by: News Release & Posted By Staff | newsweb@everythinglubbock.com
(Nexstar Media Group/EverythingLubbock.com Staff)
LUBBOCK, Texas (NEWS RELEASE) The following is a news release from the City of Lubbock:
As of 4:00 p.m. on Sunday, November 15, 2020, the City of Lubbock confirmed 750 new cases of Coronavirus (COVID-19), 412 recoveries and 1 additional death. The total number of cases in Lubbock County is 25,820: 4,881 active, 20,666 listed as recovered and 273 total deaths.
*Since the 4:00 PM cutoff, there were 32 additional cases reported or transferred in to Lubbock. These cases are adjusted into the cumulative totals.
As of 4:00 p.m. there are a combined 13 open hospital beds and 15 patients holding for beds at University Medical Center and Covenant Health System. Note that this reflects staffed beds open to receive patients and differs from the available bed count shown on the DSHS and the City of Lubbock dashboards. These dashboards count all available beds, including specialty beds, such as pediatrics, PICU, outpatient, psychiatric and others, as well as hospitalized patients in the 22 county Trauma Service Area.
Lubbock remains above the 15% threshold where the percentage of COVID-19 confirmed patients in regional hospitals as a percentage of available hospital beds. The most recent number is 24.81%. Trauma Service Area B will remain under the additional restrictions outlined under Governor Abbotts Executive Orders until we remain below 15% for seven consecutive days.
Executive Orders 31 and 32 can be found heremylubbock.info/ga-31or heremylubbock.info/ga-32
The Texas Department of State Health Services (DSHS) maintains a dashboard with state, regional, and county level COVID-19 statistics and can be found heremylubbock.info/dshs-covid
Local COVID-19 statistics can be found heremylubbock.info/covid
(News release from the City of Lubbock)
COVID-19 Test Results
The results listed are from the previous day. Additional data can be found on the NDDoH website.
BY THE NUMBERS
8,049 Total Tests from Yesterday*
1,008,066 Total tests completed since the pandemic began
935 Positive Individuals from Yesterday*****
63,796 Total positive individuals since the pandemic began
12.54% Daily Positivity Rate**
11,124 Total Active Cases
-187 Individuals from Yesterday
1,101 Individuals Recovered from Yesterday (922 with a recovery date of yesterday****)
51,936 Total recovered since the pandemic began
322 Currently Hospitalized
+17 Individuals from yesterday
10 New Deaths*** (736 total deaths since the pandemic began)
INDIVIDUALS WHO DIED WITH COVID-19
Man in his 90s from Grand Forks County.
Man in his 60s from Grand Forks County.
Man in his 70s from Grand Forks County.
Man in his 70s from Kidder County.
Man in his 50s from Mountrail County.
Man in his 80s from Ramsey County.
Woman in her 80s from Stutsman County.
Woman in her 90s from Stutsman County.
Woman in her 90s from Stutsman County.
Woman in her 80s from Walsh County.
COUNTIES WITH NEW POSITIVE CASES REPORTED TODAY
Adams County 1
Barnes County 10
Benson County 8
Billings County 1
Bottineau County 1
Bowman County 2
Burke County 1
Burleigh County 133
Cass County 129
Cavalier County 4
Dickey County 3
Divide County 1
Dunn County 2
Eddy County 1
Emmons County 2
Foster County 4
Grand Forks County 136
Grant County 2
Hettinger County 6
Kidder County 3
LaMoure County 4
McHenry County 11
McKenzie County 10
McLean County 8
Mercer County 19
Morton County 58
Mountrail County 10
Nelson County 6
Pembina County 1
Pierce County 8
Ramsey County 18
Ransom County 5
Renville County 6
Richland County 29
Rolette County 11
Sargent County 6
Sioux County 2
Slope County 1
Stark County 43
Steele County 1
Stutsman County 22
Towner County 2
Traill County 13
Walsh County 26
Ward County 132
Williams County 33
* Note that this does not include individuals from out of state and has been updated to reflect the most recent information discovered after cases were investigated.
**Individuals who tested positive divided by the total number of people tested who have not previously tested positive (susceptible encounters).
*** Number of individuals who tested positive and died from any cause while infected with COVID-19. There is a lag in the time deaths are reported to the NDDoH.
**** The actual date individuals are officially out of isolation and no longer contagious.
*****Totals may be adjusted as individuals are found to live out of state, in another county, or as other information is found during investigation.
For descriptions of these categories, visit the NDDoH dashboard.
For the most updated and timely information and updates related to COVID-19, visit the NDDoH website at www.health.nd.gov/coronavirus, follow on Facebook, Twitter and Instagram and visit the CDC website at www.cdc.gov/coronavirus.
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For the second day in a row, New Jersey hit a record number of new daily coronavirus cases, with 4,540 new cases reported on Sunday. An additional 18 deaths were also reported.
Both Saturday and Sunday saw daily new case numbers higher than those seen in April, during the height of the first wave of the pandemic.
