One night, while I was in the hospital in August, an X-Ray technician came into my room about 1 a.m. and mentioned he’s been so busy in the Emergency Room because of all the COVID-19 patients.
“I don’t understand why these people are not getting their (vaccination) shots,” he said. “91 percent of those coming in have not been vaccinated.”
It was alarming, until a nurse I befriended there told me that was not true.
“They’ve been giving updates to the staff each day, but what they are saying doesn’t coincide with what many of us know,” the RN said. “It’s actually the other way around. There are more vaccinated people coming in with COVID–almost 60 percent. Vaccinated or not, almost half of the people here with COVID are either mildly symptomatic or asymptomatic. They are misleading. Many of us know that but see the administration not telling the full story. It’s not right.”
A nationwide study of U.S. hospitals by Harvard Medical School, Tufts Medical Center, and the Veterans Affairs Healthcare System released this week, confirmed that hospitalization rates for COVID, as cited by journalists and policy makers, continue to be misleading, if not looked at carefully.
Of course there are many patients right now who are seriously ill. But we also realize that overcrowding of hospitals by COVID patients with even mild illness can have negative implications for patients in need of other care.
This study suggests that COVID hospitalization tallies can’t be taken as a simple measure of the prevalence of severe or even moderate disease, because they might inflate the true numbers by a factor of two.
Later, I called a friend who works at another hospital in administration.
“We need to reconsider what and how we are reporting these cases and hospitalizations that tend to drive policy and assess levels of risk in our country,” he said, mentioning important decisions about mask mandates, school closures, and business restrictions.
“They should redefine what hospitalization means,” he continued. “Patients who are at the hospital with COVID rather than from it don’t belong in the metric. Plus, we also know there is financial incentive for health systems when COVID is written in the patient’s assessments.”
If you want to make sense of the number of COVID hospitalizations at any given time, you need to know how sick each patient actually is. Until now, that’s been almost impossible to determine.
🔹The federal government requires hospitals to report every patient who tests positive for COVID, yet the overall tallies of COVID hospitalizations, made available on various state and federal dashboards and widely reported on by the media, do not differentiate based on severity of illness.
🔹Some patients need extensive medical intervention, such as getting intubated. Others require supplemental oxygen or administration of the steroid dexamethasone.
🔹However, there are many COVID patients in hospital with fairly mild symptoms, too, who have been admitted for further observation because of their comorbidities, or because they reported feeling short of breath.
🔹A good portion of patients are in the hospital for something unrelated to COVID, and discovered that they were infected only because they were tested upon admission.
🔹According to the researchers, 40 to 45 percent of the hospitalizations that they examined were for patients, who when tested, were shown to be positive. The problem with this is, we now know the tests are not accurate.
The researchers analyzed the electronic records for nearly 50,000 COVID hospital admissions at the more than 100 VA hospitals across the country.
🔹They checked to see whether each patient required supplemental oxygen or had a blood oxygen level below 94 percent. (The latter criterion is based on the National Institutes of Health definition of “severe COVID.”)
🔹If either of these conditions was met, the authors classified that patient as having moderate to severe disease; otherwise, the case was considered mild or asymptomatic.