As Covid-19 cases and deaths continue to rise across the country, with record numbers of patients hospitalized, there is increasing focus on monitoring for potential shortages in hospital capacity. I recently posted charts showing the percentage of all beds occupied by Covid-19 patients for every hospital in Massachusetts. As a Boston-area emergency physician and clinical informaticist, I want to help the public and health professionals make informed decisions. In addition to providing the latest data, today’s post makes two improvements.
First, I’ve added charts showing intensive care unit (ICU) occupancy. Because ICUs treat the sickest patients, often requiring ventilators, local trends in ICU occupancy could provide advance warning of a dangerous capacity crunch. The title chart shows that Covid-19 patients are taking up an increasing share of ICU beds at most hospitals in Middlesex County though, averaged over 14 days, none were even half-filled. In contrast, the ICU at Carney hospital (below) has been at or near its capacity in recent weeks, just from Covid-19. Although I was unable to find public confirmation of this, the concentration of Covid-19 cases at Carney Hospital as compared to other Steward hospitals and other, non-Steward hospitals in the same area, could be the result of Steward preferentially directing Covid-19 admissions there.
Note that the number of ICU beds for each hospital (the denominator) does NOT include surge capacity, and so hospitals may eventually exceed 100% on this measure.
Second, I’ve excluded psychiatric beds from the denominator for hospital occupancy rates. Some hospitals (e.g. CHA) have a third or more of their beds in inpatient psychiatric units. Many others have much less, or none at all. Without accounting for this difference, the effect of Covid-19 on the former hospital could be significantly under-estimated as their psychiatric beds would have few (if any) Covid-19 patients.
I was unable to identify a single, public source detailing each hospital’s breakdown of psychiatric versus medical beds. However, Massachusetts does publish the number of licensed psychiatric beds for each hospital. Subtracting these from the total bed count should permit us to compare hospitals in a more consistent way.
As expected, the resulting chart for Middlesex County above, shows significantly higher occupancy rate than before for CHA, where about one third of all beds are psychiatric, as compared to most other hospitals in the county, where on average about 10% of all beds are psychiatric. As was seen with ICU occupancy, the general occupancy trend for Middlesex County is decidedly upward, with CHA and Winchester standing out as being either flat or downward in the past few weeks. Charts of the remaining counties show a general uptrend, though with significant variability at individual hospitals. For instance, BI Plymouth was devoting over 20% of its beds to Covid-19 patients as November started, but fewer than 5% now.
Charts for each Massachusetts County
Barnstable, Dukes, Franklin, Hampshire & Nantucket are combined at bottom. The rest of the counties appear alphabetically.