These numbers are ALARMING and continue to rise. Take this seriously. Wear a mask. Social distance. Stay safe, Gov. Phil Murphy said in a Sunday afternoon tweet reporting the numbers.
As we begin the holiday season, plan accordingly and keep social distancing and safety in mind, Murphy said. We MUST redouble our efforts and crush the curve like we did last spring. Our lives literally depend on it.
As of Saturday, the seven-day average for new cases was 3,198, up 50% from a week ago and 258% higher than a month ago. Thats also the highest seven-day average since April 28.
However, it is difficult to directly compare cases from April to now because there were far fewer tests being done in the spring when supplies and testing sites were more limited. It is likely the virus was more rampant in April.
The positivity rate for tests conducted on Monday, the most recent day available, was 8.06%, down from more than 10% over the weekend. The positivity rate remained below 4% throughout the summer.
The state has now had 279,274 positive tests and 16,566 deaths 14,765 confirmed and 1,801 probable fatalities since the outbreak began in March.
Before this weekend, the single-day high for positive tests was 4,391 on April 17, when New Jersey hit the peak of the outbreaks first wave. At the time, though, tests were in short supply. The state has more than doubled its testing capacity since the spring.
Its possible the current numbers are 10 to 20% higher than those being reported by the state because rapid tests are not included in the daily reports, health officials have said.
As the second wave takes hold, some restrictions have been re-implemented after they were lifted over the summer.
Restaurants and bars have been ordered to close indoor dining by 10 p.m. and the governor signed an executive order this week that allows towns to close nonessential business by 8 p.m.
Murphy and the governors of five other northeastern states are meeting this weekend to discuss possibly coordinating new restrictions to address the spike in COVID-19 cases as a second wave of the coronavirus grips the region. Those scheduled to attend the virtual summit include the governors of New York, Connecticut, Pennsylvania, Massachusetts and Vermont.
Medical personnel put on safety gear before testing begins at the Union County drive thru coronavirus testing at Kean University in Union in July.Ed Murray | NJ Advance Media for
CORONAVIRUS RESOURCES: Live map tracker | Newsletter | Homepage
While cases hit a new high on Sunday, deaths still remain well below where they were in mid-April, when more than 400 people in the state were dying each day.
Part of this is because hospitals have improved treatment for COVID-19, health officials have said. The hospitals are also not as crowded as they were in the spring, though those numbers are also surging again.
State data shows that 2,004 people are currently hospitalized with coronavirus, with 135 people on ventilators. That is the highest number of hospitalizations since June 2.
During the peak of the first wave in April, more than 8,000 people were in New Jersey hospitals fighting the virus.
The statewide rate of transmission increased to 1.38 much lower than when it was above 5 toward the end of March, but still the highest since the summer. Any rate above 1 means the outbreak is expanding.
North Jersey counties are recording the most new cases, led by Hudson County with 413 new cases reported Saturday. Camden and Bergen counties recorded 400 and 397 new cases, respectively. All but six counties reported at least 100 new cases.
COVID-19 cases are surging all over the country. The United States recorded more than 180,000 new cases on Friday, by far the largest number of new daily cases seen during the pandemic. Nearly 1,400 people died from the virus nationwide on Friday.
COUNTY-BY-COUNTY NUMBERS (sorted by most new)
HOSPITALIZATIONS
On Sunday, there were 2,004 patients in hospitals confirmed or suspected to have COVID-19, up 4 from Saturday.
New Jersey has 392 people in intensive care (22 more than on Saturday) and 135 people on ventilators (up one from Saturday).
The state said 231 COVID-19 patients were discharged from the hospital on Saturday.
TRANSMISSION RATE
The states transmission rate has climbed to 1.38 on Saturday, up from 1.35 on Friday. Thats up from a recent low of 1.13 on Oct. 20.
A rate of 1.38 means that 100 people with the virus will transmit it to 138 people.
Over time, that means the virus is growing among the population.
SCHOOL CASES
Since the start of the school year, at least 193 New Jersey students and educators have either contracted COVID-19 or passed it on to someone else while in the classroom, walking around their schools or participating in extracurricular activities, state officials said.
The 193 cases were part of 51 confirmed school outbreaks that local health investigations concluded were the result of students and teachers catching the coronavirus at school.
GLOBAL NUMBERS
As of Saturday afternoon, there have been more than 54 million positive COVID-19 tests across the globe, according to a running tally by Johns Hopkins University. More than 1.3 million people have died from coronavirus-related complications.
The United States has the most positive tests in the world, with 10.9 million, and the most deaths, with more than 245,600.
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Katie Kausch may be reached at kkausch@njadvancemedia.com. Tell us your coronavirus story or send a tip here.
