Virus threat abates, but US hospitals remain overcrowded

CNN
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At Massachusetts General Hospital in downtown Boston, dozens of patients line up in the emergency department corridors, waiting to enter rooms on the second floor.

“Imagine spending all day and night in the corridor under the fluorescent lights of the ER next to the trauma room. [patients] have heart failure, kidney failure, or pneumonia,” said founding member of Mass General Brigham, Massachusetts, Massachusetts, Massachusetts, Massachusetts, Massachusetts, Massachusetts said Dr. Melissa Mathison, a physician in Massachusetts, Massachusetts, Massachusetts, Massachusetts.

“Everyone is trying, but where do the toilets go? How do they shower if they want to be clean? How do they eat? No privacy. It’s just awful. Absolutely awful.”

As of Friday, about 87% of all available hospital beds in the state were in usedespite a dramatic decline in the number of people receiving treatment for respiratory diseases, capacity strains have hardly eased.

“Our emergency room is flooded daily with 25 to 100 patients waiting for beds upstairs. If there were 25 today and 100 two weeks ago, so be it. Good, but there are still long lines,” Mattison said. “Perhaps when he’s only waiting 35 patients compared to 75, patients won’t pile up like sardines in the ER. But it’s still not great.”

The three winter threats of influenza, Covid-19, and RSV have eased across the United States, and, like Massachusetts, most states now have overall low or minimal levels of respiratory disease activity. reported to be.

Nationwide, respiratory virus emergency department visits are one-third lower than they were a month ago. data indicate. Influenza hospitalizations have been about as low as all seasons since October. Hospitalizations due to Covid-19 (the last of the three viruses on a downward trend) have declined over the past few weeks, with only 4% of hospital beds nationwide being occupied by Covid-19 patients.

This is a dramatic shift from when Covid-19 patients filled most hospital beds during the early Omicron surge in January 2022. But hospitals were still about as full as they were during the pandemic, and at least three-quarters of the nation’s available beds were in use throughout his 2022.

Hospitals were facing capacity and resource challenges long before the pandemic hit, experts say. The main reason is that people who are hospitalized are sicker than before.

said Nancy Foster, vice president of quality and patient safety, American Hospital Association. “What you are looking at is this incredibly sick group of people in a hospital. , is always a difficult puzzle to try to solve to help patients.”

At Mass General, an emergency department boarder program outlining plans for how to cover patients waiting for beds was well established years before the pandemic hit, Mattison said.

Hospitals began reporting capacity data to the federal government in 2020 under pandemic requirements, so there is no federal data to compare to pre-pandemic years.

But Mattison was quick to say that her hospital is now 99% full, just like it was in 2019 and years before the pandemic. That’s what the metric doesn’t reflect. ”

Aaron Weslowski, vice president of policy research, analytics and strategy at the American Hospital Association, said by and large the mix of patients in hospitals is similar to what it was before the pandemic.

As the rate of Covid-19 cases falls, it will likely be a ‘stress breather’ for health care providers frustrated by the lack of tools available to help those who desperately needed it in the early days of the pandemic. right. .

In fact, with infectious diseases being the notable exception, in most categories of care, fewer people will be seen in inpatient and emergency department settings in 2022 than in 2019, says Wesolowski, according to health care data. citing data from Strata. analytics company.

A complex mix of factors has exacerbated during the pandemic, experts say, straining resources more than ever.

“People are having longer hospital stays because they need more urgent care. Due to workforce pressure, there aren’t that many people that can be treated in hospital settings at one time,” said Wesolowski. “I mean, I think both things can be true.”

Samuel Scarpino, head of AI and life sciences at Northeastern University, said it was a “perfect storm” of problems. Pandemic 3 years after emergency care, workforce burnout.

Covid-19 remains the biggest risk factor in the equation, he says. This is not because the new variant will inevitably cause more hospitalizations, but because unpredictability is forcing hospitals to keep more beds open as a buffer just in case.

“Arguably the biggest risk is the uncertainty about what will happen,” said Scarpino, who was vice president of the Rockefeller Foundation’s Pandemic Prevention Lab.

The American Hospital Association’s Foster said the pandemic’s state of emergency declaration gave more flexibility, such as telemedicine, allowing more patients to have out-of-hospital care options. increase.

Federal government continues to update state of emergency from January 2020, but may end in May.

Without it, Foster said the hospital would likely be even more full than it is now.

“Part of the reason we have the inpatient hospital capacity that we have now is that there’s a lot of flexibility that hospitals have been given. [the Centers for Medicare and Medicaid Services] Other federal agencies and states being used for various patients during Covid,” she said. “If they were gone overnight, we would struggle with the current level of patient care.”