The Chicago Journal

Hospitals still filled despite a dropping number of patients

Edward Anderson Edward Anderson on March 20, 2023

Hospitals – The 2020 Covid-19 outbreak resulted in serious issues since US hospitals were overrun with sick people.

Patients regularly filled the hallways and rooms due to the high patient volume.

However, vaccinations have helped to lessen the problem.

Despite the virus’ lower danger, hospitals in the US are nonetheless congested.

Winter recovery

The COVID-19, the flu, and RSV posed a triple danger to the US during the winter.

As a sign that the country has been healing, the majority of states now report little to no activity in respiratory diseases.

According to government statistics, there have been 30% fewer visits to emergency departments for respiratory conditions since January.

The number of flu-related hospitalizations is almost at its lowest point since October.

4% of hospital beds are still occupied by patients statewide, notwithstanding a recent reduction in Covid-19 admissions.

A shift

The new data reveals a dramatic change between January 2022 and the first Omicron wave, when Covid-19 patients overran hospitals.

However, the situation is still packed in hospitals, and it doesn’t appear that things will improve any time soon.

Experts claim that hospitals already struggled with capacity and resource challenges since patients were sicker than ever before to the epidemic.

According to Nancy Foster, vice president for patient safety and quality at the American Hospital Association:

“It’s been a continuing trend over the last decade or so that there’s been this greater acuity of patients inside the hospitals.”

“So what you see is this incredibly sick group of people inside of hospitals.”

“If you’re a doctor or nurse or respiratory therapist or pharmacist or any other health professional working inside the hospital, that means it’s always a difficult puzzle you’re trying to solve to help that patient out.”

Factors

The patient mix at hospitals is comparable to pre-pandemic levels, according to Aaron Wesolowski, vice president of policy research, analytics, and strategy at the American Hospital Association.

According to Foster, if the number of Covid-19 patients decreases, so too could the stress on medical personnel, which at first felt resentful of the limited resources available to help them.

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However, according to Wesolowski’s analysis of Strata data, fewer people attended inpatient and emergency departments in 2022 than they did in 2019.

Experts claim that several complex issues grew worse during the course of the epidemic, taxing the available resources.

“Length of stay is longer because people are needing more acute care,” said Wesolowski.

“Because of work force pressures, there are not as many people who can be treated in an inpatient setting all at once.”

“So both things, I think, can be true.”

Samuel Scarpino, the director of Northeastern University’s AI and life sciences department, believes that the current situation is characterized by a “perfect storm” of issues, including the following:

  • Covid-19 and ongoing control measures hospital use to keep in place
  • A backlog of patients with a delayed need for acute care
  • A workforce that’s burnt out after three years of the pandemic

Covid-19, according to Scarpino, is still the most crucial component.

Instead of building additional hospital beds because a new type increases hospitalizations, hospitals must create extra beds as a safety net due to uncertainty.

“The biggest risk is almost certainty associated with what’s coming,” said Scarpino.

Flexibilities

The declaration of a pandemic emergency, according to Nancy Foster, permitted patients to use telehealth services outside of hospitals.

The emergency status has been continuously renewed by the federal government since January 2020, although it is believed that it will terminate in May.

Without the announcement, hospitals would likely have been busier than they are now, especially since the range of treatment options available outside of hospitals might once again become more limited.

“Part of the reason we have the kind of inpatient hospital scarcity that we have right now is that we do have a number of flexibilities that were granted by [the Centers for Medicare and Medicaid Services] and other federal agencies and the states during Covid that are being used for a wide variety of patients,” said Foster.

“If those were to disappear overnight, we would be struggling to care for the current level of patients.”

Image source: Vox

Covid-19 surges among senior citizens or ‘senior waves’

Edward Anderson Edward Anderson on January 30, 2023

Image source: Vox

Covid-19: Despite a spike in hospitalizations throughout the majority of states in the winter of 2022, Covid-19 has only slightly increased.

When compared to other surges, the overall rate is still a very small portion of what it once was.

Cases involving senior individuals have so far been the only prominent exception.

Senior hospitalization

The age difference is at its widest degree ever as senior hospitalizations approach the height of the Delta spike.

In Covid-19, the hospitalization rate for seniors has been four times higher than the national average since October.

There was never a gap between nursing facilities greater than threefold, even during the winter spike in 2020.