From Boston to Springfield, advocates and health organizations are launching listening sessions. Some are surveying their communities to identify trusted local leaders who can help communicate reliable information about coronavirus and counter rumors and fears. But they face a daunting prospect as many communities that have shouldered a disproportionate share of coronavirus illness and deaths also harbor deep-rooted suspicions stemming from years of discriminatory treatment by physicians and researchers.
In Boston, the Roxbury Presbyterian Church is hosting none other than the nations top infectious disease expert, Dr. Anthony Fauci, in a Zoom event later this month about grappling with health, equity, access, and trust during the pandemic.
I was a little surprised that so many people in my community dont trust this vaccine," said Rev. Liz Walker, church pastor and a member of Governor Charlie Bakers COVID-19 Vaccine Advisory Group. I am talking to parishioners to try and get people the real information and then they can make wise choices."
The drug maker giant Pfizer raised optimism last week when it announced preliminary trial results indicating its vaccine may be 90 percent effective against COVID-19. If it gets federal approval, the company said, it intends to distribute enough doses to immunize 15 million to 20 million people by the end of December.
In its latest vaccine distribution plan, the Baker administration expects to receive between 20,000 and 60,000 doses in the first batch. The state intends to prioritize workers who have direct or indirect exposure to COVID-19 patients or infectious materials in hospitals, nursing homes, and other health care settings. Next in line would be essential workers and people with underlying medical conditions at risk for severe COVID-19 illness, including those over 65.
The states blueprint doesnt indicate priority vaccination for such hard-hit communities of color as Lawrence and Chelsea but pledges that the planning will be completed with a social equity lens to ensure those who are prioritized reflect the most vulnerable.
To get an idea of just how many health care workers are thought likely to be vulnerable because of exposure to COVID-19 on the job, consider Baystate Health in Springfield, the largest health care system in Western Massachusetts, with over 12,000 employees. Dr. Mark Keroack, Baystates president, estimates half of those workers are at risk.
We have looked at direct care givers, people who lay hands on patients the doctors and nurses, Keroack said. But it also involves people bringing in the food trays and cleaning the rooms. People who transport patients would be in that group as well.
In early October, the Baker administration assembled the 17-member vaccine advisory group, composed of public health and medical experts, community leaders, and elected officials for guidance on communication, distribution, and equity issues. The administration acknowledged, in its recent vaccine report to federal regulators, the uphill climb it anticipates in persuading some immigrant, Black, and Latinx communities the vaccines will be safe.
Walker said she joined the group because, as a person of color, she feels a responsibility to learn as much she can about the vaccines and share it with her community.
We cant just say I wont do it without at least knowing what the real information is," she said. "We are living in a time with so many rumors and outright lies, and I am going to try my hardest to get at the facts and my way to do that is to be at the table.
Kate Reilly, a spokeswoman for the states COVID-19 Command Center, declined to say whether the Baker administration will mandate that residents get a vaccine, as it did with flu shots this season for workers in nursing homes, assisted living centers, rest homes, and dialysis centers, where vaccination rates are historically low. The mandate seeks to head off a devastating twindemic of flu and COVID-19.
Dr. Asif Merchant, medical director at four nursing homes in the Metro West area and chief of geriatric medicine at Newton-Wellesley Hospital, said the flu shot mandate has significantly boosted vaccination rates. But its an open question whether that will translate to more buy-in for COVID-19 vaccines.
I see a mix of staff members who want the [COVID-19] vaccine as soon as possible and some who say what if its not safe and it could be dangerous," said Merchant, also a member of the governors advisory group.
Merchant said many nursing home workers have been devastated by the magnitude of death and disease theyve witnessed in the pandemic and that may help sway acceptance of a vaccine.
We need to amplify that to say this is for the greater good," he said. But there will need to be a lot of education.
A higher hurdle will likely be among the states homeless, who would not be prioritized in the first batch of vaccines under the states plan, although elderly homeless people who are at risk for severe complications from COVID-19 could be considered in the second phase. During the first peak of the pandemic, a third of homeless people in Boston were found to be infected.
Last flu season, about 3,500 homeless Boston residents, roughly half the citys estimated homeless population, agreed to get the flu shot, said Dr. Denise De Las Nueces, medical director of Bostons Health Care for the Homeless Program.
Gaining acceptance for the COVID-19 vaccine, she said, will be unchartered territory.
To better address gaping inequities surrounding the virus, the Baker administration recently launched a 62-question survey and asked community groups statewide to share it with residents. The survey inquires about race, ethnicity, education, income, and gender identity and asks where respondents seek the most reliable and up-to-date information about COVID-19 and whether they believe their community is receiving adequate support to prevent infections and bolster those who have lost work during the pandemic.
The states vaccine distribution plan indicates the Baker administration will rely on the dozens of community health centers across Massachusetts to help bridge the gap in trust with many neighborhoods.
Michael Curry, the incoming chief executive of the Massachusetts League of Community Health Centers, said YMCAs, churches, and local groups within its "community health ecosystem'' are banding together to hold listening and learning sessions about the vaccine.
