The 513 intensive care beds in the Cincinnati region's hospitals are full, with COVID-19 patients now making up roughly 1 in 3 ICU patients. That's near the upper range of the level that health officials describe as "critical operations, 'all hands on deck', greatest good provided to the greatest number of patients."
The problem for the 40 hospitals isn't limited to pressure on the number of beds and other facilities, but the strain that having so many critically ill patients puts on hospital workers. More than 100 COVID-19 patients in the hospitals are on ventilators, each one needing a worker to monitor and operate that ventilator.
The information about hospital bed space comes from the Health Collaborative, a coalition of the six hospital systems in the Cincinnati area. The ICU crunch comes as pandemic cases in the region are at their highest levels since late January, according to data from the Johns Hopkins University COVID-19 tracking project. See a chart of rates of new COVID-19 cases in the last seven days by county at the end of this story.
All indicators on the novel coronavirus' grip on the region "continue to move in the wrong direction," the collaborative said in a statement Friday. The rate of new cases in the region rose 12.7% this week to 62 new cases per 100,000 people per day. The new cases are most prevalent among those under age 40.
"The hospitals are looking at their beds and their staffing every day," said Tiffany Mattingly, vice president, clinical strategies for the Health Collaborative. Staffing, she added, is "very fluid," changing based on quarantined staff, people who call off sick and other variables.
Patients are still getting safe and needed care, she said, but there is an extreme strain on staffing and some tasks that aren't immediately essential (such as getting a patient a warm blanket) may take more time to complete or are omitted.
The ICUs had been operating at normal levels as recently as late July, the data from the Health Collaborative (the trade group for the region's hospitals) shows.
Emergency rooms at the region's hospitals were swamped earlier this month by people without COVID-19 symptoms seeking tests. The ERs were being overrun by people seeking tests to clear themselves for entertainment or activities or reduce their quarantine times
COVID-19 hospitalizations are "putting dangerous strain on the state's health care structure," Dr. Bruce Vanderhoff, the Ohio Department of Health's director, warned in a Thursday news conference. Some hospitals have delayed elective surgeries; others are limit visitation, Vanderhoff said, adding "some have even reached their full capacity."
The situation should "raise some alarm because none of us wants our hospitals to get so busy that there isn't a bed for you in a hospital if you need one," he said.
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To show how the fourth wave of the COVID-19 pandemic across the region has hit hospital ICUs, consider these numbers from the Health Collaborative's Situation Dashboard:
On July 19, there were 20 COVID-19 patients in local ICUs. On Aug. 18, there were 87. On Sept. 15, the most recent date for which data is available, there were 151.
The region has 513 ICU beds, so the current operating status of 101% means there are 518 ICU patients. The region has the ability to operate its ICUs at 107% of capacity – or add another 31 patients.
The number of in-house COVID-19 patients on Sept.15 was 526, up 30% from Sept. 1. The patient count on Sept. 1 of 404 was up from 363 on Aug. 25 and up 303 on Aug. 18.
The region's hospitals continue to have a slight cushion of empty medical-surgical beds. Those nearly 2,500 beds were 94% occupied on Sept. 15. On Sept. 1, they were 97% occupied.
The local seven-day rate of positive COVID-19 cases now is 11.4%, down slightly from 11.7% last week but up from 9.5% two weeks ago.
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Where is COVID-19 especially strong now?
The Health Collaborative's dashboard identifies local ZIP codes with the highest per capita rates of cases over the last 14 days.
On Sept. 15, those were 45232 (Spring Grove Village and Winton Hills), 45225 (Camp Washington, Villages at Roll Hill, East Westwood, Millvale and part of North Fairmount), 45204 (Lower Price Hill, Sedamsville, Riverside and part of East Price Hill), 45205 (parts of East Price Hill and West Price Hill) and 45207 (Evanston).
Four of those ZIPs have had the highest level of cases in the county for the last month.
The vaccination rates in each of those five ZIPs are below 40%. In 45225 and 45232, the vaccination rates are below 30%, according to the Health Collaborative's dashboard.