Where hospitals' omicron data and realities diverge

A subtle difference in HHS data reporting is one reason why the public and even some health professionals are under the impression that hospitals never exceeded their safe care capacity during the latest COVID-19 surge of omicron, one physician argues.  

"HHS' public reporting on hospital capacity more closely resembles fire capacity than safe care capacity," Jeremy Faust, MD, an emergency physician at Boston-based Brigham and Women's Hospital and an instructor at Harvard Medical School, writes for Inside Medicine

Since 2020, HHS has instructed hospitals to report the number of staffed beds they would possibly be able to shore up in worst-case scenarios — not the normal number of patients they can safely treat.

As a result, hospital capacity as represented by HHS data has grown inflated, with no distinction between inpatient beds in cardiac units and gurneys lining the hallways. "Even chapel spaces and parking garages hastily converted into care areas 'count' as 'staffed inpatient beds,' as far as HHS is concerned," writes Dr. Faust.

It is reasonable to assume a hospital with 750 staffed beds could temporarily operate with a 10 percent increase to the maximum amount of care delivered. "So, if a 750-bed hospital were to report that it actually had 825 staffed inpatient beds, I'd buy it, briefly," Dr. Faust writes. "But broadly speaking, hospitals have been reporting far more staffed beds than they can safely handle for weeks or months on end; it appears that many hospitals have been reporting 25 percent more potential beds than their usual ceilings, according to pre-pandemic figures from the American Hospital Directory."

Dr. Faust and his team operate the U.S. Hospital Circuit Breaker Dashboard, which shows hospital capacity at state and county levels daily. A time-lapse video in the original article (found here) shows hospitals with more patients — COVID-19 and otherwise — than they could safely treat. "There were times when thousands of US counties were either over 100 percent hospital capacity or close to it," he writes. 

This mismatch in hospitals' data reporting from hospitals' reality results in the public not fully realizing the scope of hospitals exceeding their safe care capacity, and for sustained periods of time, throughout the omicron surge.

"This matters because there are very few reasons for which the public appears willing to alter its behavior to slow the spread of COVID-19; keeping local hospitals safe for everyone remains one, seemingly," Dr. Faust writes. "If during future spikes, people mistakenly believe local hospitals are fine (when in fact they aren't), they may not take precautions that lower case counts enough to keep hospitals from overflowing. Remember flattening the curve? We still need to do that at times."

Dr. Faust says he has asked federal officials to look into changing how hospitals report their safe inpatient capacity to HHS. He encourages an approach in which hospitals would report their normal safe staffed bed capacity and their surge capacity. "Currently, hospitals report these numbers combined as one number. Teasing this out should be easy," Dr. Faust writes. 

"The officials I spoke to indicated that they understood the problem and recognized the importance of fixing it. I hope they follow through. Our hospital system was not sufficiently protected during the Omicron surge. We owe it to our communities to do better next time."

Read Dr. Faust's piece in full here.

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