Recognizing that each community is different and that doubts borne of discrimination run deep, they are asking at each stop whom residents trust as authority figures.
Is it your bishop? Your minister? Your local Dr. Anthony Fauci? Curry said. A lot of children educate parents in first-generation immigrant families. We should be educating those children on the vaccines.
Dr. Dean Xerras, medical director of Massachusetts General Hospitals Chelsea Healthcare Center, sees a ray of hope. Convincing residents, many of whom are immigrants uncomfortable with the health care system, to get flu shots each year is a struggle. But this year, he is seeing something different.
I have had people say, This is probably the only year I am going to get a flu shot, " Xerras said. I think people were so devastated by coronavirus, at least families I have talked to, that patients who have not gotten flu shots in the past are willing to get a coronavirus vaccine.
Kay Lazar can be reached at kay.lazar@globe.com Follow her on Twitter @GlobeKayLazar.
Medical workers wearing personal protective equipment register people in vehicles at a drive-through coronavirus testing site Monday in El Paso, Texas. Joel Angel Juarez/Bloomberg via Getty Images hide caption
Medical workers wearing personal protective equipment register people in vehicles at a drive-through coronavirus testing site Monday in El Paso, Texas.
Coronavirus cases are surging across the U.S., prompting many state and local leaders to impose new restrictions. But some experts say these efforts may be too little, too late like a Band-Aid on a bullet wound.
The virus is spreading unchecked through communities in nearly every state, and new cases topped 150,000 for the first time on Friday, according to Johns Hopkins University. The U.S. is expected to continue breaking records as temperatures drop, bringing people into closer quarters indoors.
"It's a very daunting problem, to control the numbers of cases that we're seeing right now with these kinds of minor efforts," said Andrew Pekosz, a professor of microbiology and immunology at Johns Hopkins University.
The new restrictions have sprung up rapidly in recent weeks. For example, Massachusetts imposed a statewide curfew. Indoor operations for restaurants are not allowed in many counties in California and Connecticut, and part of Montana prohibits indoor dining after 10 p.m., while New York is limiting indoor and outdoor gatherings to 10 people. Chicago is asking residents not to have guests in their homes and cancel Thanksgiving celebrations.
The Denver area is under curfew overnight with few exceptions. Local authorities are trying to avoid imposing a stay-at-home order, even though they have said cases are "substantially above" rates that would merit one.
"The restrictions might seem uncomfortable, but we believe that they are one of our last best hopes to slow the spread of COVID-19 in our community without the necessity of Adams County moving to the Stay at Home orders that we had in the spring," said Dr. John Douglas Jr., executive director of the Denver area's health department.
An electronic overhead sign in downtown Denver on Monday reminds residents to follow a curfew put into effect to curb the spread of the coronavirus. David Zalubowski/AP hide caption
Pekosz, who has studied emerging viruses for more than 20 years, said these are steps in the right direction. But he questioned whether these minor changes will be enough to control the virus.
He said there would be two basic strategies that would be effective and we're seeing neither at this point. Coronavirus restrictions, he said, "either have to be incredibly widespread everybody has to do it across the country to see this downtick or we have to go to more strict measures that target the events that we think are driving the spread of cases right now."
Thanksgiving, one of the busiest travel periods of the year, could exacerbate the spread of the virus. The Centers for Disease Control and Prevention is projecting 260,000 to 282,000 deaths in the U.S. by Dec. 5. Experts are also looking with concern to the rest of the upcoming holiday season.
The country is in unfamiliar territory, Pekosz said.
Beth Blauer, executive director and co-founder of the Centers for Civic Impact at Johns Hopkins, is hoping to aid leaders in combating the virus. She has been collecting data and crunching numbers to help cities, states and federal agencies make informed policy decisions.
It's not just the complacency of individuals driving the death toll higher and higher, Blauer said. Unfettered movement between cities and states and conflicting messages and guidelines from leaders fueled the rising case counts.
"If there isn't something that's more consistent, either at a regional or national level, you really are not going to realize the kind of gains that you need to see in order to actually stop what's happening right now," she said.
"We are in a full upward swing that requires like a pretty comprehensive approach," Blauer added, saying she doesn't expect that before President-elect Joe Biden is sworn in. "The sad part about it is we're not going to get that at least until January, which means that a lot of people are going to die."
However, neither Blauer nor Pekosz said they believe the U.S. has to revert back to a lockdown status to stop the spread. In fact, they both said society can still turn the tide with limited government intervention. The key is wearing a mask.
"Not only does a mask protect you as the individual, it also protects all the people around you," Blauer said. "It is one of the most essential public health interventions that we have."
With cases still on the rise and the holiday season rapidly approaching, Blauer and Pekosz advise people to get creative with their festivities and do their best to avoid gatherings. It has been a tough year, Blauer said, but this is not the time to lose sight of the big picture.
"There is a light at the end of the tunnel. We had tremendous news [Monday] around vaccine development," she said, with the company Pfizer reporting promising results from a clinical trial.