Seniors who tested positive for Covid-19 during the pandemic have repeatedly been a source of concern.

Only 13% of all cases reported in the US were adults 65 years of age or older, according to the US Centers for Disease Control and Prevention.

However, that age group has been responsible for 50% of all hospitalizations and 75% of all deaths.

According to larger trends, the hospitalization rate for seniors in Covid-19 has changed.

Before seeing a steep drop in the summer, it hit a record high during the Omicron spike last winter.

However, senior hospitalization rates have often been greater than those of other age groups.

Age Gap

Professor of molecular medicine at Scripps Research, Dr. Eric Topol, has termed the latest increase the “senior wave.”

“Right now, we have an immunity wall built up against the Omicron family – between shots and prior infections and combinations thereof – that seems to be keeping younger folks in pretty good stead,” said Topol.

“But the immune systems of people of advanced age are not as strong.”

Topol says that the most recent wave is likely having disproportionately severe effects on young people who have immunocompromised systems.

To assess the trends in that age range, however, not enough data is available.

According to Dr. Eric Topol, a factor in the growth in senior hospitalization rates may have been the underuse of medications like Paxlovid and new, immune-evasive variants.

He emphasized booster deficiency as the main culprit, notwithstanding the appallingly low rates.

“It all points to waning immunity,” said Topol.

“If more seniors had their booster, the effect would be minimal.”

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Vaccines & boosters

Only a third of those 65 and older had an updated booster shot, according to CDC data, which worries experts.

Infectious diseases and geriatric medicine specialist Dr. Preeti Malani from University of Michigan Health said: “It’s very, very concerning.”

“There’s a sizable number of people who actually got previous boosters who have not gotten this one and I worry that there’s confusion, there’s misinformation,” Malani added.

“So to seniors – and to everyone – I say: if you have not been boosted, get boosted.”

According to a Kaiser Family Foundation survey, 60% of seniors were concerned about an increase in Covid-19 cases and hospital admissions this winter.

More over 40% of respondents said they were concerned about becoming sick, but almost as many said they had no immediate plans to get the new booster.

Additionally, 25% of seniors claim they don’t have any plans to get a booster and will only do so if it’s required.

Communities

Vaccinations and booster doses continue to be effective at preventing serious illnesses.

Seniors still utilize boosters more frequently than other age groups, despite their low uptake.

Less than 10% of adults under 50 and less than 5% of children got their most recent booster, according to CDC data.

Despite this, experts insist that the difference in hospitalization rates cannot be explained by the expanding gap in vaccination rates alone.

“The truth is that, really, anyone can get this,” said Dr. Preeti Malani.

“But the older you are, the more likely you are to have severe symptoms, the more likely you are to be hospitalized, and the more likely you are to die.”

According to experts, viral diseases like COVID-19 spread equally among older and younger people.

Seniors are often introduced to Covid-19 by family, friends, and the greater community since they are more likely to suffer more serious consequences.

“Seniors are the most at risk, but we bring it to them,” said Malani.

“A thing unique to older adults is that many of them are grandparents and many of them provide childcare for their grandchildren.”

“So they sometimes get infected from their grandkids, who may also be going to school or daycare.”

Malani also emphasized the particular risks that senior citizens who live in communal settings, like nursing homes, present.

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Nursing homes

Despite how vulnerable they may appear, seniors do not constitute the majority of population growth.

A government watchdog report from earlier this month discovered a strong connection between breakouts in nursing homes and community spread.

This winter, nursing homes are at risk once more.

With the exception of the initial winter wave and the Omicron wave, weekly cases among residents have already surpassed previous highs.

They continue to rise.

However, according to information from the US Centers for Medicare and Medicaid Services, only 22% of the staff and 47% of the residents had received all of their vaccines.

The Council of State and Territorial Epidemiologists’ executive director, Janet Hamilton, said:

“We all would have hoped that we would have a vaccine that prevents transmission. We don’t have a vaccine that does that, but it does reduce transmission and it does reduce severe outcomes.”

Hamilton underscored the importance of vaccination for elders who interact with other seniors in order to avoid detrimental consequences.

“But really, any individuals that come in contact with high-risk groups need to be the primary focus for getting vaccinated.”

Reference:

A Covid-19 ‘senior wave’ is diving up hospitalizations