Hospitals and Covid Mortality Rates

Overall, 2020 is the deadliest year in US history according the the CDC. We’ve had 400,000 more deaths this year than in 2019, representing the largest year-to-year increase since the flu epidemic of 1918. More than 75% of this spike in death were due to Covid-19.

“[T]he characteristic that is most associated with poor or worsening hospital outcomes is high or increasing community case rates,” write David A. Asch, MD, MBA, executive director of the Center for Health Care Innovation at the University of Pennsylvania in Philadelphia, and colleagues.”

https://www.medscape.com/viewarticle/943153?src=mkm_covid_update_201223_MSCPEDIT&uac=153634BV&impID=2756342&faf=1#vp_1

This analysis is based on 38,517 adults who were admitted with COVID-19 to 955 US hospitals between January 1 and June 30 of this year. Anonymous data was provided by a national health insurer.

Overall, 9.1% of the patients either died in the hospital or were referred to hospice care for eventual death. However, that figure varies from 5.7% among the best performing hospitals to 24.7% among the worst. The factors associated with the death percentage include:

  • How swamped the hospital is with cases. Intubation adds risk, and the care required to avoid it is intensive and has to be meticulous. That’s hard to do when patients are being treated in hallways. That’s why “flattening the curve” is so critical.
  • The experience of the hospital staff with Covid-19. There is a learning curve. Early patients pay so that later patients have a better chance. That’s the usual way with any new disease.
  • The quality of hospital staff and how well the facility is provisioned with equipment. That’s more of a challenge for smaller, rural hospitals.
  • Admission criteria. Going back to the first point, when hospitals are overrun to the point that care has to be rationed, results are going to be worse. We’re approaching rationing is some western states in the US now.

As the Covid mutation from UK penetrates the US, we may see another surge in cases. Fauci says that mutation is probably in the US already, and there’s no reason to questions that view.

Frankly, if I had to get seriously ill with Covid, I’d rather be in New York, Boston or Philadelphia than probably any other place in the US. Those cities combine governors who are committed to public health with extensive healthcare facilities and first line staff with ample experience with the disease.

Of course, there remain in the Northeast some anti-mask idiots as well as some religious zealots who think they are immune, but the number in this region is small and growing smaller by the day. Darwin works. Those who ignore common sense have a way of becoming less common.

Given a choice of illness or wellness, I’d really rather wear a mask.

Sources:

  1. https://www.medscape.com/viewarticle/943153?src=mkm_covid_update_201223_MSCPEDIT&uac=153634BV&impID=2756342&faf=1#vp_1
  2. https://www.medscape.com/viewarticle/943084?src=mkm_covid_update_201223_MSCPEDIT&uac=153634BV&impID=2756342&faf=1

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