Am I reading the data wrong? Coronavirus preparedness by state

[ctuser1]

I have some time in hand, so I decided to do a bit of research on state-by-state preparedness for coronavirus.

I am surprised by this chart of #of hospital beds per 1000 people, by state:
https://www.kff.org/other/state-indicator/beds-by-ownership/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Total%22,%22sort%22:%22desc%22%7D


It seems that the "rich" blue states have less hospital beds per person than the "poor" red states.

e.g. South Dakota has 4.8 hospital beds per 1000 people, whereas Connecticut only has 2.0.
NJ/NY are a bit better - @2.4 and 2.7 respectively, MA has 2.2, and California is at a dismal 1.8.

The only "rich" blue state/region I see up there is District of Columbia (i.e. Washington DC) - with 4.4 hospital beds per 1000 person.

Do you happen to have any stats on the # of ventilators, ICU beds etc by state?

[Milizard]

I have a friend who is a nurse that explained that, in order to qualify for some kind of more exalted status (I can't remember the actual term for it), the local hospital changed all the rooms from single occupancy from double.  This helps with the infection rate.

I wonder if those states with more beds actually have more because they have more double occupancy rooms.  I wouldn't exactly call that better prepared for coronavirus.  I didn't look to see if there was more information provided by your link.

[StashingAway]

Total, complete naive guesses from an amateur who has no idea how hospitals work:

Can it be a attributed to a scenario where hospitals need minimum occupancy for various wings to account for higher variability in lower populations? South Dakota has a low population density, so their spikes and lulls in hospital need are going to vary much more drastically than large populations. (you are more likely to see a 20% swing in pregnancy rates in a low population than a high one due to mean regression) So those states are more likely going to need to prepare for those swings. Especially if a hospital is segmented, so they need enough ICU beds and maternity beds and long term care beds to handle all of this. If you had a population of 5 people, just from sheer luck you could have 60% of them in the hospital at once. If you have a population of 500K people, this is less likely.

Now maybe combine that with poor populations being less healthy in general, and those states are looking at higher variability and less healthy populace.

Those are just guesses. I wouldn't say they hold much weight, but stats can be deceiving.

[AnnaGrowsAMustache]

Those beds are no frickin use to anyone seriously ill with corona virus unless they have respirators attached. Dig up some data on that.

[MilesTeg]

I have some time in hand, so I decided to do a bit of research on state-by-state preparedness for coronavirus.

I am surprised by this chart of #of hospital beds per 1000 people, by state:
https://www.kff.org/other/state-indicator/beds-by-ownership/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Total%22,%22sort%22:%22desc%22%7D


It seems that the "rich" blue states have less hospital beds per person than the "poor" red states.

e.g. South Dakota has 4.8 hospital beds per 1000 people, whereas Connecticut only has 2.0.
NJ/NY are a bit better - @2.4 and 2.7 respectively, MA has 2.2, and California is at a dismal 1.8.

The only "rich" blue state/region I see up there is District of Columbia (i.e. Washington DC) - with 4.4 hospital beds per 1000 person.

Do you happen to have any stats on the # of ventilators, ICU beds etc by state?

A contributing factor is probably rural vs urban states. When you have more cows than people it's a lot easier to have a high ratio of beds to people.

Especially when those big urban states are footing the bill for your hospital (along with other infrastructure).

[Adam Zapple]

Probably has to do with population density

[pdxmonkey]

I'm in Oregon which has a very low number if beds per 1000. What I read is that they were previously proud of this metric as it is only possible with good management of assume and chronic disease. Care that lets people stay at home instead of in hospital beds.

It works make sense that richer areas can afford better preventative care... Therefore less beds.

[PDXTabs]

It seems that the "rich" blue states have less hospital beds per person than the "poor" red states.

It's because they've worked really hard to keep people out of the hospital, or as this article puts it:
Allen said Oregon is able to keep the overall bed number so low “by providing access to primary care so that people don’t require hospitalization, so we’re able to save costs and the healthcare system.”

Or perhaps because we are cheap:
But the idea that early intervention and primary care is keeping people out of hospital beds is not reflected in the experiences of doctors and nurses, who say the trend for the last ten years has been one of trying to do more with less.