Even if the U.S. can avoid new lockdowns, Blauer added, leaders will likely "have to make some hard decisions in the short term so that we can all get to a place in the long term where we yearn to be."
MADISON (WKOW) -- There were 12 deaths due to COVID-19 in the past day and 155 people were newly-hospitalized, according to the latest numbers from the Wisconsin Department of Health Services.
There have been 6,058 positive COVID-19 tests since yesterday and 11,919 new negative tests.
As of Saturday afternoon, 2,034COVID-19 patientswere being treated in Wisconsin hospitals, a decline for the third day in a row. Of those, 435 are in the ICU, no change from the day before,according to the Wisconsin Hospital Association.
(CLICK HERE FOR THE FULL DHS DASHBOARD)
The Department of Health Servicesdashboardshows the seven-day average of both positive tests by day and test by person.(CHART)
(App users, see the daily reports and charts HERE.)
The 12 deaths have raised the total of those killed by the disease in Wisconsin to 2,637 people (0.8 percent of positive cases).
Of all positive cases reported since the pandemic began, 240,075 or 76.9 percent, are considered recovered.
DHS now has a county-level dashboard to assess the COVID-19 activity levelin counties and Healthcare Emergency Readiness Coalition regions that measure what DHS calls the burden in each county.View the dashboard HERE.
The Wisconsin Department of Health Services updates the statistics each dayon its website around 2 p.m.
(Our entire coronavirus coverage is available here.)
The new strain of the coronavirus causes the disease COVID-19. Symptoms include cough, fever and shortness of breath. A full list of symptoms is available onthe Centers for Disease Control website.
In severe cases, pneumonia can develop. Those most at risk include the elderly, people with heart or lung disease as well as anyone at greater risk of infection.
For most, the virus is mild, presenting similarly to a common cold or the flu.
Anyone who thinks they may have the disease should call ahead to a hospital or clinic before going in for a diagnosis. Doing so gives the staff time to take the proper precautions so the virus does not spread.
Those needing emergency medical services should continue to use 911.
(County by county results are available here).
Public health has a code of 12 ethical principles which have guided behavior during the COVID-19 pandemic, number 2 which says, Public health should achieve community health in a way that respects the rights of individuals in the community. Despite the rapidly changing and tumultuous circumstances of the COVID-19 pandemic, local and national leaders have striven to strike the right balance between protecting the community while respecting the rights of individuals.
What has been lost on many people during COVID-19 is that consideration of the rights of individuals is not synonymous with giving people the freedom to do whatever they want. This ethical principle of protecting the community is built upon the concept of interdependence, which teaches that all the individual members of a community are dependent on one another for the common good, and that no single individual is an autonomous agent with unlimited freedom.
Part of the problem lies with people confusing medical ethics with public health ethics. Medical ethics places the autonomy of the individual patient first, and focuses on their needs. But under a pandemic, elected officials are required to make difficult decisions to protect the publics safety, and ensure the common good, but to do so cannot also confer unlimited autonomy upon individuals. Of course individuals still have a say in the decisions, and are able to give input through public hearings. But at the end of the day, the public needs to accept that public health officials are trying to do whats best for the majority. While it may not appear so in the short run, these measures are also what is best for the individuals in the long run, for the suppression of the pandemic and the minimization of morbidity and mortality resulting from it are the only pathways to a return to normalcy and a recovered economy.
RELATED
In implementing mitigation measures, public officials are striving for measures that are proportional to the magnitude of the harm to be prevented. So the magnitude of the harm that might come from having to grind through 18 months of uncertainty, justifies the same magnitude of lockdown necessary in the short term. This is in order to shrink the height of the epidemic peak (flattening the curve) to reduce the burden of disease, and to shorten the length of time that the pandemic rages so as to reduce the duration to less than say 18 months. If this can be accomplished, then the stringent mitigation measures implemented early are justified.
From the U.S. experience, it might easily be argued that an insufficient balance has been struck during COVID-19. It appears that excessive concern for individual freedoms, with lax mitigation measures, and premature lifting of these measures, has contributed to the prolongation and intensification of the pandemic, including many lost lives.
For the public to accept decisions made for the common good is to share in the community struggle by making individual sacrifices. Wearing a mask in public and maintaining social distancing are some of the least obtrusive measures to be taken, and allow a society to avoid the most obtrusive measures, such as shutting down businesses.
That some people consider the requirement to wear a mask to be a substantial sacrifice, and a violation of their individual liberty, when wearing a mask is done largely in service of protecting those who are vulnerable to the worst COVID outcomes the elderly and those with underlying medical conditions is unimaginable. Sacrificing individual liberty for benefit of others, even though it isnt ones personal preference, is a reflection of true virtue whether from humanistic or Christian motivations.
