. May require hospitalization. , San Francisco.

“The Delta isn’t over yet. As the CDC director reminds us“Hospitalization and death are still caused by this variant,” Gandhi said in an email. “Mild coronaviruses, adenoviruses, rhinoviruses, and even other viruses that cause upper respiratory tract symptoms in winter. This can lead to hospitalization of the frail elderly. That is why COVID vaccination is so important. “

More precisely, what is an accidental COVID-19 hospitalization?

This is when the patient is admitted to the hospital for reasons other than the virus, but is positive on arrival. Some of these are really accidental — the patient had a broken leg and was tested on admission and found to be positive. They have no or mild symptoms and the virus has nothing to do with why they are in the hospital.

However, many of these cases are related to patients who had to go to the hospital to treat the condition exacerbated by COVID-19 infection, health care workers said.

COVID-19 can affect multiple systems and often worsens even in mild cases of other conditions. Before the advent of Omicron, healthcare providers discovered that the most serious cases of COVID-19 attacked the lungs.And while Omicron has Found so far Because it causes more upper respiratory tract disease than previous variants, COVID-19 infections can cause a variety of pro-inflammatory or vascular symptoms such as heart attack, stroke, and blood clots.

COVID-19 may not be listed as the reason for hospitalization, but without the virus the patient would not have been there.

Dr. Ashish Jha, Dean of the Faculty of Public Health at Brown University, gave an example of such a situation involving an 86-year-old kidney disease patient.

“This 86-year-old woman was infected with COVID a week ago and had two days of fever and sore throat.” Jha wrote in a recent Twitter thread..

“Two days of fever caused him to become dehydrated and have acute renal failure. His COVID is” better “, but he is hospitalized for renal failure. Was he hospitalized with COVID? no. With COVID? Yes. “

Dr. Jeanne Noble, an associate professor of emergency medicine at the University of California, San Francisco, says it’s important to take these numbers lightly because hospitals are defined differently as “accidental.”

“The percentage of COVID hospitalizations classified as accidental varies considerably from 30% to 70% because the definitions of” COVID hospitalization “and” COVID hospitalization “have not been agreed. ”

Are these “accidental” cases still problematic?

Yes.

Everything, whether asymptomatic patients who happen to test positive, those whose condition has deteriorated due to COVID-19 infection, or those who went to the hospital primarily for COVID-19. I am using hospital beds and resources. Experts say they have already been detained.

Dr. Craig Spencer, a doctor in the New York City Emergency Room, recently wrote about this: New York Times Articles.. Almost all of his patients have experienced mild illness compared to March 2020, but they still occupy the same amount of space, he said.

“If the hospital doesn’t have the beds and care providers needed to care for the patient, it’s not the right distinction between going to the hospital with the virus and going to the hospital with the virus,” he says. I did.

Faust, a doctor at Brigham and Women’s Hospital, said that many accidental cases can pose a significant risk to healthcare professionals and other patients.

“In the early waves, most people were hospitalized for COVID pneumonia before the Delta and before the vaccine. This was a later discovery, so people were less likely to be transmitted.” He said. “We are now accepting people who are more contagious and can make healthcare professionals and fellow patients sick. That’s a bad combination. We want hospitals to be hotbeds for COVID. plug.”

Why did some states start reporting accidental hospitalizations?

Some hospitals may have collected this information before the advent of Omicron, but experts say the practice has recently become widespread due to the large number of COVID-19 inpatients. ..

“We did this throughout the pandemic, but hospitalization was not” with COVID “because Omicron is the most contagious variant and is likely to be found in the nasal passages of many individuals in the community. There are more problems with correctly assigning to “for COVID”. Omicron’s problem. “

This type of data collection also helps health and hospital staff track illness behavior and coordinate practices and procedures.

“One of the reasons we want to keep track of everything is that we want to learn from it,” said Neysa Ernst, nurse manager at The Johns Hopkins Hospital in Maryland. “And the challenge is that everything is changing. At our hospital, we make decisions hourly, not daily.”

Does this indicate that the COVID-19 hospitalization data is bloated?

no.

The distinction between hospitalizations by COVID-19 is important for the medical community to learn more about pandemic conditions, but that is only so far.

Many so-called accidental cases are caused or exacerbated by the virus in the first place, and they are still hospitalized in record numbers regardless of whether patients come to the hospital with or without COVID-19. doing.

“I don’t think people understand it just because they haven’t seen the apocalyptic scene of being pulled out of the ventilator yet. That means this level of ability isn’t extremely dangerous. Not, “Faust said.

“In many areas, higher capacity hospitals are known to kill more patients for all reasons, including lack of necessary care or fear of entering the hospital. “

Last note

Outside of the accidental hospitalization turmoil, many doctors like Gandhi and California emergency physician Michael Dyno Insist More detailed and uniform hospitalization indicators reported at the national level.

They found that data on COVID-19-positive cases in hospitals were either accidental, primary, or “nosocomial infections,” that is, patients who were not positive on arrival but were infected during hospitalization, and It suggests that patients in need of ICU care should be included.

“We don’t just ask for more detailed hospital data to get it.” The doctor wrote in a recent article.. “The effectiveness of these approaches all depends on accurate data. It can inform our state and country pandemic responses and allocate resources accordingly.”

Noble, a professor of emergency medicine, agreed.

She said it would be helpful for the federal health agency to provide hospitals with rigorous guidelines that apply uniformly across the country, such as the percentage of patients hospitalized with COVIDs who require oxygen supplementation.

“This is a more accurate determination of the number of COVID patients with serious respiratory illnesses that may actually require the most limited resources of ventilators and ICU beds,” said Noble. It will help you. “