Either way we're fucked:
Leading countries have more than 10 beds for every thousand residents. The U.S. has fewer than three.

https://www.opb.org/news/article/coronavirus-patient-surge-in-oregon-prompts-joint-hospital-efforts.

[ctuser1]

Either way we're fucked:
Leading countries have more than 10 beds for every thousand residents. The U.S. has fewer than three.

If this translates into:
1. Fewer ventilators per person
2. Fewer ICU beds per person

Then we *are* fucked.

At least we'll avoid socialized medicine!!

[American GenX]

My "poor" blue state is down the list a ways.

[StashingAway]

Either way we're fucked:
Leading countries have more than 10 beds for every thousand residents. The U.S. has fewer than three.

If this translates into:
1. Fewer ventilators per person
2. Fewer ICU beds per person

At least we'll avoid socialized medicine!!

Good points, this doesn't mean much without more context. The US has extremely good intensive care relative to the rest of our healthcare system. We don't really know how well we'll be able to handle the flux of oncoming cases. My guess is that it will be noticeably better than Italy, but that's not something to brag about. It's also not defending the cost or preventative care or anything else, but it might not be as bleak as these stats predict.

We also might have more resources via national guard and military that other countries don't have as much of. Temporary hospital tents might make up for some of the beds... assuming we organize them well. It's very speculative from this armchair I'm sitting in.

[bacchi]

We're probably in worse shape than Italy.

https://fivethirtyeight.com/features/coronavirus-may-make-millions-of-americans-sick-but-we-only-have-about-100000-ventilators/

And Italy may have had more capacity to begin with than the United States has now. The latest data is from 2017, but at that point, the country had a usage rate of only about 48 percent for its intensive care beds. It’s hard to pin down an exact number for the U.S. — hospital participation in the surveys that count bed occupancy varies a lot from year to year — but some estimates place occupancy of ICU beds in this country at around 68 percent.

==> Italy had more empty beds going into this than the US has.

But it's also about the number of ventilators.

The best estimate available comes from a 2010 survey that estimated the number of full-function ventilators in the country at around 62,000.

Now we can throw some numbers around. If 20% of a population get the virus, and 20% of them need urgent care (like China), we are fucked, if it happens around the same ~3 week span.

Imagine if 40% of a small county gets the virus. 10,000 people * 40% = 4000 * 20% needing hospital care = 800. Do counties with 10,000 population have 800 spare beds? Do they have the ventilators needed?

[Omy]

While Italy has an older population, our younger peeps have conditions like diabetes, obesity, hypertension that puts them at risk. And 8% of Americans don't have health insurance. We may wish we were as good as Italy...

[StashingAway]

We're probably in worse shape than Italy.

https://fivethirtyeight.com/features/coronavirus-may-make-millions-of-americans-sick-but-we-only-have-about-100000-ventilators/

And Italy may have had more capacity to begin with than the United States has now. The latest data is from 2017, but at that point, the country had a usage rate of only about 48 percent for its intensive care beds. It’s hard to pin down an exact number for the U.S. — hospital participation in the surveys that count bed occupancy varies a lot from year to year — but some estimates place occupancy of ICU beds in this country at around 68 percent.

Those numbers scare me a bit more.

[ctuser1]

Finally, some stats on ventilators.
https://www.nytimes.com/2020/03/18/business/coronavirus-ventilator-shortage.html

Hospitals in the United States have roughly 160,000 ventilators. There are a further 12,700 in the National Strategic Stockpile, a cache of medical supplies maintained by the federal government to respond to national emergencies.

US population: 372 million.
= 0.477 ventilators per 1000 people

In Germany, where about 25,000 ventilators are now available nationwide, the government ordered 10,000 from a domestic manufacturer, Dräger, to be made over the next year.

Germany population: 83 million
= 0.301 ventilators per 1000 people

And in Britain, where the country expects to need far more than the 5,000 ventilators now available...

Britain population: 66 million
= 0.0706 ventilators per 1000 people
 
So, US has less hospital beds, but more ventilators available. That's an interesting stat! 

Also interesting and somewhat sobering...

As the initial epicenter of the coronavirus outbreak, China snapped up whatever slack there was in the market for the assisted-breathing machines. When the disease spread to South Korea and Italy, hospitals in those countries put their orders in. Now manufacturers are getting inundated with orders from all over the world.
The United States is toward the back of the queue, according to manufacturers.