During the past several weeks, hospitals and government leaders have been working to figure out how they can stretch their limited numbers of beds and ventilators to prepare for a surge in COVID-19 cases that could potentially overwhelm the healthcare system.
In Missouri, however, dozens of hospitals have not been reporting the numbers of COVID-19 patients they are treating or the availability of resources like beds. That's making it harder for health experts and leaders throughout the metro — even across the state line in Kansas.
“Our hospitals need to be our partners in this,” Mike Brown, vice-chair of the Johnson County Commission, said a commission meeting this week. “We’re on the front end, and as a commissioner, I’m trying to answer questions for people, and I don’t have all the data to be able to explain to them what they’re doing is effective and that it is efficient and that it makes sense to continue.”
On Thursday, data from the Missouri Hospital Association showed that state has had a total of 3,539 positive tests for COVID-19, with 568 patients admitted to hospitals. Roughly a third of the state’s 10,795 standard hospital beds and 2,129 ICU beds are currently in use.
However, 37 of the states’ 154 hospitals had not reported COVID-19 patient numbers or ventilator data, and 24 hospitals had not reported bed availability data. The report does not include data more than three days old.
Dr. Karen Joynt Maddox, a public health researcher at Washington University in St. Louis, says that as hospitals, cities and health departments explore how they might share resources and coordinate efforts, lack of this hospital data harms their progress.
“It’s a matter of public health at this point,” Maddox says. “It’s not just about any given hospital or any given person. It’s collectively, as a state, how can we make sure we’re getting resources where they need to be, and we can do that best if we have good information.”
Public health experts also say that, because testing has been strictly limited to a narrow group of patients, data from hospitals are some of the few metrics they can use to measure the spread of COVID-19.
Missouri’s Department of Health and Senior Services does not require hospitals to routinely report on numbers of ventilators or staffed beds or report on the numbers of COVID-19 patients they are treating, but last week, the Missouri Hospital Association began issuing daily reports based on data reported from hospitals on a voluntary basis.
In an email, MHA spokesperson Dave Dillon told KCUR that the large majority of hospitals had provided information.
“The numbers generally reflect, despite the occasional variation, very good situational awareness statewide,” Dillon wrote.
Dillon wrote that some lack of reporting was due to some hospitals not having COVID-19 patients or ventilators, but he said the MHA would not disclose which hospitals have or have not been reporting data.
Several hospitals and health care systems in the Kansas City area contacted by KCUR provided COVID-19 patient numbers and hospital capacity, including the University of Kansas Health System, Truman Medical Centers and AdventHealth Shawnee Mission.
HCA Midwest, the health system whose hospitals include Lee’s Summit Medical Center, Menorah Medical Center, Overland Park Regional Medical Center and Research Medical Center (among others) is not providing information to the public regarding COVID-19 patient numbers or hospital capacity “due to the rapidly evolving nature of the pandemic,” according to spokesperson Christine Hamele.
Several others hospitals, including St. Luke’s, Olathe Medical Center and North Kansas City Hospital did not respond to informational requests from KCUR.
Kansas City, Missouri, health department director Dr. Rex Archer says he’s been frustrated by slow reporting and incomplete data from area hospitals, including a recent COVID-19 death that was not reported by a hospital for three days.
“We have been seeing a challenge there,” Archer said this week. “I issued a health department directive reminding and requiring hospitals to report more immediately to us on a number of things.”
On Monday, the Missouri Department of Health and Seniors Services also issued new rules that require hospitals to report COVID-19 deaths within 24 hours and require COVID-19 test results to be reported directly to the state health department.
Hospitals, health departments and other organizations in Kansas City have plans to work collaboratively in the event of a COVID-19 surge using aggregated hospital data.
Steve Hoeger, Missouri co-chair for Mid-America Regional Council Health Care Coalition, downplayed the need for specific information from individual hospitals.
“We know how many total ICU beds are available in the region. We know how many ventilators are available. And if we have to, we can break the glass and actually get the drill down by individual hospitals, but the majority of the time, for our planning efforts, that’s not required,” Hoeger says.
However, Johnson County Commissioner Brown argued this week, because of the unique nature of the pandemic, which has required drastic measures by the general public, hospitals should provide more transparency.
Without more specific data about how hospitals are faring, he warned, residents in his district might grow complacent in their social distancing efforts.
“We have asked businesses and citizenry to make massive sacrifices and stay home,” Brown said. “But to keep them in the dark is going to cause a restlessness and a vacuum of information, and I’m feeling it. I can hear it now.”
