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US hospitals buckling under delta surge: 25% of ICUs are over 95% full


Masked people stand in front of a tent amidst traffic cones.
Enlarge / PALM BAY, FLORIDA, 2021/07/29: A woman arrives at a treatment tent outside the emergency department at Palm Bay Hospital.

The current surge of the COVID-19 cases driven by the hypertransmissible delta variant is straining hospitals across the US, particularly in the South. Twenty-five percent of hospital intensive care units around the country are now above 95 percent full. That percentage is up from 20 percent in July and just 10 percent in June, according to data tracking by The New York Times.

The spike in critical care follows a surge in cases and hospitalizations. Average new daily cases in the country skyrocketed from around 12,000 a day in late June to the 150,000 or so in mid-September. Hospitalizations have likewise risen, shooting up from an average of nearly 17,000 a day at the start of July to around 100,000 now. Though cases and hospitalizations are starting to plateau or decline slightly, they are still extremely high. Deaths, meanwhile, are increasing. In the past two weeks, deaths have increased 40 percent to the current average of nearly 1,900 per day.

Most of the cases and nearly all of the hospitalizations and deaths remain among the unvaccinated. Around 60,000 people in the US have died of COVID-19 since the start of July. With highly effective vaccines freely available, nearly all of the current deaths are preventable.

Now, along with the surge, public health experts fear strain on health care systems will lead to additional suffering and death in non-COVID patients. Hospitals in several states have been forced to ration treatments and enact crisis-care standards.

Hospitals in Alabama have exceeded 100 percent capacity of ICU beds. The Alabama Hospital Association on Tuesday reported that there were 1,592 ICU patients in the state and only 1,549 staffed ICU beds, an excess of 43 patients. The seven-day average of positive tests for the Yellowhammer State is 19 percent, suggesting that transmission is still extremely high. Alabama is one of the least-vaccinated states in the country, with only 40 percent of the population fully vaccinated.

Affecting everyone

Generally, the hospitals and ICUs most overburdened are in the South, where vaccination rates are relatively low and transmission of delta has soared. In Texas, 169 out of 506 reporting hospitals have ICUs above 95 percent full, which is up from just 69 in June, the Times notes. In Florida, 24 hospitals have reported having more ICU patients than beds in the last week. In Mississippi, 94 percent of the entire state’s ICU beds are full.

But the South isn’t the only place where hospitals are becoming overwhelmed. Last week, Idaho’s health department activated its crisis standards of care in 10 northern hospitals. Likewise, Alaska’s largest hospital—Providence Alaska Medical Center in Anchorage—implemented crisis standards over the weekend. The hospital announced the decision in a two-page letter sent Tuesday.

“The acuity and number of patients now exceeds our resources and our ability to staff beds with skilled caregivers, like nurses and respiratory therapist,” according to the letter, which was signed by Providence Chief of Staff Dr. Kristen Solana Walkinshaw. [W]e must prioritize scarce resources and treatments to those patients who have the potential to benefit most. We have been required to develop and enact policies and procedures to ration medical care and treatments, including dialysis and specialized ventilatory support… Due to this scarcity, we are unable to provide lifesaving care to everyone who needs it.”

The letter also noted that, with the crush of COVID-19 patients, some people seeking emergency care were sitting for hours in their cars outside of the hospital, waiting to be seen by a doctor.

In Illinois, the state’s Department of Public Health reported for the first time that one of its health regions had run out of ICU beds. The southern region (region 5), which includes 19 hospitals, serves roughly 400,000 people, according to the Chicago Tribune.

The Illinois Medical Professionals Action Collaborative Team released a statement Tuesday saying: “This is not ‘a pandemic of the unvaccinated,’ but a pandemic that affects everyone as emergency and routine healthcare collapses for a region.”





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