Research worries officials in region
Longer-than-expected hospital stays could hinder efforts in future
As health experts in the U.S. planned for a surge in coronavirus patients earlier this spring, they relied on data from China and elsewhere to estimate everything from how many hospital beds would be needed to demands for protective gear for doctors and nurses.
But new research out of Kaiser Permanente and UC Berkeley suggests the pandemic is playing out very differently, at least in California and Washington. A study of 9.6 million Kaiser patients across the two states found that the more than 1,200 people hospitalized with the coronavirus by early April stayed longer on average than Chinese patients and were more likely to need intensive care.
“The hospital resources needed to meet the needs of severely ill patients are substantial,” Joseph Lewnard, an assistant professor of epidemiology at UC Berkeley and lead author of the study, said in a statement. “We found that observations from China may not provide a sufficient basis for anticipating the U.S. health care demand.”
And while the study says social distancing has been successful at keeping COVID-19 case counts low enough that health care providers on the West Coast can handle them without being overwhelmed like hospitals in New York and Italy, that could change as businesses reopen and people have more contact with others outside their homes.
In other words, local hospitals might get hit harder in the future than they anticipated.
“We have to be really strategic and vigilant about how and when we roll back our social distancing measures,” Vincent Liu, a research scientist at Kaiser’s Northern California research division and co-author of the paper, said in a statement. “It’s going to require coordination between health care systems, community partners, government and public health agencies, academic institutions and industry.”
Already, shops and restaurants across California are reopening. While restrictions on activity in the Bay Area are tighter than in other parts of the state, public health officials have begun to relax them.
According to the study, Kaiser patients who survived stayed in the hospital for 10.7 days on average. Patients who died stayed 13.7 days, compared to 7.5 among those who died in China.
A quarter of those in the Kaiser study remained hospitalized for at least 16 days, a stark difference from a widely used model out of the United Kingdom that projected an average stay of eight days. Some patients have spent a month or longer hospitalized. One Oakland man spent several weeks on a ventilator and roughly 30 days in the hospital before being discharged. The longer people are hospitalized, the more staff time and protective equipment their care requires.
Data out of China suggested that about 30% of hospitalizations require intensive care. But 42 percent of the Kaiser patients hospitalized ended up in an intensive care unit.
In the Kaiser study, half of the people hospitalized were at least 60 years old, while in China the average age of those hospitalized was slightly younger. The Kaiser data also showed that men were hit harder by the disease. Those over age 80 had a 58 percent chance of dying compared to just a 32 percent chance for women of the same age range.
The study authors say more research is needed to understand exactly what’s behind the differences.
For instance, researches didn’t thoroughly review medical records, so patients in the U.S. may be more likely to have underlying medical issues that make battling the coronavirus more difficult. There may also be differences between the U.S. and China when it comes to who gets admitted to the hospital and transferred to intensive care.
Ultimately, the study authors hope the report paints a clearer picture of how the pandemic is hitting the Western U.S. and helps officials more accurately predict what’s to come.
“When people engaged in protecting themselves and their communities through social distancing, their efforts translated into a substantial reduction in the transmissibility of the disease,” Liu said. “We need our communities to stay really engaged, because these data show that even the actions of individuals and small groups can really impact the spread of the virus.”