{"id":931,"date":"2020-12-11T09:21:35","date_gmt":"2020-12-11T14:21:35","guid":{"rendered":"https:\/\/covidqanda.org\/?p=931"},"modified":"2020-12-11T09:21:35","modified_gmt":"2020-12-11T14:21:35","slug":"how-full-are-icus-normally","status":"publish","type":"post","link":"https:\/\/covidqanda.org\/?p=931","title":{"rendered":"How full are ICUs normally?"},"content":{"rendered":"\n

Question:<\/u><\/strong>\u00a0How full are ICUs normally (before COVID)? It was my understanding that in order for hospitals to make enough money, they usually kept their beds, including ICU beds, close to full most of the time. While it\u2019s clearly upsetting that they are now mostly COVID patients instead of elective surgeries, is it really abnormal for hospitals to have ICU\u2019s at or near capacity?<\/p>\n\n\n\n

Answer:<\/span><\/strong>\u00a0Good question!\u00a0 ICU capacity typically averages 68%, ranging from 57% to 82%.\u00a0 We know this with such specificity thanks to rigorous\u00a0research published a few years ago in Critical Care Medicine<\/em>, ICU Occupancy and mechanical ventilator use in the United States<\/a>. The study found that ICU occupancy varied considerably, but on average about 1\/3 of ICU admissions were discretionary. \u00a0For example, an average of 18% of ICU patients were admitted directly after elective surgery.\u00a0 Another study published earlier this year, Cancellation of Elective Surgery and Intensive Care Unit Capacity in New York State: A Retrospective Cohort Analysis<\/a>, concluded,\u00a0“Patients undergoing elective surgery comprised a small fraction of ICU bed and mechanical ventilation use in New York State….Suspension of elective surgeries may have a relatively minor impact on ICU capacity.”\u00a0 Upshot here is that on average (with big variation) ICUs have 7 in 10 beds occupied. Cancelling elective surgeries could free up another bed, giving ICUs a bit more slack (guesstimate average: ~4 open beds out of every 10).\u00a0\u00a0<\/p>\n\n\n\n

The problem with ICU capacity is that even if you add beds and other equipment, you need the personnel to care for these\u00a0very sick patients.\u00a0 And with the pandemic raging across the country, that slack just isn’t there.\u00a0 STATNews ran a good article on this issue back in August,\u00a0ICU capacity is more about the clinicians than the number of beds<\/a>\u00a0and the NY Times<\/em> had an informative article about the current state of affairs earlier this week, “\u2018There\u2019s No Place for Them to Go\u2019: I.C.U. Beds Near Capacity Across U.S<\/a>” (Figure 1<\/strong>).\u00a0 Along with increasing ICU occupancy, another concerning trend has arisen.\u00a0 As recently reported in <\/a>The Atlantic<\/a> <\/em>and the Washington Post<\/a>, <\/em>hospitalization rates are dropping.\u00a0 As public health expert, Dr. Ashish Jha states in the Atlantic<\/em>\u00a0and writes in the Post<\/em>, “As hospitals fill up, they are admitting fewer and fewer people… as the demand for beds soars, the threshold for admission rises with it.”\u00a0 In summation, the ICU occupancy we’re seeing and experiencing across large swaths of the country is indeed abnormal.\u00a0<\/p>\n\n\n\n

Figure 1. Mapping ICU Occupancy <\/strong>(Dec. 9, NY Times<\/a><\/em>)<\/p>\n\n\n\n

\"\"<\/figure>\n","protected":false},"excerpt":{"rendered":"

Question:\u00a0How full are ICUs normally (before COVID)? It was my understanding that in order for hospitals to make enough money, they usually kept their beds, including ICU beds, close to full most of the time. While it\u2019s clearly upsetting that they are now mostly COVID patients instead of elective surgeries, is it really abnormal for […]<\/p>\n","protected":false},"author":1,"featured_media":932,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","om_disable_all_campaigns":false,"_monsterinsights_skip_tracking":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[67],"tags":[117,156],"class_list":["post-931","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-treatment","tag-hospital","tag-icu","fallback-thumbnail"],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/i0.wp.com\/covidqanda.org\/wp-content\/uploads\/2020\/12\/image-12.png?fit=1756%2C1217&ssl=1","_links":{"self":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts\/931","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=931"}],"version-history":[{"count":1,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts\/931\/revisions"}],"predecessor-version":[{"id":933,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/posts\/931\/revisions\/933"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=\/wp\/v2\/media\/932"}],"wp:attachment":[{"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=931"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=931"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/covidqanda.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=931"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}