Wednesday, March 18, 2020

With just 182 beds, Oshkosh hospitals would fall far short for covid-19 response in new Harvard model


By Miles Maguire
In the case of a covid-19 surge, the math on Oshkosh hospital beds is brutal.

The city has only about half the beds it would need under a moderate rate of infection, a new study from the Harvard Global Health Institute indicates.

Researchers at the institute did not look at Oshkosh directly but instead focused on a larger area, called the Neenah Hospital Referral Region, which includes Oshkosh. These referral regions are the way analysts look at local health care markets.

Of the nine scenarios reviewed by Harvard, there is only one in which local hospital capacity would not be overtaken. In that scenario, just 20% of the population would be infected over 18 months. If the proportion of infections increases or the timeframe shrinks, local hospitals would need to add more beds--perhaps as many as four times what are currently available.

The Oshkosh Examiner applied the Harvard model to local hospital data to see what effect covid-19 could have and how great the shortage would be.

According to the 2018 directory of the American Hospital Association, the city’s two hospitals have a total of 182 beds, including 24 “special care” units, a category that includes intensive care.

The larger of the two Oshkosh hospitals is Ascension North East Wisconsin - Mercy Campus. According to the AHA’s data, the hospital has 110 beds and in 2018 ran at 38% capacity. These figures indicate that at any given time, the facility has about 68 open places.


Its special care units run at about 36% capacity and have about seven or eight open beds, according to the AHA data.

Aurora has 72 beds and was about 45% full in 2018, according to AHA data. These numbers translate into about 40 open beds. Its special care availability was about seven beds.

In summary the local hospitals can be expected to have 108 open beds and maybe 15 special care beds.

But Oshkosh has an adult population of 54,851, including 1,751 in the high-risk over 65 category.

Using assumptions from the Harvard Global Health Institute, a 40 percent infection rate in Oshkosh would lead to the need for 4,500 hospitalizations, with each patient staying for 12 days.


This is roughly twice the available capacity over 12 months.

The number of patients needing intensive care would be about 950 under the 40 percent infection rate scenario, which was described as moderate.

Because the Harvard researchers did not have Oshkosh-specific data to analyze, they used information for the Oshkosh-Neenah area. Their results were roughly the same. They estimated that the intensive care shortage to be about 4.6 times less than what is needed.

Representatives of the two hospitals were not immediately able to respond to questions about these data points, although Aurora has said, without giving details, that it is looking to expand capacity.

The Winnebago County public health director was also not immediately available for comment.

The Harvard results were published jointly by The New York Times and ProPublica. Here is the section on the Neenah Hospital Referral Region.

As of 2018, Neenah, WI had 450 total hospital beds, of which about 41%were occupied, potentially leaving only 260 beds open for additional patients. The bed count includes 46 beds in intensive care units, according to data from the American Hospital Association and the American Hospital Directory. Intensive care units are best equipped to handle the most acute coronavirus cases. 
The Neenah, WI region has a population of about 242,000 residents; 17% are over the age of 65. The experience in other countries has shown that elderly patients have significantly higher hospitalization and fatality rates from the coronavirus.
In the moderate scenario, in which 40% of the adult population contracts the disease over 12 months, Neenah, WI would be among the regions that would need to expand capacity.
It is estimated that about 8% of the adult population would require hospital care. In a moderate scenario where 40% of the population is infected over a 12-month period, hospitals in Neenah, WI would receive an estimated 16,100 coronavirus patients. The influx of patients would require 540 beds over 12 months, which is 2 times times the number of available beds in that time period. The Harvard researchers' scenarios assume that each coronavirus patient will require 12 days of hospital care on average, based on data from China.
In the Neenah, WI region, intensive care units would be especially overwhelmed and require additional capacity. Without coronavirus patients, there are only 25 available beds on average in intensive care units, which is 4.6 times times less than what is needed to care for all severe cases.



1 comment:

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