Each morning when New York Gov. Andrew Cuomo briefs the media and the public about the status of the coronavirus pandemic in his state, he pays particular attention to two numbers: How many patients with COVID-19 are in the hospital and how many require intensive care.
“That is the number we watch because that’s the number that are flowing into the health care system,” Cuomo said on March 18, adding that 549 patients were in the hospital as of that morning.
The numbers have gone up each day. On Friday, the number of hospitalizations broke 1,000. On Monday, 2,000. On Tuesday, 3000. And on Thursday, there were 5,327 people hospitalized in New York state, of which 1,290 were in intensive care units.
If New York does not act quickly to expand the number of beds available to treat infected patients, it will likely run out, Cuomo has said. He’s ordered all hospitals to come up with a plan to increase their capacity by at least 50%, with a goal of doubling their bed count.
But as states across the country confront the growing threat posed by the coronavirus, some aren’t telling the public how many patients are in the hospital and whether their state hospital systems can handle the deluge. And the states that are releasing data are doing so in very different ways, making it difficult to make comparisons.
As of Wednesday, 17 states regularly release this information, including Florida and Louisiana, two of the hardest hit, according to The COVID Tracking Project, which runs a website that tallies key metrics of the national response to the virus. Eleven more occasionally release this data in some form. In all those states combined, 6,136 people were hospitalized as of 4 p.m. Wednesday, with the majority in New York.
Other states, including Washington, California and Illinois, which each have significant numbers of patients who have tested positive for COVID-19, do not disclose their data.
“It’s particularly important for us to know as a signal which states are getting into trouble when,” said Dr. Ashish Jha, director of the Harvard Global Health Institute, which last week estimated a significant shortage of hospital beds to treat COVID-19 patients if the spread of the disease is not slowed. “In order for all of us to help states ... we have to know how the numbers are and when they’re getting into trouble.”
ProPublica and The COVID Tracking Project are launching a distributed reporting project in which we’re asking reporters to check in with state health departments each day to seek accurate information on coronavirus hospitalizations. The information will be released publicly on The COVID Tracking Project’s website so that people can follow the trajectory of the coronavirus in their states and compare states to one another. Reporters can sign up to join our effort here.
The lack of information has hampered even public health officials. Last week, the Centers for Disease Control and Prevention released a report on the first 4,226 COVID-19 cases in the United States that had been reported to the CDC. Overall, the report found, 31% of cases, 45% of hospitalizations, 53% of ICU admissions and 80% of deaths were associated with people 65 and older. But the CDC did not have data on the hospitalization status on more than a third of the cases and lacked information on ICU admissions for more than half of all cases.
In Illinois, a spokesperson for the state’s Department of Public Health said that officials doubt they’ll be able to report the number of COVID-19 patients who are hospitalized and on ventilators every day. The spokesperson emphasized that it is difficult to track down those numbers in what is “a very fluid situation.” Public health officials for Cook County and Chicago declined to provide local numbers and referred queries to the state Department of Public Health.
The California Department of Public Health said in an email: “The California hospital systems are complex and we are a large state. We are working in real time on data and the best method to release it to the public.”
A COVID-19 spokesman in Washington state said, “We have not been tracking COVID related hospitalizations. That is about to change. I believe we will reporting that data late this week or early next week.”
Even states that release the information do so in different ways. Some states release patients currently hospitalized while others include all COVID-19 patients who were hospitalized at some point.
Cuomo now releases both the number of patients in the hospital and those in ICU beds, but almost no other state does so.
“The more refined number is, of those who are hospitalized, how many require the ventilators, because the ventilators are the piece of equipment that is most scarce,” he said at a briefing on Saturday.
This week, Louisiana started sharing the number of patients on ventilators.
Florida releases a host of information on its COVID-19 patients, including the age, gender, county of diagnosis and travel status of each person infected. It also releases the number hospitalized as well as details on the types of symptoms emergency rooms are seeing.
We’re hoping for one consistent dataset, and that’s why we’re asking for reporting partners in every state, including those that release some hospitalization information.
Alicia Mitchell, senior vice president of communications for the American Hospital Association, said hospitals are doing what they can to share information with states. “From what we have heard, many hospitals in many states are reporting this number to their state department of health,” she wrote in a statement.
“We were not aware that this information was not being released by the states. That said, the continued lack of testing supplies in various spots around the country has meant that many who are suspected of having the disease are not yet confirmed. Some may be reluctant to make these data public because it is likely not reflective of the overall number of people infected.”
Jha said the data is vital to both understand which states’ hospital resources are stretched and also to learn for the future.
“It helps us track how the disease is playing out in communities across America. It also helps us anticipate when hospitals and when communities are going to get in trouble with capacity issues,” he said. “It’s much better to be ahead of this than to be able to solve this problem after we’ve exhausted our capacity of beds and ICUs. It’s critical for learning and it’s critical for taking good care of patients.”
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