Understanding Hospital Capacity and Media Coverage of Covid-19: A Case Study from South Carolina
Hearing words like “capacity,” “surge,” and “shortages” can potentially lead us to make assumptions that the situation is worse than it is (or that these things have not happened before).
For those who are understandably concerned about hospital capacity right now, I wanted to provide some context that was helpful for me. First, here’s a link to SCDHEC’s page that tracks hospital occupancy:
https://scdhec.gov/covid19/hospital-bed-capacity-covid-19
This page not only tracks percentage utilization rates by county but also tracks more details of utilization within the state. For example, the ICU bed utilization rate across the state is currently 80.25% (as of midnight on December 30th), and the ventilator utilization rate across the state (again as of December 30th) is 31.56%. The current overall inpatient bed utilization across the state is at 82.76% (as of December 30th).
The website also has a breakdown of bed usage in the state’s four regions: PeeDee, Lowcountry, Midlands, and Upstate. It is worth noting that the occupancy rate can change drastically from week to week and even day to day. As just one example, Lowcountry hospitals had a 95% occupancy rate on December 25th, but that number fell to 69% only one day later on December 26th. When looking at these fluctuations, it would be very easy to paint a picture that hospitals are either completely overwhelmed or not full at all depending on the day or region one chooses and if one judges only by these percentages.
Second, while there certainly seems to be a surge of hospitalizations right now, it’s likely helpful to put this into context. To be clear, my aim is not at all to downplay hospitalizations from covid or any other illness, but hearing words like “capacity,” “surge,” and “shortages” can potentially lead us to make assumptions that the situation is worse than it is (or that these things have not happened before). Consider the following examples from the 2017-2018 flu season:
(1) “Hospitals in Mississippi and surrounding states are coping with rising numbers of flu patients in the wake of a recent outbreak. . . . There has been an uptick in neighboring states who are looking for resources for patients, Jones said. It's normal to have requests to take patients from Louisiana or Alabama, but Jones said there have been requests from New Orleans, Birmingham and Memphis this year as well. . . .
“Jones said for ICUs to fill up is not terribly unusual for this time of year since many diseases have a seasonal variance that renders them more severe in the winter.”
(2) “Big-city hospitals in Texas have been overwhelmed this week by an influx of flu patients . . . . At Parkland Memorial Hospital in Dallas, waiting rooms turned into exam areas as a medical tent was built in order to deal with the surge of patients. A Houston doctor said local hospital beds were at capacity, telling flu sufferers they might be better off staying at home.”
“On Monday alone, Parkland's emergency department had seen 930 patients — double what the hospital typically sees for people with flu symptoms by this time of year, Dr. Joseph Chang, associate chief medical officer for Parkland, told CBS11.
Across town on Sunday, Methodist Dallas Medical Center rerouted non-emergency ambulance patients to different area facilities in order to take care of ‘emergency patients like trauma, stroke, and sexual assault’ due to the lack of bed availability from flu patients.”
“But high emergency room volumes and filled hospital beds are "not uncommon" for this point during flu season, which runs from October to May, said Lara Anton of the Texas Department of State Health Services.”
(3) “The huge numbers of sick people are also straining hospital staff . . . . Hospitals across the state are sending away ambulances, flying in nurses from out of state and not letting children visit their loved ones for fear they’ll spread the flu. Others are canceling surgeries and erecting tents in their parking lots so they can triage the hordes of flu patients. . . .
Palomar Medical Center Escondido in northern San Diego County also pulled out a flu tent this month, but was still so busy that some patients were treated in the hallways, said Gunnett, a nurse who oversees their emergency services. . . .
Now they’re running low on beds because many patients were admitted with severe flu. Gunnett said she has started canceling scheduled surgeries and turning single-patient rooms into doubles to free up space.
On Thursday, the former storage area opened as an extension of the emergency room. . . .
Many hospitals also say they’re too full to accept any more patients or ambulances. And when paramedics are allowed to drop off patients at a hospital, the emergency room is often so crowded that there aren’t available staff members to transfer care to. So the emergency responders can’t get back on the road to answer incoming 911 calls.”
(4) “Health officials across the Southland are warning the public to be wary during this intense flu season that has some hospitals rerouting patients due to their increasingly limited capacity.
From Laguna Beach to Long Beach, emergency rooms were struggling to cope with the overwhelming cases of influenza and had gone into ‘diversion mode,’ during which ambulances are sent to other hospitals.”
There are many more articles I could share, but I think these four demonstrate that what hospitals are currently experiencing is not all that different from what was experienced less than 3 years ago. Again, I’m not saying this is no big deal but am simply trying to put recent headlines into perspective. For right or wrong, with good intent or bad, every media network benefits when people are drawn to headlines that evoke fear or that imply (or directly state) that things are really bad and getting worse, as most everyone (myself included) is drawn to read the bad news. But despite ongoing reports to the contrary, covid is not a categorically different threat and has not overwhelmed the healthcare system in the United States as so many claimed that it would. For example, see this thread that garnered much attention back in March:
The author of this thread claimed in part:
“By this estimate, by about May 8th, all open hospital beds in the US will be filled. (This says nothing, of course, about whether these beds are suitable for isolation of patients with a highly infectious virus.) . . .
If we’re wrong by a factor of two regarding the fraction of severe cases, that only changes the timeline of bed saturation by 6 days in either direction. If 20% of cases require hospitalization, we run out of beds by ~May 2nd.”
For those interested, here are two articles that discuss how covid is not a categorically different threat and how adjusting our public health approach could actually save lives:
“Covid is Not Categorically Different.”
“Reaching Immunity: A Private Summit of Epidemiologists Against Lockdowns (Video)”