As the virus grows, governors rely on misleading hospital data

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Governors in places that see huge spikes in coronavirus infections often cite state-level data to assure the public that they have strong hospital capacity to survive the attack, even when states routinely lose critical benchmarks to guide their response. to the pandemic.

Public health officials and experts say heavy reliance on data from state hospitals is a misleading and sometimes irresponsible metric to justify maintaining an open state or curbing the imposition of new limits.

This is because state statistics can be misleading, especially in large states where individual hospitals may be in crisis mode, even when overall capacity numbers look good.

Thomas LaVeist, dean of the Tulane School of Public Health and Tropical Medicine in New Orleans, said basing the pandemic and reopening the policy on the capacity of hospital beds across the state “is incredibly irresponsible.”

“Choosing precisely the capacity of the hospital and using that metric without the context of the number of cases, the number of deaths, is shocking,” said LaVeist.

The issue of hospital capacity has become urgent across the country this week as Florida, Texas, California, Arizona and other states reported a dizzying number of cases. Governors have repeatedly invoked the hospital’s ability to argue against the new trade restrictions, although the dynamic began to change on Friday when Texas and Florida closed the bars in an increasingly dire situation with COVID-19.

At the first White House coronavirus briefing, which took place nearly two months on Friday, Vice President Mike Pence also cited hospitalizations when analyzing the prospects for the pandemic.

Two months ago, Pence said that 15% of patients were being hospitalized. Now it is around 5%. That means the health care system is better positioned to deal with a resurgence in cases, he says.

In Texas, the state health department website on Thursday showed 12,951 beds available, 1,320 beds available in the ICU, and 5,850 fans available. What is not broken down is how bleak the situation is in some particular places, including Houston, the country’s fourth largest city. Hospital beds in Houston are filling up so fast that Texas Children’s Hospital is beginning to treat adult patients, and 97% of ICU beds at Texas Medical Center were in use.

In Miami, Homestead Hospital confirmed Tuesday that it was full. The hospital was transferring patients to other hospitals and preparing to convert regular beds to ICU beds and acute care patients, if necessary.

In Arizona, Republican Governor Doug Ducey refused to impose new restrictions on business activity or an order to stay home, repeatedly citing extensive capacity at state hospitals as the reason he feels comfortable staying open.
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“That’s the most important thing when there’s an increase in cases,” Ducey said earlier this month.

Ducey has condemned as “disinformation” the notion that hospital space is running out, even when state data shows that 85% of Arizona hospital beds are occupied. Arizona has about 2,500 patients hospitalized with COVID-19.

At the same time, the state is losing the mark on benchmarks set by the White House task force to guide the reopening of the economy, with 23 percent of the COVID-19 tests testing positive last week. in Arizona.

The task force does not include state hospitalizations as part of the criteria that states must meet before reopening. Those criteria include a downward trajectory of cases within a two-week period. They also specify that hospitals must have sufficient intensive care unit capacity to treat a surge in patients and must have a robust testing program for health workers at risk, including testing for virus antibodies.

Dr. Joseph Gerald, an associate professor of public health policy and management at the University of Arizona, said that if the trend continues, the cases will likely exceed the capacity of hospital beds across the state in the coming weeks.

California has broken several of its own daily records due to the amount of positive tests and hospitalizations have increased by more than 30 percent in the past two weeks. Democratic Governor Gavin Newsom has cast an optimistic tone in recent days about the hospital’s capacity, but changed his tone a bit on Friday, saying he wants a southern California county that borders Mexico to again consider an order to stay in House.

Dr. Colleen Kraft, associate medical director at Emory Hospital in Atlanta and a member of the Georgia coronavirus task force, said the capacity of beds in regional hospitals would be a better metric than state capacity. She regretted that the pandemic had apparently become a “political situation”.

“As someone who entered medicine to serve people, it is difficult to see,” Kraft said.

Robyn Gershon, a professor and public health expert at New York University, said using the capacity of hospital beds across the state to guide policy is “completely unethical.”

“It is unethical to say that we continue with our business and, by the way, we can handle the overflow,” said Gershon. “A better measure is the infection rate of cases of 14 days and seven days. That is what tells us what is happening right now. “

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