Since mid-November, a coronavirus surge has sent an average of roughly 180 patients with COVID-19 to Kansas City area hospitals each day.
Though COVID-19 cases and hospitalizations have declined slightly from their peaks in November and December, data show that many hospitals are continuing to operate at or near their intensive care capacity.
The “high plateau” of cases that has persisted for weeks has left hospitals straining, according to infectious disease specialist Dr. Dana Hawkinson, who spoke about capacity at the University of Kansas Health System's daily briefing on Thursday.
“That’s good that it’s not going up, but it’s bad in the fact that we still have this many people here,” Hawkinson said. “And the problem is we have a lot of new admissions every day.”
Fewer than 15% of intensive care unit beds were available for use in the Kansas City area as of Wednesday, according to the Mid-America Regional Council.
In early December, the U.S. Department of Health and Human Services began issuing weekly reports showing the capacity of individual hospitals across the country, as reported by the hospitals themselves.
The most recent of these reports shows three hospitals — Overland Park Regional Medical Center, Saint Luke’s East Hospital and St. Joseph Medical Center — had no intensive care unit beds available to treat additional patients during the week ending December 31, as measured by seven-day averages.
Many other local hospitals had less than 5% of ICU bed capacity available. Those included North Kansas City Hospital, Saint Luke’s Kansas City, Saint Luke’s North and Lee’s Summit Medical Center.
Some of these hospitals may be using surge capacity created earlier in the year, according to Missouri Hospital Association spokesman Dave Dillon.
Hospital data reporting during the pandemic has been plagued with inconsistencies and changing guidelines. All local hospitals are now reporting their data, and the data being reported by HHS does appear to be accurate, according to Kansas Hospital Association spokeswoman Cindy Samuelson.
Samuelson cautioned that the federal data represents only a past point in time and does not necessarily reflect current capacity.
But the number of patients who go to hospitals seeking treatment is much larger than the number actually admitted for care. For example, just 61% of patients with COVID-19 who seek treatment in KU’s emergency room are admitted.
KU emergency medicine specialist Dr. David Lisbon said on Thursday that the decision to admit patients can depend on their need for supplemental oxygen, the ability to monitor the person at home and the patient's underlying health conditions.
“We do try to individualize it on a case-by-case basis,” Lisbon said.
Staffing shortages also remain common, with a quarter of Kansas City area hospitals reporting that they expect critical staffing shortages this week.
Though it is not unusual for hospitals to operate near capacity during certain busy times of year, such as flu season, health experts have warned that pandemic surges can threaten the hospitals' ability to provide critical care. Some states, such as California and Massachusetts, require additional measures to limit virus transmission when ICU availability falls below certain percentages.
The data show some larger hospitals are less strained. Both KU Hospital and Research Medical Center had more than 30% of ICU beds still available, as did several mid-sized hospitals, including AdventHealth Shawnee Mission and Olathe Medical Center.
Many hospitals are keeping ICU beds available to accommodate non-COVID-19 patients.
“Hospitals are actively managing the ICU resource in most multi-hospital cities in Missouri to maintain ICU space for COVID-19 and non-COVID-19 patients,” Dillon said.
Saint Luke’s Health System did not respond to requests for comment.
Despite the strained supply of beds indicated by the federal reports, hospital leaders say the data should not be used to guide decisions about seeking emergency care.
“Individuals needing emergency care should go to the closest appropriate hospital,” Dillon said. “Using the data to inform a choice of where to go in an emergency (COVID-19 or not) is not a good idea.”
