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Deaths tend to increase as hospitals fill. And hospitals are overflowing due to COVID


The number of people in the hospital with COVID-19 has reached alarming levels. It is now at 131,000 patients, close to the record peak seen last winter. Many hospitals are so full, they are struggling to cope. And as NPR's Will Stone explains, that is a bad situation for everyone who needs care.

WILL STONE, BYLINE: The awful, simple truth is an overcrowded hospital can be the difference between life and death. This is what pandemic research shows and what doctors are witnessing firsthand right now, like when Dr. Doug White says his ICU in Pittsburgh got a call from a small hospital in another state pleading for a bed. A patient had acute renal failure and needed dialysis to survive.

DOUG WHITE: We didn't have any beds. And they had called numerous other hospitals, and no hospital could accept the patient.

STONE: Later, White learned the patient never found a bed somewhere else.

WHITE: That patient died in the hospital that didn't have the sort of basic therapy that we provide all the time to patients, dialysis.

STONE: White is a professor of critical care at the University of Pittsburgh School of Medicine.

WHITE: The same thing is happening for patients with acute heart attacks or patients with acute stroke.

STONE: Maybe you've heard stories like this over the past two years. But White worries Americans are not hearing enough of them.

WHITE: There is a huge disconnect between reality and what is in the public awareness and what, in my view, many state governments are willing to acknowledge. The simple reality is that there is rationing happening every day right now in American medicine.

STONE: White says this rationing isn't always obvious. But it can take the form of a nurse caring for too many patients at once or a procedure getting delayed or canceled or people rushing and making medical errors. These are the deadly complications of a health care system crushed by COVID. Right now more than 1 in every 4 ICU beds has a COVID-19 patient in it. And unlike a year ago, there are far fewer health care workers to care for them. Some have quit, and others are out because they're infected. Dr. Sameer Kadri says it's intuitive that overcrowded hospitals are not good for patients. But...

SAMEER KADRI: What surprised me was the sheer magnitude of the impact.

STONE: Kadri is a critical care physician at the National Institutes of Health. He studied what happened to COVID patients who were in hundreds of hospitals during surges earlier in the pandemic.

KADRI: Almost 1 in 4 patients who died of COVID-19 - their death was potentially attributable to extreme overcrowding.

STONE: And in the most overwhelmed hospitals, the risk of a COVID patient dying doubled. Kadri says it's not hard to come up with an explanation. After all, he's seen it on the frontlines.

KADRI: There were just not enough eyes or hands to take care of these very sick COVID patients that require very high-precision care.

STONE: And this isn't just about COVID patients. Dr. Amber Sabbatini at the University of Washington analyzed previous surges to find out what happened to non-COVID patients.

AMBER SABBATINI: So those top conditions that already are sort of the highest-mortality conditions - your sepsis, heart failure, respiratory failure - almost 1 out of every 100 patients are admitted is now dying. You know, it's a substantial increase.

STONE: In other words, those are people who would not have died if they did not need care at the same time a COVID surge was hitting a hospital.

SABBATINI: If units are stressed by COVID patients, they may get to a heart failure patient or a septic patient in a less timely fashion.

STONE: This is the lesson of the last two years. A crowded hospital endangers health care for everyone, even the vaccinated. Again, Doug White at the University of Pittsburgh.

WHITE: So every time we surge up, there are consequences for other patients. In that sense, it's kind of a zero-sum game, unfortunately.

STONE: Things are different now - vaccines, treatments and the omicron variant itself. Early data show it causes less severe disease than delta. But with so many more people getting infected, the math is grim for America's hospitals.

Will Stone, NPR News. Transcript provided by NPR, Copyright NPR.

Will Stone
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