Overwhelmed Hospitals? The Data Says Otherwise

Arizona's Nonexistent "Crushing Demand" In Hospitals

According to the Associated Press, Arizona is facing a “crushing demand” at its hospitals.

The numbers of coronavirus infections and hospital stays are trending up, as they did this time last year as families gathered for the holidays, culminating in a crushing demand at hospitals.

There's just one problem: the numbers do not add up.

Cases Are Increasing, But Slowly

The 7-day moving averages for new COVID-19 cases in Arizona for the past week are as follows:

• November 16: 3,564

• November 17: 3,516

• November 18: 3,596

• November 19: 3,686

• November 20: 3,686

• November 21: 3,686

• November 22: 3,991

While the trend in new cases is upward, the rate of increase is far more consistent with the slowing and plateauing that is observed close to the peak of an outbreak.

Moreover, the reproduction rate across Arizona is currently calculated at 0.87, and has been below 1 since around November 7 (when the reproduction rate is below 1, cases will soon start trending down), further indicating that the Arizona outbreak is at or near the peak.

No Beds Available? Not According To HHS

The hospital numbers as reported by the Department of Health and Human Services are likewise much less dramatic than is being reported. From last week to this week the total number of COVID-19 patients statewide rose from 2,423 to 2,496—hardly a dramatic rise. At the same time, the total number of staffed inpatient hospital beds declined from 16,909 to 15,709, while available beds rose from 4,091 to 4,358.

This is “crushing demand”? When available beds are increasing, even as the total number of staffed beds are declining? When there has been an abundance of inpatient beds available literally all year?

It is also worth noting that this week is the first week since the end of February the total number of non-COVID patients in Arizona hospitals was below 10,000. As is the case in Michigan and Minnesota, as well as Massachusetts, the primary patient burden in Arizona hospitals is and has been the non-COVID patients.

Further, Arizona ICU beds are only 68% utilized.

Even in the ICU, non-COVID patients are by far the dominant patient demographic.

The “Real” Problem: Shortage Of Nurses

To the extent there is genuine crisis at Arizona hospitals, it appears to be mainly staffing related.

Among the toughest challenges for hospitals has been staffing. Doctors, nurses and respiratory therapists are exhausted after nearly two years of treating COVID-19 patients. And the competition for new hires and temporary help is fierce as infections rise throughout the country and the world.

In other words, Arizona hospitals are facing the same labor supply problem that is afflicting other industries.

Labor shortages are a real problem, and in healthcare can indeed impact the quality of care. What labor shortages are not, however, is the result of “too many” COVID patients. Reducing the COVID patient demographic will not increase the supply of nurses.

Furthermore, when the total statewide supply of staffed inpatient beds is only 72% utilized, the extent to which there is even a labor shortage is open to debate. The very nature of the “staffed” bed indicates an availability of staff--of doctors, nurses, and other personnel to deliver patient care. If Arizona is facing a shortage of healthcare workers, the reported number of staffed hospital beds should be much less, and the percentage of utilization should be much higher, close to 100%. Per the HHS data, Arizona has not been close to saturating its hospital beds all year long.

“Crushing Demand”

“Crushing demand” implies scarcity. For demand of any good or service to “crush” the available capacity, that demand has to exceed available capacity.

In Arizona hospitals, that simply is not happening.