Study spotlights how COVID-19 admissions burdened ICUs

News brief

COVID-19 hospital admissions greatly affected occupancy rates of intensive care units (ICUs) across 45 US states, according to a new study in JAMA Health Forum.

The study looked at hospital occupancy rates for each week in 2020 at 3,960 hospitals, as recorded by the Healthcare Cost and Utilization Project State Inpatient Databases, and compared the number of occupied beds to the same week in 2019. Each week was categorized based on the number of COVID-19 admissions per 100 beds, with 15 admissions per 100 considered high COVID-19 activity, and less than 1 per 100 considered low.

Unsurprisingly, overall hospital occupancy levels decreased during weeks with low COVID-19 admissions and increased during weeks with high COVID-19, with ICUs most affected.

ICU occupancy rose nearly 70%

ICU occupancy rates increased 67.8% (95% confidence interval [CI], 60.5% to 75.3%) during weeks with more than 15 COVID admissions per 100 beds.

Of note, occupancy decreased for surgical patients when COVID-19 admissions increased, as many surgeries were put on hold during the early months of the pandemic, by as much as 43.1% (95% CI, 38.6% to 47.2%).

Though most periods of high COVID-19 admissions lasted less than a month—with 34.3% lasting 1 week, 49.8% lasting no more than 2 weeks, and 63.1% lasting no more than 3 weeks—they could have greatly affected patient care, the authors said.

Large increases in ICU occupancy may have strained ICU staff, possibly reducing quality of care for critically ill patients.

"Large increases in ICU occupancy may have strained ICU staff, possibly reducing quality of care for critically ill patients. This result is in line with increased in-hospital mortality during COVID-19 surges, documented by previous studies," they concluded.

CWD detected in new part of Utah

News brief
Mule deer buck
tuchodi / Flickr cc

The Utah Division of Wildlife Resources (DWR) last week confirmed the first case of chronic wasting disease (CWD) in Payson, located in Utah County in the central part of the state.

The confirmed case was 1 of 26 positive CWD cases, including 25 deer and one elk, identified from July 1 to November 28. Most of the cases were from the northeastern part of the state, but Payson is a new area for CWD, DWR officials said. Eighteen of the animals were harvested by hunters, five were found dead, and three were sick animals that were euthanized by the DWR.

Disease appears to be spreading

"We can't accurately compare each year's positive cases to determine how fast the disease is spreading because we sample different areas of the state each year that have different prevalence; alternatively, we compare each unit from year to year," DWR State Wildlife Veterinarian Ginger Stout, DVM, said in a DWR press release. "However, we are finding the disease in new areas, so unfortunately, it does appear to be spreading in Utah."

CWD was first detected in a mule deer in northeastern Utah in 2022. A total of 188 mule deer and four elk have tested positive for the disease, which is a fatal neurologic condition found in deer and other cervids. Caused by misfolded proteins called prions, CWD is similar to bovine spongiform encephalopathy ("mad cow" disease).

Although no human cases of CWD have been found in Utah or elsewhere, infected cervids can shed prions in urine, feces, and saliva, and transmission may occur through direct contact with an infected animal or indirectly through environmental contamination. Health officials urge people to avoid eating the meat of infected animals and to take precautions when field-dressing or butchering cervids.

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