The media are grossly distorting the reality of the pandemic.
The COVID-19 pandemic in the U.S. is ebbing, but you would never know it from the headlines. Bad news, accurate or not, sells. And in the case of COVID-19, it also supports the journalists’ prejudices.
The seven-day moving average of new COVID-19 cases and hospitalizations peaked and started to decline in early September. Nationwide, COVID-19 hospitalization rates have decreased 17 percent over the past two weeks. Only 19 states had any increase, and many were small. The remaining 31 states and the District of Columbia saw hospitalization rates decline. But that hasn’t stopped journalists from publicizing localized exceptions to the good news.
A recent article, for example, starts with the statement, “Coronavirus patients are flooding and straining hospitals across the U.S.” and goes on to describe how some states are promulgating “crises standards of care” to guide health-care providers on how to allocate limited resources. The article cites as evidence high ICU utilization, ranging from 77 percent to 90 percent of capacity, in seven states: Alabama, Alaska, Georgia, Idaho, Kentucky, Montana, and Texas.
Yet the most recent government data shows other indicators of pandemic severity and health-care capacity look pretty good in those seven states. New COVID-19 hospital admissions per 100 beds were lower compared with the previous week in five of the states, with only small increases in Idaho and Montana. New COVID-19 cases per 100,000 population were lower in Georgia and Texas and essentially unchanged in Idaho. Test positivity rates (a rough indicator of how widespread disease is and how quickly it is spreading) were lower in all the states other than Montana. New COVID-19 deaths — a lagging indicator — were up in four states, down in another and unchanged in Georgia and Texas, which both showed declines in the three other indicators.
The ICU capacity figures cited in the article also lack context. What is the normal utilization level for the ICUs in those states? Most trauma-center and tertiary-care-center ICUs routinely functioned at 80–90 percent of capacity even before the pandemic. And ICU beds are not a static resource.
In a study of 13 academic medical centers across the country during the first wave of the pandemic (March–June 2020), only five reported an ICU census on at least one day that exceeded their overall pre-pandemic ICU capacity. Only two exceeded pre-pandemic capacity for more than 17 days. COVID-19 patients were a quarter of the median daily ICU census during this period. All of the 13 centers were able to increase their ICU capacity to accommodate COVID-19 patients by limiting elective, non-emergent procedures and by shifting providers and beds into medical ICU usage. Staff and beds from other types of ICUs and recovery rooms were repurposed for critically ill COVID-19 patients.
The situation was similar during the recent Delta variant wave. Currently, three-quarters of hospital inpatient beds are filled. COVID-19 patients account for only 11 percent of the available beds. Seventy-eight percent of ICU beds are filled. COVID-19 patients represent 26 percent of the capacity.
The suggestion in many articles is that people who refuse vaccination are forcing widespread life-and-death choices. Journalists appear to be channeling President Biden who, in remarks late last week, chastised “the unvaccinated [who] overcrowd our hospitals, overrunning emergency rooms and intensive care units, leaving no room for someone with a heart attack or a cancer operation needed to get the lifesaving care because the places where they would get that care are crowded; they are not available.”
Yet, while the unvaccinated may be foolish or misinformed, there is little evidence they have crowded out others. Some people delayed necessary care during the pandemic, but that was usually the result of fear, exacerbated by stay-at-home orders and other lockdown measures. Few if any people were unable to obtain emergency care if they sought it out.
Anyone who has worked in a hospital knows that ICU beds are a scarce resource and that ICU physicians often need to choose which sick patients get available beds and which do not. Perhaps the pandemic has made these choices more acute in limited locations for limited amounts of time. But triaging ICU patients is not a new phenomenon.
Distorting the news to censure the unvaccinated is unhelpful and unwarranted. The unvaccinated are primarily harming themselves. Unfortunately, many media outlets are misleading us all.