US data on hospitalizations from COVID-19

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In the decisions of governments, what really counts is the COVID-19 hospitalization rate.  As shown in a local city announcement, it said that:

(December 5, 2020) Effective Dec. 5, businesses must ‘roll back’ operation capacities to 50% because Trauma Service Area (TSA) Region E  has experienced a 15% COVID-19 hospitalization rate for seven consecutive days since Nov. 27 (per Governor  Greg Abbott’s Executive Order 32) . 

Per the GA-32, areas with high hospitalizations means any Trauma Service Area that has had seven consecutive days in which the number of COVID‑19 hospitalized patients as a percentage of total hospital capacity exceeds 15 percent, until such time as the Trauma Service Area has seven consecutive days in which the number of COVID‑19 hospitalized patients as a percentage of total hospital capacity is 15 percent or less.

More specifically it's:

• Capacity at intensive care units

As shown in the California's announcement:

The new restrictions followed orders announced by California governor Gavin Newsom that would limit travel and commerce if capacity at intensive care units fell below 15 per cent in five regions of the state. As of Saturday, the central San Joaquin Valley area and the broadly defined Southern California region, which includes Los Angeles, had breached the limit.

Figure 1.  Avg. weekly hospitalization and deaths of coronavirus patients

Hospitalized COVID-19 Patients

On Jan 06, The COVID Tracking Project reported more than 132,000 people in the United States hospitalized with COVID-19 right now—more than there have been at any time since the pandemic began (see Figure 1).

Hospital systems are designed for average patient loads, not epidemics.  With the unchecked spread of a novel virus, any geographic and temporal clustering of outbreaks can overwhelm a health care system.  

Patients with severe disease from COVID-19 require a mean of approximately 13 days of respiratory support.^[4] Such lengthy treatment time will further stress resources.

When crushes of patients overwhelm hospitals, as is now occurring in dozens of U.S. states. With the country setting new records of hospitalizations daily, care is getting threatened, and death rates — not just deaths — could increase.

Persistent Symptoms in Patients After Acute COVID-19

As time passes in a pandemic there’s a greater chance of survival for those getting infected. The reason for this is that Doctors and scientists know more about Covid-19 now than 9 months ago and hence are able to treat patients better. 

However, Covid-10 survivors still report a wide range of long-term symptoms (Figure 2).  Even mild Covid-19 infections can make people sick for months.

Figure 3.  Persistent Symptoms in Patients After Acute COVID-19

Follow-up study of 143 people hospitalized for COVID19. At a mean of 60 days, only 13% were completely symptom-free, and 44% had poorer quality of life:

Common symptoms were fatigue (53%), shortness of breath (43%), joint pain (27%), and chest pain (22%) as shown in Figure 3 (left: symptoms during the acute phase of the disease and right: at the time of the follow-up visit) .

 

Final Words

In some welcome good news, insurers Cigna and Humana have announced that they will waive cost-sharing and co-payments for patients diagnosed with Covid-19.^[6] The move comes amid a new spike in coronavirus cases, and reports that some hospitalized patients were hit with seven figures bills for their treatment.

References

1. 8 In 10 Hospitalized Covid-19 Coronavirus Patients Were Vitamin D Deficient: New Study
2. Persistent Symptoms in Patients After Acute COVID-19
3. One Million Cases in Seven Days: This Week in COVID-19 Data, Nov 19
4. Guan WJ, Ni ZY, Hu Y, et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020.
5. Even Mild Covid-19 Infections Can Make People Sick for Months
6. Cigna, Humana Waive Patient Out-Of-Pocket Costs For All Coronavirus Treatment (Forbes)