State not near capacity on ICU beds, ventilators

BRANSON MO NEWS:

A key goal of health care professionals and citizens alike throughout the COVID-19 epidemic has been to “flatten the curve.”

The concept refers to slowing the spread of COVID-19 so as to not overwhelm health care systems and has been used to motivate people to stay home amid the outbreak.

But what exactly does Missouri’s health care system capacity look like? Data from the Missouri Hospital Association, first made public April 3 by the Missouri Department of Health & Senior Services and updated regularly since, gives a broad overview.

Since April 3, the total number of people who have tested positive for COVID-19 has more than doubled from 2,113 to 4,686. The number of deaths has also grown from 19 on April 3 to 133 as of Tuesday.

The number of confirmed COVID-19 patients in hospitals in the state on any given day has generally trended upward, from 475 to 589 since April 3. The state is also tracking the number of patients under investigation for COVID-19, and that figure fluctuates from day to day.

The hospital association also tracks hospital bed availability. The state’s 154 hospitals have a total of 10,795 medical/surgical beds and 2,129 ICU beds. Medical/surgical beds are standard hospital beds not used in specialized care settings like in an emergency department or an intensive care unit. The number of medical/surgical beds in use has trended downward, meaning more beds have become available if needed, from about 7,400 on April 3 to 6,795 on Tuesday. The number of ICU beds in use has fluctuated but was 1,416 on Tuesday.

Tracking the total number of ventilators available in Missouri has proved difficult.

According to MHA Vice President of Public and Media Relations Dave Dillon, the number of ventilators depends on how many hospitals report data each day, which also changes every day. Dillon said there are a few reasons the data vary. For one, that data is not what hospitals are usually required to report. Though hospitals are required to report various data points every day by 10 a.m., Dillon said, not every hospital can make the deadline and not every category will be applicable to all hospitals. Dillon also said that reporting errors have also impacted ventilator numbers but that they have been fixed.

As a result, the numbers fluctuate, but as of Tuesday, there were 901 ventilators in use out of a total 2,253.

“Despite the daily variation, or apparent variation, we believe that the daily update provides a good overall perspective,” Dillon said via email.

In addition to ventilators reported by individual hospitals, the state also owns 123 ventilators that it is able to lend to hospitals that request them and has ordered 220 more. At Gov. Mike Parson’s Monday COVID-19 briefing, Randall Williams, director of the Missouri Department of Health & Senior Services, said the state has not received the 220 ventilators yet and has not had to lend out any of the state-owned ventilators.

Starting this week, DHSS began publishing hospital association data showing PPE and testing supply shortages for hospitals in the state.

The largest number of hospitals, 31, reported shortages of surgical masks. Twenty-nine reported shortages of N95 masks, and 27 reported shortages of surgical gowns.

According to the state report, shortage refers to a facility experiencing “a current or anticipated shortage” of supplies despite using contingency strategies. Four hospitals reported a critical shortage of N95 masks, and 11 reported a critical shortage of surgical gowns. Critical shortages are when a hospital has less than two days of supply, despite contingency strategies.

PAPRs are respiratory support devices, and biological filters and hoods are other types of personal protective equipment included that cover a person’s face or whole head, Dillon said.

Additionally, Tuesday’s report shows that 19 hospitals are experiencing a shortage of testing swabs and that six hospitals are experiencing a critical shortage.

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