Hospital capacity concerns took center stage in late 2022, as health experts' warning of a "tripledemic" materialized.
Flu, COVID-19 and respiratory syncytial virus sent patients flocking to hospitals, creating significant operational challenges for facilities already grappling with staffing shortages. This convergence of viruses underscored that severe capacity challenges were not just a temporary crisis of the pandemic but a recurring and significant obstacle for hospitals, even as COVID-19's immediate threats receded.
Today, inpatient bed use rates are not far from what they were during the winter of 2022. Once a marker of acute crisis during the pandemic, hospital capacity challenges have now become a baseline reality for many health systems.
The shift from a crisis-driven response to a routine challenge highlights how hospital capacity management has evolved since 2020.
Then
Virus season hit hospitals particularly hard in 2022, as RSV converged with flu and COVID-19, creating a "tripledemic." Nationwide, more than 80% of hospital beds were in use as of early December 2022. While this metric hovered above 70% for much of the pandemic, it crossed the 80% threshold only one other time during the pandemic, when the Omicron wave swept the country in January 2022. However, in late 2022, far fewer beds were filled by COVID-19 patients — about 6% in December 2022 compared to 25% in January 2022.
An unseasonably early and severe surge in RSV cases placed immense strain on children's hospitals nationwide. Many organizations were operating at or above capacity amid the surge. Flu also peaked early in the 2022-23 season. In late November 2022, the weekly flu admission rate was 27.6, compared to just 2.1 for the same week this season.
In response to these capacity challenges, hospitals turned to immediate measures, such as setting up overflow tents, housing two patients to a room, diverting pediatric patients to other units or postponing elective surgeries to free up resources. Despite these efforts, labor shortages still complicated hospitals' response strategies, as the workforce had yet to stabilize after COVID. In October 2022, a nurse at St. Michael Medical Center in Silverdale, Wash., made national headlines for calling 911 for help responding to her short-staffed and overcrowded ED.
These collective challenges brought heightened national attention to hospital capacity issues for seasons beyond COVID-19 alone. Children's hospitals equated the virus season to "their March 2020," with pediatric groups calling for federal officials to declare the surge a public health emergency.
Now
Hospital bed capacity has remained elevated — consistently sitting above 70% — since 2023, HHS data shows.
Nearly 76% of staffed inpatient beds at U.S. hospitals were occupied for the week ending Jan. 11. Occupancy rates for ICU beds are nearly the same, with 74.6% occupied during the same time period, according to data reported to the CDC.
Across the country, hospitals are facing significant capacity strain amid virus season, rising volumes and discharge delays due to a lack of available post-acute care beds. In many cases, hospitals are reenacting pandemic-era strategies to manage an influx in patients, such as visitor restrictions, repurposing specialty beds to admit patients from the emergency department and meeting daily with officials at other hospitals in the region to ensure capacity is maintained for trauma patients.
Some hospitals have reported unprecedented numbers of patients presenting to the emergency department.
One physician who has worked at Wilmington, Del.-based ChristianaCare for more than 10 years recently told the Delaware News Journal that the number of patients being treated in hallways is at the highest level he has ever seen.
Similarly, hospitals in Fresno, Calif., are experiencing unprecedented numbers of patients in their emergency departments.
"The volume of patients is similar, actually more than when we took care of patients during COVID times," Danielle Campagne, MD, chief of emergency medicine at UCSF Fresno, told local news outlet KFSN on Jan. 23. "The nice thing right now is our ICUs are not full."
Once a sign of acute crisis, operating with sustained high occupancy rates has now become routine for many hospitals. Over the past several years, staffing levels have stabilized and health systems have made progress in reducing emergency department length of stay, enabling leaders to direct more energy and resources toward long-term enterprise strategies to improve patient throughput and operational efficiency. Many leaders are now placing strategic focus on reducing length of stay and improving access to care in ambulatory settings.
Editor's note: This article was updated Jan. 29 at 3:30 p.m. CT.