In summary, public health officials are not trammeling individual rights when they implement public-focused mitigation measures. These have been imposed only to the level that has been absolutely necessary. In so doing public health officials are using principles of reciprocity to minimize the burdens imposed on individuals and maximize the public benefit to be achieved. In so doing, they are simply obeying their professional public health code of ethics.
Strand lives in Fargo.
This column does not necessarily reflect the opinion of The Forum's editorial board nor Forum ownership.
Surging hospitalizations are straining health care systems around the United States. Justin Sullivan/Getty Images hide caption
Surging hospitalizations are straining health care systems around the United States.
Updated Wednesday 1:20 p.m. ET
Seriously ill COVID-19 patients are starting to fill up hospital beds in record numbers, and health care workers are bracing for even more patients to come in the wake of skyrocketing coronavirus infections. But the burden on hospitals is not evenly spread. Some communities, particularly in the West and Midwest are particularly hard-hit.
As of Wednesday, nearly 62,000 COVID-19 patients were hospitalized around the country, surpassing the highs of the midsummer and spring surges. This is double the numbers hospitalized as of late September.
"We have legitimate reason to be very, very concerned about our health system at a national level," says Lauren Sauer, an assistant professor of emergency medicine at Johns Hopkins University who studies hospital surge capacity.
The spring and summer waves of COVID-19 hospitalizations were concentrated largely in a handful of cities in the Northeast and parts of the South.
With the virus now surging across the country, experts warn that the impact of this next wave of hospitalizations will be even more devastating and protracted.
"I fear that we're going to have multiple epicenters," says Dr. Mahshid Abir, an emergency physician at the University of Michigan and researcher at the Rand Corp. who has developed a model that helps hospitals manage surge capacity.
If that happens, Abir warns that there won't be flexibility to shuffle around resources to the places in need because everywhere will be overwhelmed.
The impact varies state by state with certain areas showing much more rapid increases in hospitalizations. As of Monday, hospitalizations are rising in 47 states, according to data collected by The COVID Tracking Project, and 22 states are seeing their highest numbers of COVID-19 hospitalizations since the pandemic began.
Where are hospitals at risk of maxing out?
With the numbers growing nearly everywhere, the key question for hospital leaders and policymakers is, when is a community on the brink of having more patients than it can handle?
In parts of the Midwest and the West, hospitals are already brushing up against their capacity to deliver care. Some are struggling to find room for patients, even in large urban hospitals that have more beds.
But the surge in hospitalizations is not evenly spread and hospitals' capacity for weathering case surges varies greatly.
One way to gauge the growing stress on a health care system is by tracking the share of hospital beds occupied by COVID-19 patients.
The federal department of Health and Human Services tracks and publishes this data at the state (but not the local) level. Several experts NPR spoke to say that, though imperfect, this is one of the best metrics communities have to work with.
Though there's not a fixed threshold that applies to all hospitals, generally speaking, once COVID-19 hospitalizations exceed 10% of all available beds, that signals an increasing risk that the health care system could soon be overwhelmed, explains Sauer.
"We start to pay attention above 5%," says Sauer. "Above that, 10% is where we think, 'Perhaps we have to start enacting surge strategies and crisis standards of care in some places.'"
Crisis standards of care is a broad term for how to prioritize medical treatment when resources are scarce. In the most extreme cases, that can lead to rationing of care based on a patient's chance of survival.
The latest data from HHS shows that in 18 states mostly in the Midwest COVID-19 hospitalizations have already climbed above 10%.
Seven states are over 15%, including North Dakota and South Dakota, which are now over 20%.
Hospital capacity is flexible ... until it's not
The percentage of hospital beds taken up by COVID-19 patients does not tell a complete story about hospital capacity, says Sauer, but it's a starting point.
Hospital capacity is not so much a static number, but an ever-shifting balance of resources. "It's space, staff and stuff, and you need all three, and if you don't have one, it doesn't matter if you have the other two," says Abir.
The level of COVID-19 hospitalizations that would be a crisis in one place might not be in another. Still, a growing share of beds occupied by COVID-19 patients can be a strong signal that the health care system is headed for trouble.
COVID-19 patients can be more labor intensive because health care workers have to follow intricate protocols around personal protective equipment and infection control. And some of the patients take up ICU space.
"When the numbers go up like that, particularly for critical care, that strains the system pretty significantly," says Abir. "This is a scarce resource. Critical care nurses are scarce. Ventilators are scarce. Respiratory therapists are scarce."
In Utah, where the share of hospitalized COVID-19 patients is about 8%, state health officials have already warned that hospitals may soon be forced to ration care because of limited ICU space.
There is no "magic number" to indicate when a health care system may be overwhelmed, says Eugene Litvak, who is CEO of the Institute for Healthcare Optimization and helps advise hospitals on how to manage their capacity. But hospitals must be alert to rapid increases in patient load.
"Even a 10% increase can be quite dangerous," says Litvak. "If you are a hospital that's half empty, you can tolerate it." But U.S. hospitals generally run close to capacity, Litvak says, with above 90% of beds already full especially toward the end of the week.
