It’s hard to believe how quickly the COVID-19 pandemic has impacted us. As Governor Cuomo dubbed New York State (NYS), “the canary in the coal mine,” the numbers really do tell the story. On February 26, 2020 there were no confirmed cases in the state. By March 12, the number had risen to 325, and on March 28, there were a staggering 53,218 cases with 7,328 hospitalized and 1,755 in ICU’s.3,4 This sudden and dramatic rise has put pressure on the NYS healthcare system and similar strain is unfolding in other parts of the country as well. Viewing the current challenge through the lens of our extensive experience with influenza may shed some light on these startling numbers.
In October 2019, the Agency for Healthcare Research and Quality (AHRQ) published statistics regarding Influenza in the U.S. from 2005 through 2016. During that period, the country experienced huge variation in the burden of influenza from a low of 31,500 hospitalizations in 2006-07 to a high of 223,300 in 2014-15. The national average during that decade was 105,000. In the worst month of the worst year, January 2015, there were 75,700 hospitalized patients in the country.1 Assuming an average length of stay for influenza is 6.3 days1, there were over 15,000 patients in the hospital on any given day of that month. If we further assume the worst case, that 10% of those patients went to the ICU (historical data is 5-10%2), that’s about 1,500 patients in an ICU bed on a given day in the worst month of the worst year of influenza.
Applying those influenza numbers specifically to NYS, the resultant daily hospital and ICU censuses were 950 and 95, respectively. Compare that to the March 28 numbers mentioned above. On that day, NYS saw seven times as many patients in the hospital and 18 times as many in the ICU for COVID-19 than on the worst day of the worst year of influenza. The graph below visually depicts the extent to which the current pandemic in NY dwarfs influenza with regard to the drain on hospital and ICU capacity.
This unprecedented demand puts victims of the pandemic at risk, but also puts those with severe acute issues such as heart attack, stroke and motor vehicle accidents at risk as well. With a shortage of hospital and ICU capacity, care that we’ve come to expect for these problems may not be there when needed.
Despite these sobering statistics, there is reason for hope. With heroic efforts regarding social distancing, increasing hospital capacity, sharing resources across hospitals, adding temporary hospitals, and calling up volunteers, NYS has over doubled its capacity and closed much of the gap that was anticipated for these resources. As providers throughout the country work hard to reorganize their practices to assure continued service to their patients, they might also look to the ongoing interventions and best practices of others to guide their decisions about when, where and how they can be most effective. NextGen Advisors invites you to share with us your organization’s experiences, challenges and successes as you have planned for and implemented your response to this unprecedented pandemic.6 While there are still major hurdles to overcome, working together we will not only get through this, but come out better prepared for future challenges.
4Verbal report from Monroe County Department of Public Health, 3/28/2020
5Data for graph from references 1 and 4, above
6Email us at Advisors@nextgen.com