COVID

Why Ashish Jha is concerned about COVID-19 hospitalization rates falling nationally

“The virus is beginning to overrun our health-care defenses.”

Dr. Ashish Jha. Jonathan Wiggs / The Boston Globe

Dr. Ashish Jha is raising concerns that the surging COVID-19 pandemic is distorting health care systems across the United States and is affecting the ability of patients to get treatment at hospitals.

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“The virus is beginning to overrun our health-care defenses,” the dean of the Brown University School of Public Health wrote in an op-ed in The Washington Post on Monday, in which he presented his worries about the trends he’s seeing in his analysis of national COVID-19 hospitalization numbers.

Jha said unlike the spring surge, where health care systems were overwhelmed in particular regions, the current wave of infections is occurring across large parts of the country.

“Counterintuitively, the reason we know COVID-19 is overwhelming the system is because of what might look like a good sign at first glance: The hospitalization rate for patients with the virus is dropping quickly,” he wrote.

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Throughout most of the fall, Jha wrote that in general, health officials could look at the number of COVID-19 cases reported on a single day and predict that a week later a proportion of those cases — that he said was about 3.5 percent — would end up hospitalized.

“The rate, in fact, was remarkably consistent,” Jha said. “On Oct. 15, we had 53,000 new cases. On Oct. 22, you would expect 1,844 hospitalizations. What was it actually? 1,855. But as we entered November, something began to change.”

As November went on, the gap between the projected rate of hospitalizations based on new infections and the actual hospitalizations widened. On Nov. 15, 146,000 new cases were reported, which, according to Jha, should have resulted in about 5,100 new hospitalizations.

Instead, there were less than 3,700.

Jha said this indicates hospitals are admitting fewer and fewer people as the threshold for admissions rises with beds filling up.

The virus surge is essentially resulting in rationing care, he wrote.

“What is happening is that patients who would have been admitted to hospitals earlier in the year are not being admitted now,” Jha wrote. “Indeed, by my best calculation, between a third and half of COVID-19 patients who would have been admitted in the beginning of October are now being sent home instead. This is really bad for patients. Some will get much sicker at home. Some may die there.”

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To mitigate the disaster of overwhelming the health care system and preventing such care rationing, Jha urged the public to continue following social-distancing measures and wearing masks, as well as to demand policies limiting indoor gatherings from their local leaders.

“If we don’t, hospitals across America really will become incapable of caring for any but the sickest of us, causing so much unnecessary suffering and death,” he wrote in the Post. “And with the pandemic’s end now in sight, that outcome would be particularly tragic.”

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