"Imagine that 10% of extremely sick patients on top of that," he says. "What are your options? You can not admit ambulances and patients with non-COVID medical needs, or you have to cancel your elective surgeries."
In the spring, some states ordered that most elective surgeries come to a halt so that hospitals had room for COVID-19 patients, but Litvak says this leads to all kinds of collateral damage because patients don't get the care they need and hospitals lose money and lay off staff.
State data may miss local hot spots
Statewide COVID-19 hospitalization metrics mask huge variations within a state. Certain health care systems or metro areas may be in crisis.
"It's very valuable information, but a state average can be misleading," says Ali Mokdad with the Institute for Health Metrics and Evaluation at the University of Washington, which projects that many states will face big problems with hospital capacity this winter. "It doesn't tell you where in the states it's happening."
Big urban centers may be much better equipped to absorb a rush of patients than smaller towns.
In New York City, Mount Sinai Health System was able to more than double its bed capacity during the spring surge. Other communities don't have the ability to ramp up capacity so quickly.
"Especially the states that don't have major cities with major hospitals, you see a lot of stress on them," Mokdad says.
But it's hard for researchers and health leaders to get a clear picture of what's happening regionally without good data, he adds. NPR has reported that the federal government does not share this local data, although it does collect it daily.
Some states publish their own hospital data sets. Texas, which shares the data in detail, provides a striking example. Statewide, COVID-19 hospitalizations have reached about 11%. Meanwhile, El Paso is above 40%, which has pushed the health care system to the brink.
Ultimately, it's difficult to know the true capacity for a region because many hospitals still don't coordinate well, says Dr. Christina Cutter, an emergency physician at the University of Michigan who collaborated on the Rand model with Abir.
"It's really hard to make sure you're leveraging all the resources and that one hospital is not overburdened compared to another hospital, and that may have unintended loss of life as a consequence," Cutter says.
Dire consequences of overfilled hospitals
During the height of Arizona's summer surge, COVID-19 patients filled nearly half of all beds in the state.
"When 50% of our hospital is doing COVID, it means the hospital is overloaded. It means that other services in that hospital are being delayed," says Mokdad. "The hospital becomes a nightmare."
Health care workers are pushed to their limits and are required to treat more patients at the same time. Hospitals can construct makeshift field hospitals to add to their capacity, but those can be logistically challenging and still require health care workers to staff the beds.
In Wisconsin, COVID-19 patients account for 17% of all hospitalizations, and many hospitals are warning that they are at or near capacity.
The Marshfield Clinic Health System, which runs nine hospitals in primarily rural parts of the state, is expecting its share of COVID-19 patients to double, if not more, by the end of the month.
"That will push us well beyond our staffing levels," says Dr. William Melms, chief medical officer at Marshfield. "We can always make more space, but creating the manpower to take care of our patients is the dilemma."
During earlier surges, many hospitals relied on bringing in hundreds or even thousands of out-of-state health care workers for backup, but Melms says that is not happening this time.
"We are on an island out here," he says.
An increase in COVID-19 hospitalizations statewide is also associated with higher mortality, according to a recent study that analyzed the relationship between COVID-19 hospitalizations and deaths.
"It's an indicator that you're going to have more deaths from COVID as you see the numbers inch up in the hospital," says Pinar Karaca-Mandic, professor and academic director of the Medical Industry Leadership Institute at the University of Minnesota.
Specifically, Karaca-Mandic's research found that a 1% increase of COVID-19 patients in a state's ICU beds will lead to about 2.8 additional deaths in the next seven days.
She says a statewide level of 20% COVID-19 hospitalizations may not look all that alarming, but that number doesn't capture the constraints on the health care system in adding more ICU beds.
"That's not very flexible," she says. "It requires a lot of planning. It requires a lot of investments. So the more you fill up the ICU, the impact is going to be larger."
Sean McMinn produced the data vizualizations and contributed reporting to this piece.
The governor has announced several statewide restrictions to help curb the spread of coronavirus. These restrictions go into effect on Monday and go until Dec. 14.
OLYMPIA, Wash. Gov. Jay Inslee has announced new statewide restrictions to help curb the spread of the coronavirus, which includes closing indoor service for restaurants and bars and prohibiting indoor social gatherings.
These rules will mostly go into effect on Monday at 11:59 p.m. and will remain in effect until Dec. 14.
The announcement comes following days of increasing COVID-19 cases.
The impacted industries/areas are:
During an 11 a.m. press conference, Inslee announced $50 million for aid to businesses who have been impacted.
Watch the press conference below or by clicking here.
For the second day in a row Saturday, the Washington State Department of Health (DOH) reported a record number of daily cases, with 2,233 new cases in a trend officials describe as alarming.
"This puts us in as dangerous a position as we were in March, when we first stayed home to stay healthy. And it means, unfortunately, the time has come to reinstate restrictions on activities statewide to preserve the publics well-being, and to save lives," Inslee said.
