If COVID-19 cases contracted during the pandemic are concentrated in a six-month period, U.S. hospitals would face a shortage of 1.3 million inpatient beds and nearly 300,000 intensive care unit beds, according to new analysis.
In a blog on Health Affairs, three researchers from the Harvard Global Health Institute in Cambridge, Mass., detailed results of an analysis assessing the capacity of U.S. hospitals to care for the expected surge in hospitalized patients as the virus spreads.
The researchers combined hospital infrastructure data from the 2018 American Hospital Association Annual Survey and the American Hospital Directory to estimate inpatient and ICU bed capacity in nonfederal acute care hospitals across the country. Using that data, they calculated average inpatient and ICU occupancy rates and used population estimates from the U.S. Census American Communities Survey to project estimated numbers of infected patients, hospitalization rates and ICU use rates.
For the analysis, the researchers assumed a moderate pandemic scenario, where 40 percent of the U.S. adult population contracts COVID-19, as described in a previous Harvard Global Health Institute report. The researchers assessed U.S. hospitals' capacity to care for those infected with the disease using three transmission timelines: six months, 12 months and 18 months. The analysis assumed that 50 percent of currently occupied beds could be freed up to care for COVID-19 patients.
Here is what the researchers predicted:
1. About 98.8 million people in the U.S. will contract COVID-19 during the pandemic; 20.5 million will need hospitalization; and 4.4 million will need ICU-level care.
2. If the infection transmission curve is not flattened and the pandemic is concentrated in a six-month period, U.S. hospitals will be short 1.3 million inpatient beds and 295,350 ICU beds.
3. If the curve is not flattened and the pandemic is concetrated over a 12- month span, the shortage of inpatient beds would be 686,624 and ICU beds 147,675.
4. If hospitals can reduce current bed occupancy by 50 percent and flatten the transmission curve to 18 months, there would be a shortage of 447,798 inpatient beds and 96,310 ICU beds.
5. If the infection rate is lower, with only 20 percent of the U.S. adult population contracting the disease, "we would largely be able to meet the needs for inpatient care if we flatten the curve to 12 months," researchers wrote.
"We are at an inflection point, and clearly do not have the capacity to care for our population of COVID-19 patients if the infections occur quickly, and there is a spike in acutely ill patients," researchers concluded. "However, spreading the disease out and providing new strategies to expand the number of beds and the workforce can help ensure that we get through this difficult period."