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U.S. Hospitals Running Out of ICU Beds for COVID Patients

WEDNESDAY, Dec. 9, 2020 – In a sign that the coronavirus pandemic is entering its most dire stage yet, new federal data shows that more than a third of Americans now live in areas where hospitals are critically short of intensive care beds.

Hospitals serving more than 100 million Americans had fewer than 15 percent of intensive care beds still available as of last week, a New York Times analysis of government data on hospitals finds.

Things are even more troubling across much of the Midwest, South and Southwest, where intensive care beds are either completely full or fewer than 5 percent of beds are available. Under that scenario, experts warn that caring for the sickest patients may be difficult or impossible.

"There's only so much our frontline care can offer, particularly when you get to these really rural counties which are being hit hard by the pandemic right now," Beth Blauer, director of the Centers for Civic Impact at Johns Hopkins University in Baltimore, told the Times. "This disease progresses very quickly and can get very ugly very fast. When you don't have that capacity, that means people will die."

Hospitalization figures collected by the COVID Tracking Project show that the number of people hospitalized with the virus nationwide has doubled since the beginning of November, the Times reported.

The new hospital data shows that some areas — like Amarillo, Texas, Coral Gables, Fla., and Troy, Mich. — are seeing rates of serious illness that approach the levels seen in New York City during the worst weeks of the spring, the Times said.

In California, more than 10,000 COVID-19 patients are now hospitalized, more than 70 percent above levels from just two weeks ago, and the effects of Thanksgiving travel may not have been fully felt yet, the Times reported.

While survival rates have improved as doctors have learned which treatments work, hospital shortages raise the possibility of increasing mortality rates once again if patients don't get the level of care they need.

Thomas Tsai, an assistant professor of health policy at Harvard University, told the Times that healthcare workers must make tough decisions about who receives care when resources are critically tight.

Already, there is some evidence that is happening, Tsai said. For the last several weeks, the rate at which COVID-19 patients are going to hospitals has started decreasing. "That suggests that there's some rationing and stricter triage criteria about who gets admitted as hospitals remain full," he explained.

So far, policymakers have relied heavily on data on testing and cases to make policy decisions, but the new, detailed data on hospitals prompt a rapid shift in what leaders consider as they make decisions, Blauer told the Times.

"If you're living in a place where there's no ICU bed for 100 miles, you have to be incredibly careful about the social interaction that you allow the community to take," she explained.

Pfizer's COVID Vaccine Starts to Work Shortly After First Dose

New data released Tuesday suggests that Pfizer's two-dose coronavirus vaccine begins to work well protecting recipients against COVID-19 within 10 days of the first dose. It also appeared to work well regardless of the trial volunteers' age, sex or weight.

The data was published on the U.S. Food and Drug Administration's website in advance of a meeting of its vaccine advisory committee on Thursday, the Times reported.

Last month, Pfizer presented data showing a 95% effectiveness of the vaccine after two doses, but the new data suggests protection arrives even after the first dose.

But will Americans who need the shot get one? In related news, Pfizer has already told the Trump administration it can't deliver additional doses of its coronavirus vaccine until summer because other countries have snatched up most of the company's supply.

That means the U.S. government may not be able to ramp up its vaccination campaign as quickly as it had hoped. Right now, 100 million doses of the Pfizer vaccine have been purchased, but whether most Americans can get the vaccine by late spring or early summer is no longer certain, the Washington Post reported.

Trump administration officials denied there would be availability issues in the second quarter, noting that other coronavirus vaccines are moving through the pipeline.

"I'm not concerned about our ability to buy vaccines to offer to all of the American public," Gen. Paul Ostrowski, who oversees logistics for Operation Warp Speed, told the Post Monday. "It's clear that Pfizer made plans with other countries. Many have been announced. We understand those pieces."

But several officials knowledgeable about the vaccine contracts said that vaccines from other countries may not fill the gap.

Last summer, Pfizer officials had urged Operation Warp Speed to purchase 200 million doses, according to people knowledgeable about the issue who spoke on the condition of anonymity, the Post reported. But Warp Speed officials declined, opting instead for 100 million doses, they said.

It was only last weekend, with U.S. Food and Drug Administration's emergency clearance of the Pfizer vaccine imminent, that federal officials asked to buy another 100 million doses from Pfizer. By then, the company said it had committed its supply elsewhere and it might only be able to provide 50 million doses at the end of the second quarter, and another 50 million doses in the third quarter, the Post reported.

Pfizer spokeswoman Amy Rose would not confirm any information about the company's discussions with the government, and said a separate agreement would have to be negotiated for any doses beyond the 100 million the United States has already purchased, the Post reported.

Moncef Slaoui, chief science adviser to Warp Speed, told the Post Monday that the government strategy was to spread its risk widely over many different types of vaccines from different companies. He declined to comment on negotiations with any particular company, but said he did not believe vaccine supply would fall off sharply at any point.

Slaoui did note that Johnson & Johnson was likely to report trial results in early January and be ready to ship doses in February, if its vaccine is authorized. He also predicted that AstraZeneca's trial would report results in late January or early February and potentially begin distributing doses later that month.

"We could have all of them," Slaoui told the Post. "And for this reason, we feel confident we could cover the needs without a specific cliff [drop in supply] … We have planned things in such a way as we would indeed avoid a cliff."

The contract that Pfizer signed with the government in July included an option to contract to buy an additional 500 million doses. No agreements with Moderna beyond its initial contract have been announced, but the United States has the option to purchase 400 million additional doses of that vaccine, the Post reported.

A global scourge

By Wednesday, the U.S. coronavirus case count passed 15.2 million while the death toll passed 286,000, according to a Times tally. According to the same tally, the top five states in coronavirus cases as of Wednesday were: California with over 1.4 million cases; Texas with over 1.3 million cases; Florida with just over 1 million cases; Illinois with over 805,000; and New York with over 728,000.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

Many European countries are tightening restrictions, the Associated Press reported. France has entered a nationwide lockdown, and Germany and Austria have started partial lockdowns as government officials across the continent scramble to slow a sharp rise in infections that threatens to overwhelm their health care systems.

England has followed suit, while Italy, Greece and Kosovo also announced new measures, the AP reported.

Things are no better in India, where the coronavirus case count passed 9.7 million on Wednesday, a Johns Hopkins University tally showed. More than 141,000 coronavirus patients have died in India, according to the Hopkins tally, but when measured as a proportion of the population, the country has had far fewer deaths than many others. Doctors say this reflects India's younger and leaner population. Still, the country's public health system is severely strained, and some sick patients cannot find hospital beds, the Times said. Only the United States has more coronavirus cases.

Meanwhile, Brazil had over 6.6 million cases and over 178,000 deaths as of Wednesday, the Hopkins tally showed.

Worldwide, the number of reported infections passed 68.3 million on Wednesday, with over 1.5 million deaths recorded, according to the Hopkins tally.

© 2021 HealthDay. All rights reserved.

Posted: December 2020

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