Daily COVID-19 deaths are plateauing in New York City, but some states haven't reached their peak. With peak dates in the back of their mind, hospitals leaders nationwide are asking the same question: How quickly will they rebound from the pandemic?
"Now that we are starting to see a number of markets peak, what will it mean?" Christopher Kerns, vice president of executive insights at the Advisory Board research firm, asked during an April 16 web conference. "When we start to think of volume recovery, a lot of attention has been paid to the amount of elective volumes or nonelective volumes that have been forgone during this period."
How providers recapture that volume will vary widely. Here are three questions and answers from the Advisory Board that map what a rebound could look like:
Access the full web conference here.
Question: How long will it take a typical provider to recover losses from the cancellation of elective surgeries?
Answer: The Advisory Board considered an inpatient surgery scenario where a 1,000-bed health system that usually performs 40 surgeries a day, six days a week, at 80 percent of max capacity saw those procedures canceled for three months. If supply remains where it was before the pandemic, and no patients leave the hospital's queue for competitors, the Advisory Board predicts it will take 25 weeks to clear the queue. This time frame could be shortened to eight weeks if capacity is expanded by 20 percent, and 5 percent of patients left the queue each week. It varies based on capacity and other factors.
Question: When will "normal" return, and what will it look like?
Answer: The Advisory Board said hospitals could face a surge in COVID-19 cases after social distancing is lifted, which could put strain on capacity. The return of elective procedures will also bump inpatient hospital admissions, as could complications from nonelective procedures that people have delayed. Viral infections due to immune systems weakened from isolation could also increase volumes.
When it comes to volume recovery, Mr. Kerns said there are four main questions hospitals should ask:
- When do we reopen this service, considering safety, legal and public relation concerns?
- How many patients should we leave in the queue?
- What is our post-COVID-19 capacity for this service?
- How is post-COVID-19 demand for this service different?
"Our planners should be looking for answers to all of these questions. I would recommend that VPs of planning, chief strategy officers, CFOs [and] CEOs have answers for all of these questions for the major service lines within their organization," Mr. Kerns said.
Question: When will utilization get back to pre-COVID-19 levels?
Answer: The speed of recovery will vary based on several factors, some of which will have a significant effect on utilization, while others will have a lesser effect.
In the near-term, state and federal orders that continue to prohibit elective procedures will have the highest negative effect on utilization, while an increase in availability of personal protective equipment and tests will offset this.
In the medium-term, several things will negatively affect utilization: backfilled cases, capacity constraints, lingering fear of infection and loss of insurance or job.
In the long-term, utilization will increase as the availability of therapeutics and vaccines reduces the likelihood of a second COVID-19 wave.