Indeed, state-wide statistics can be misleading, particularly in large states where individual hospitals may be in crisis mode even if the overall capacity figures appear correct.
Thomas LaVeist, dean of the Tulane School of Public Health and Tropical Medicine in New Orleans, said that basing the pandemic and reopening policy on statewide hospital bed capacity “is incredibly irresponsible. ”
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“The selection of hospital capacity and the use of this measure without the context of the number of cases, the number of deaths, is shocking,” said LaVeist.
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The issue of hospital capacity became urgent across the country this week, as Florida, Texas, California, Arizona and other states reported a dramatic increase in the number of cases. Governors repeatedly invoked hospitals’ ability to argue against new trade restrictions, although the dynamics began to change on Friday when Texas and Florida imposed restrictions in an increasingly dire situation with COVID-19 .
Friday, at the first briefing on the coronavirus at the White House, almost two months, Vice President Mike Pence also spoke about hospitalizations.
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Two months ago, Pence said that 15% of the patients were hospitalized. Now it’s about 5%. This means that the health system is better placed to deal with a resurgence of cases, he says.
In Texas, the state health department’s website said on Thursday there were 12,951 beds available, 1,320 intensive care beds available and 5,850 ventilators available. What is not broken is how grim the situation is in some places, including Houston, the country’s fourth largest city. Hospital beds in Houston fill up so quickly that Texas Children’s Hospital begins to treat adult patients, and 97% of the Texas Medical Center’s intensive care beds were in use.
In Miami, Homestead Hospital confirmed on Tuesday that it was at full capacity. The hospital was transferring patients to other hospitals and preparing to convert ordinary beds to intensive care beds and patients to acute care, if necessary.
In Arizona, Republican Governor Doug Ducey has refused to impose new restrictions on business or a home stay order, repeatedly citing the sufficient capacity of state hospitals as the reason he is at home. comfortable staying open.
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“This is most important when there is an increase in cases,” said Ducey earlier this month.
Ducey condemned the idea that hospital space is lacking as “misinformation”, although state data shows that 85% of Arizona hospital beds are occupied. Arizona has approximately 2,500 COVID-19 hospitalized patients.
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At the same time, the state is sorely missing the benchmarks established by the White House task force to guide the reopening of the economy, with 23% of COVID-19 tests positive earnings last week in Arizona.
The task force does not include statewide hospitalizations among its criteria that states are expected to meet before reopening. These criteria include a downward trajectory of cases over a two-week period. They also point out that hospitals should have sufficient intensive care unit capacity to handle a wave of patients and should have a robust testing program in place for at-risk health care workers, including viral antibody testing .
Dr. Joseph Gerald, Associate Professor of Public Health Policy and Management at the University of Arizona, said that if the trend continues, cases will likely exceed the capacity of statewide hospital beds over the next few weeks.
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California has broken many of its own daily records for the number of positive tests and hospitalizations have increased by more than 30% in the past two weeks. Democratic Governor Gavin Newsom has been optimistic in recent days about hospital capacity, but changed his tone somewhat on Friday, saying he wants a southern California county bordering Mexico to consider again to stay at home.
Dr. Colleen Kraft, Associate Surgeon at Emory Hospital in Atlanta and a member of the Georgia Coronavirus Task Force, said regional hospital bed capacity would be a better measure than national capacity. She lamented that the pandemic had apparently become a “political situation”.
“As a person who came to medicine to serve people, it’s hard to watch,” said Kraft.
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Robyn Gershon, professor and public health expert at New York University, said that using statewide hospital bed capacity to guide policy was “completely contrary to ethics”.
“It is unethical to say that we will continue our business and, by the way, we can manage the overflow,” said Gershon. “A better measure is the infection rate for 14- and 7-day cases. That’s what tells us what’s going on right now. ”
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