The latest update brings the states totals to 127,731 cases and 2,519 deaths, according to the DOH. Officials also reported that 9,281 people have been hospitalized in the state because of the virus.
"A pandemic is raging in our state. Left unchecked, it will assuredly result in grossly overburdened hospitals and morgues; and keep people from obtaining routine but necessary medical treatment for non-COVID conditions. Left unchecked, our economic devastation will be prolonged, and, most importantly, we will see untold deaths. We will not allow this to happen," Inslee said.
At this point, schools that have in-person learning will not be asked to close unless directed by local health authories.
Inslee also issued a travel advisory on Friday, urging anyone entering the state to self-quarantine for 14 days to slow the spread of COVID-19.
Oregon Gov. Kate Brown and California Gov. Gavin Newsom issued similar advisories Friday.
The advisories urge the public to avoid non-essential out-of-state travel and encourage residents to stay close to home.
The governor and his wife, Trudi, also made a televised address on Thursday pleading with people to reconsider holiday gatherings because of the jump in cases.
"We have to rethink these holidays so that we may be thankful when we don't lose more lives to COVID," Inslee said during the address.
"We are optimistic that Thanksgiving 2021 will be the best ever, but this year, it's just too dangerous to gather together indoors where the virus can spread so easily," he said.
Washington businesses have warned they may not survive another shutdown.
During a briefing on Friday, the Washington Hospitality Association released their latest estimates that show hospitality sales are down 45%.
When you talk about 35% of restaurants going out of business, each one of those is a story, said Anthony Anton, president and CEO of the Washington Hospitality Association.
A statewide stay-at-home order was issued in March because of coronavirus. When businesses shut their doors, the hospitality industry lost 191,000 jobs, according to the association. Anton said as Washington has slowly reopened, 100,000 of those jobs came back.
"If we have to shut down again, that means we're going to lose those 100,000 jobs, Anton said.
The industry is urging the public to take coronavirus seriously and follow health protocols so businesses don't have to move backwards.
France
The country announced a second lockdown from 30 October after daily Covid-related deaths reached their highest levels since April. Due to last at least a month, it is having a limited effect: new infections and hospital admissions dropped sharply at first only to increase sharply at the end of last week. , health ministry data showed
People are allowed to leave home only for essential work and medical reasons; restaurants and bars have been told to close but schools and factories can remain open. All non-essential travel has been banned and the countrys external borders are closed (although journeys are still permitted inside the EU). Travellers must be tested on arrival.
Austria
Yesterday, Vienna ordered a three-week lockdown starting on Tuesday to bring a surge in Covid-19 cases under control in time for Christmas. Austria now has one of Europes highest infection rates per capita. Daily new cases hit a record of 9,586 on Friday, nine times higher than at the peak of the first wave.
A current night-time curfew will become an all-day requirement to stay at home, with a few exceptions such as shopping or exercise. Working from home should happen wherever possible. Non-essential shops will close, as will service providers such as hairdressers. Secondary schools have already switched to distance learning; primary schools and kindergartens will continue to provide childcare.
Early this month, Germany began a circuit-breaker national lockdown to try to stop a sharp rise in cases, closing restaurants, bars, cinemas and gyms, and banning leisure travel. Schools remain open, and worship and protests are still allowed.
But daily infections have continued to increase, hitting a record 23,542 on Friday, and officials have dampened hopes that restrictions would be lifted at a meeting on Monday, when the effect of the lockdown will be discussed. Winter events such as office Christmas parties were unlikely to be allowed, the health minister said.
The country is having a second wave that is worse than its first, and in response has brought in one of the strictest lockdowns in Europe, with a nightly curfew and weekend shutdowns in nearly 200 municipalities, home to more than three-quarters of the population. People have been urged to work from home if they can, though schools, shops and restaurants are still open. In affected areas, people must stay at home from 11pm to 5am, or from 1pm at weekends.
The country has recorded a comparatively low 191,011 cases and 3,181 deaths, but last Saturday daily infections rose to over 6,600.
Since the start of the pandemic, Sweden has opted for a light-touch, anti-lockdown approach. There were hopes that this could mitigate a second wave by producing a higher level of immunity, but studies so far show that the national health agency has been over-optimistic about levels of antibodies in the population. In recent days, infections and hospital admissions have surged, and several regions have brought in tighter controls though people are asked, rather than legally obliged, to comply with most measures. On Friday, the country registered 5,990 new cases, the highest since the start of the pandemic.
But shops, bars, restaurants and gyms have stayed open throughout, and wearing a face mask is still not an official recommendation outside hospitals. The countrys death rate per capita is far higher than that of its Nordic neighbours, but lower than in countries such as Spain.
The headline to this article was amended on 15 November 2020. An earlier version referred to borders being closed; while France, for example, has closed its external borders, internal EU borders are open with a regime for restriction measures in place.
