This story was updated April 1 to include the link to Governor Pritzker’s claim that Illinois will need 4,000 more ventilators than it will have at the peak, which is far more than reflected in the University of Washington data described below.
By: Mark Glennon*
This isn’t complicated.
The key information we need about the COVID-19 crisis according to a growing chorus of experts is how many people are getting hospitalized. Those numbers are not hard for a state to get.
Illinois, however, either doesn’t have them or isn’t providing them. Governor JB Pritzker, when asked for them last week, said his staff would be working on it over the weekend. We still don’t have them and there is no excuse.
Many stories across the country, citing medical experts, say hospitalization numbers are currently the best measure for how the crisis is trending and how much we must “bend the curve” to assure hospitals are not overloaded. The “new case” number you always see mean little because it mostly just reflects the huge surge in testing now being done, and most new case victims aren’t seriously sick and get sent home — or never knew they had coronavirus in the first place.
ProPublica last week complained about certain states not providing the numbers, including Illinois, which gave them the run-around. We wrote about that here as have many others around the country. On Tuesday, for example, NPR wrote,
With tests scarce, epidemiologists are looking at hospitalizations as an indicator of how the novel coronavirus is spreading. But in some of the areas of the country worst-hit by COVID-19, states and counties aren’t releasing that data…. “So as long as people aren’t being turned away, we must focus on hospitalizations and ICU cases,” says Steven Goodman, an epidemiologist and Stanford University’s associate dean of Clinical and Translational Research. “The more reliable numbers, aside from the number of deaths, are how many people get sick enough to be in the hospital and in the ICU. That’s what we need to know.
The solution isn’t complicated either. All hospitals complete a daily inventory of patients that includes what they are in for, how many beds are available and more, including who is a Covid-19 patient or a PUI (person under investigation as a possible victim). That’s according to three hospital employees I have heard from. “Oh, sure, we call it ‘The Huddle’ and it’s the first thing we all go over every morning,” a nurse administrator told me.
Governor Pritzker, have them send that daily information to the state and total it up! That’s the simple solution.
Illinois has given us only piecemeal information about hospitalizations and capacity in its daily briefings, describing facts only about a few hospitals or locations. Last Friday, Pritzker said, “We’re working on that now, I mean we obviously, we talked to all the hospitals all across the state. We get data, but you know, over history that data has been collected in different ways across the state. We want to make sure that it’s all in one system. We’ve been piecing it together.”
That’s totally unacceptable.
What’s actually happening?
The only source we find is from the University of Washington’s Institute for Health Metrics and Evaluation. Their current numbers and projections are now being widely used and cited around the country. Where they get their numbers for Illinois is not clear. I have tried to contact them twice but have no response.
It says, as of March 31, Illinois has 14,552 hospital beds available but will only need 8,654 when the crisis will peak in Illinois – April 16. In other words, Illinois has 40% more hospital beds than it will need.
The study does project Illinois will need 268 more intensive care beds than will be available and 1,119 more ventilators than it has. However, Pritzker went on CNN on April 1 claiming the state needs 4,000 ventilators.
Importantly, those totals say nothing about hospital overloads in particular places. Hotspots may be localized and bed shortages may be more acute in particular areas. However, we’ve heard no discussion about moving patients around instead of just paying for more capacity everywhere. France has addressed that issue by spreading patients around, putting them on trains to places with more capacity when necessary.
What we most need is how hospitalizations for the virus are trending. The University of Washington updates its data daily but does not show trends. Illinois should be providing that, and it easily could be.
California and Washington were among the states criticized last week for not providing hospitalization numbers, but they provide it now. Great news for the Washington resulted this week when its hospitalizations dropped by 20%. Other states got very bad news on that, including California.
Is Illinois like California or Washington? Who knows? Illinois isn’t telling us.
Hospitalization numbers aren’t important just for measuring how much capacity we need. They will also be essential for the difficult decision about when to end the stay-at-home order that has shut down most of our economy. Without knowing whether more or fewer people are actually getting sick from the virus, we cannot set that date rationally.
Finally, for the umpteenth time, none of this is meant to imply that current levels of social distancing and shutdowns are too harsh or too lenient. It’s just that policy should be informed by facts — facts we don’t have.
*Mark Glennon is founder of Wirepoints.