Hospital stays start to rise

Maryland officials tracking stats closely as bed use numbers tick up

One of the top measures that Gov. Larry Hogan said he would monitor when it came to lifting pandemic-related restrictions in Maryland was the number of hospitalizations for coronavirus — and it is going up.

Bed use began ticking up this month after weeks of declines. And while the total remains far below the highs of April and May, the sustained creep is more than the governor’s reopening plan suggests is acceptable before new restrictions should be imposed.

There were 533 hospitalized on Friday, with daily increases growing more than 3% on four consecutive days this week.

The rising cases in Maryland, though not as dramatic as those in other states, prompted Baltimore Mayor Bernard C. “Jack” Young on Wednesday to order city restaurants to suspend indoor dining by Friday evening. He also expanded requirements for face coverings.

Leaders in Baltimore and Anne Arundel counties also imposed new restrictions. And in a letter this week, half a dozen of the state’s largest jurisdictions also called on Maryland health officials to consider new statewide measures, but Hogan has so far declined.

The governor said during a Wednesday news conference he was “concerned that we’ve seen a slight uptick” in hospitalizations this week, but he noted that ICU bed use went down and remains flat.

The number hospitalized is “down 70% from the peak of 1,711, which occurred 83 days ago on April 30,” he said. “Some of this slight uptick is younger patients, who fortunately are not as sick as

those older, more vulnerable, more serious cases, many of whom were coming from nursing homes.”

The governor has slowed the reopening of the state in response to the increase in cases and hospitalizations, and has pressed local leaders to crack down on bars and restaurants where young revelers are not complying with the distancing and masking orders, said Mike Ricci, a Hogan spokesman.

The governor “will not hesitate to take statewide actions if and when we deem them to be necessary,” Ricci said

There were 930 new cases reported in the state Friday, bringing the total since the pandemic began to more than 81,700. Five new hospitalizations were reported, bringing the total currently hospitalized to 533.

Hospitalizations exceeded 1,700 as recently as May 6. They declined for weeks to 385 on July 10 before rising again.

In Hogan’s Road map to Recovery, he outlines three “stop signs requiring the easing to slow, stop, or even be reversed.” They included indications that Marylanders were disregarding physical distancing, as well as evidence of significant outbreaks of community transmission. A third was an unexpected increase in hospitalizations or a sustained increase in cases requiring intensive care.

A footnote indicates such an increase would be three days of COVID-19 hospitalizations in which the increases were larger than the seven-day average.

Though cases in Maryland have dropped significantly from their highs, that bar appears to have been met this week, with four days in a row when the daily increases exceeded the weekly average.

But Hogan has all along called for some flexibility with the measures, pointing to general trends that show the pandemic in hand.

He said he would not begin reopening the state until there were 14 straight days of declining cases. That standard wasn’t specifically met when he lifted his stay-athome order amid a general downward trend in May. Some local leaders criticized that move as premature and chose to keep tighter restrictions in their jurisdictions.

When Hogan moved to allow more activity in June, there was not a sustained testing positivity rate below 5%, a measure of how much disease is circulating. So his decision drew pushback from a top adviser to the Republican governor, Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security.

The increases in hospitalizations have continued to catch the attention of public health officials.

“I’m concerned about the trends seen in Maryland,” said Dr. Leana Wen, a George Washington University professor of health policy and management and former Baltimore health commissioner. “We’ve seen what happens when other states reopen too soon and are too slow to reimpose restrictions.”