Failure to 'flatten the curve' may kill more people than we thought


Date:
August 24, 2020
Source:
University of Washington
Summary:
New research finds that every six additional ICU beds or seven
additional non-ICU beds filled by COVID-19 patients leads to one
additional COVID-19 death over the following week.



FULL STORY ==========================================================================
New research by the University of Minnesota and the University of
Washington finds that every six additional ICU beds or seven additional
non-ICU beds filled by COVID-19 patients leads to one additional COVID-19
death over the following week.


==========================================================================
"A spike in hospitalization naturally leads to more deaths, but these
deaths may not only come from those who are hospitalized, but also from
those who should have been hospitalized but were not," said co-author
Anirban Basu, a UW professor of health economics.

Results of the study, published in the Journal of General Internal
Medicine, show the impact of ICU bed use remains fairly constant as ICU
bed availability changes. These effects are also in line with recent
literature estimates for the mortality among COVID-19 patients receiving critical care, that show mortality rates increase as ICUs fill up.

What was surprising, Basu explained, was the effect of non-ICU beds. For additional seven hospitalized patients not in intensive care, one would
expect about 0.5 deaths over the next seven days based on general data
put out by CDC.

However, this new research finds that the total number of COVID-19 deaths actually occurring is much higher.

"This may indicate that constraints in available capacity of non-ICU
beds may have a spillover effect to non-hospitalized patients. In fact,
the study found that the effect of non-ICU beds rises steadily as more
and more non-ICU beds are occupied by COVID-19 patients," said Basu,
who is also director of the CHOICE Institute at the UW School of Pharmacy.

For example, when 20% of non-ICU hospital beds are occupied by COVID-19 patients, an additional seven COVID-19 admissions to non-ICU beds will
produce two additional COVID-19 deaths over the next seven days.

"Even when, say, 80% of non-ICU beds are still available, a further
increase in COVID-19 admissions leads to significantly more numbers of
deaths than what we would expect from only the hospitalized patients. This
may be because the health care delivery within a hospital is not only
driven by hospital beds but also personnel and COVID-specific supplies,
which may be stretched thin, and affecting COVID-19 admission policies of
the hospitals." Consequently, Basu said, efforts to "flatten the curve"
-- that is, reduce or stop the increase of people infected with the
novel coronavirus through public health measures such as mask-wearing and physical distancing -- are more important than simply keeping hospitals
from becoming overwhelmed. Failure to flatten the curve, even before
hospitals reach capacity, is killing more people than just those who
end up in hospital beds.

"These results have very important implications as large numbers
of students head back to schools and colleges across the nation and
resistance to public health measures continues to stymie efforts to
reduce the number of infected," Basu said.

"Our study quantifies the relationship between COVID-19 deaths
and COVID-19 hospitalizations using actual data," write the study
authors. "These estimates provide a better understanding of the
projections of the COVID-19 pandemic in the USA especially when states
are gearing up to restart economic activities and provide important
practice insights for hospitals in terms of assessment of hospital bed
and ICU bed capacity and preparedness." The study's lead author is Pinar Karaca-Mandic, University of Minnesota professor and academic director
of the Medical Industry Leadership Institute in the university's Carlson
School of Management. The researchers used the University of Minnesota's COVID-19 Hospitalization Tracking Project to examine data from 23 states
that reported daily percentages of ICU and non-ICU-bed use by COVID-19 patients. The research was partially funded by the University of Minnesota Office of Academic Clinical Affairs and the United Health Foundation.


========================================================================== Story Source: Materials provided by University_of_Washington. Original
written by Jake Ellison. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Pinar Karaca-Mandic, Soumya Sen, Archelle Georgiou, Yi Zhu,
Anirban Basu.

Association of COVID-19-Related Hospital Use and Overall COVID-19
Mortality in the USA. Journal of General Internal Medicine, 2020;
DOI: 10.1007/s11606-020-06084-7 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200824105538.htm

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