New data released by the Department of Health and Human Services on Monday gives the most detailed picture to date of how COVID-19 is stressing individual hospitals in the United States.
The information provides nationwide data on hospital capacity and bed use at a hospital-by-hospital level. This is the first time the federal agency has released the COVID-19 hospital data it collects at the facility level. Previously, HHS released data aggregated at the state level only.
"The new data paints the picture of how a specific hospital is experiencing the pandemic," says Pinar Karaca-Mandic, a professor at the University of Minnesota who worked with HHS to vet the data before it was published, through her work with the COVID-19 Hospitalization Tracking Project.
The dataset — which includes capacity reporting from hospitals in 2,200 counties in the U.S. — spotlights areas where hospitals are getting dangerously full. In 126 counties, the average hospital is at least 90% occupied, according to an analysis of the data by the COVID-19 Hospitalization Tracking Project. The states with the most counties above this threshold are Kentucky, Georgia, Minnesota, Oklahoma and Texas.
Hospitals both large and small are feeling the strain, the data show. In Texas, for example, both the Memorial Hermann Hospital System, with its 250 beds, and the Hereford Regional Medical Center, with its 31 beds, were above 90% capacity in the past week.
Previously, with only state-level data available, it was hard for health leaders and researchers to identify regional hot spots. The new data show where individual hospitals are being overwhelmed, even when a state overall isn't at crisis levels.
"I was surprised and blown away [that they're releasing this data]," says Karaca-Mandic, "Facility-level data, the ability to look at an area smaller than a state, is very important."
The dataset, uploaded to Healthdata.gov, provides a weekly snapshot of how COVID-19 is impacting individual hospitals across the country, including the number of COVID-19 patients admitted to the hospital and the number of severely ill patients requiring intensive care. The information dates back to July 31. Going forward, the data is expected to be updated each week.
As NPR reported in October, HHS has collected this facility data since mid-July and has shared it internally, but not publicly. Researchers have been calling on the federal government to release this data.
HHS says the severity of the pandemic in the U.S. caused it to publish the data now. "The COVID-19 hospitalizations have increased dramatically over the last two months, and the data needs to be available for all of those who can assist in the response, including at the local level," a spokesperson for HHS wrote in an email to NPR. "Additionally, the general public needs to be able to see the severity of the impact in their local area at their local facility."
Data transparency advocates celebrated the release. "This is really huge," says Ryan Panchadsaram, co-founder of the website COVID Exit Strategy, who was consulted by HHS about the dataset. "What you can see in this data is that our hospitals are under so much stress. And when we're thinking about how serious we should be taking this crisis, this open data release is helping provide the data that's needed to help people make the right decisions."
The data can help local and state leaders make decisions about when to implement restrictions or mandates in their communities to avoid overwhelming hospitals or where hospitals need support. And it can help the public understand why they should comply with such guidance. Using the state's own data, for example, California Gov. Gavin Newsom announced last week that the state would use regional ICU capacity figures to dictate stay-at-home orders.
While the data can inform people about the capacity of their local hospitals, it should not stop people from seeking care, says HHS. "Patients should not be discouraged from seeking hospital care based on their interpretation of the data," an HHS spokesperson wrote in an email to NPR. "Hospitals have protocols in place to keep patients safe from exposure and to ensure all patients are prioritized for care."
Alexis Madrigal, co-founder of the COVID Tracking Project and a staff writer at The Atlantic, also reviewed the data before it was released. He says that in addition to health care leaders being able to make better decisions, making the data available to the public can also help address concerns that political appointees may have changed the data to downplay the pandemic.
"The most important thing was ... did we see any hint that there was an attempt to minimize the impact of COVID in these hospitals?" he says. "These were the things that people were really worried about. Now that HHS is running this data, is there political influence on it? And I can say we haven't been able to detect anything like that."
Public health experts raised concerns about possible political influence when HHS took over the collection of COVID-19 hospital data from the Centers for Disease Control and Prevention in mid-July. At the time, HHS officials said the CDC's hospital data collection was incomplete and time-lagged — which HHS has tried to remedy by mandating daily hospital reporting, on the threat of losing Medicare and Medicaid funding.
More hospitals have reported more data into the HHS system in recent months. And the quality of the reported hospital data, which was severely compromised by the July reporting change, appears to be improving.
"The data release is not perfect," says a GitHub FAQ about the data, written by data journalists and researchers who reviewed the data. But "[it] has been reliable enough to be used in Federal response planning for some time and continues to improve each day."
What's still missing nationally, says Panchadsaram, is a clear link between the data collected and federal guidance. "There's this void of connecting the data being reported about the virus and the guidelines and thresholds that go with them. The administration continues to hesitate to share how the guidance that CDC issues connects with the data being reported," says Panchadsaram, who worked as a data official in the Obama administration.
NOEL KING, HOST:
The Department of Health and Human Services has released data about individual hospitals that shows in detail how badly COVID-19 is stressing them. NPR's Pien Huang has been going through all that data. Good morning, Pien.
PIEN HUANG, BYLINE: Good morning, Noel.
KING: I should start by saying that this was a big data drop. You went through it all - went through a lot of it. And what did you learn?
HUANG: Yeah. Absolutely. It's a huge data set. And what it really spotlights is the areas of the country where hospitals are getting dangerously full. It includes reporting on the number of COVID patients, the number of ICU beds they're taking up from individual hospitals. And it covers 2,200 counties across the U.S. In 126 of those counties, the average hospital is at least 90% occupied. Now, some hospitals try to operate at a pretty high capacity in normal times. But in a pandemic, with more and more patients needing hospital care, that's when things get a little scary.
And my NPR co-reporter, Sean McMinn, and I found that the states with the most counties above that 90% thresholds include Kentucky, Georgia, Minnesota, Oklahoma. And it's impacting both big hospitals and small ones. In Texas, for example, there's a hospital with 250 beds and one with 31 beds. And both of them were above that 90% capacity in the past week.
KING: This seems like important information for people. I certainly would like to know how full my neighborhood hospital is. Why are we only getting the data now?
HUANG: That's a good question. I mean, HHS has been collecting this data from every hospital since mid-July. And they've been sharing it internally, but not publicly. So the public so far has only been seeing state-level data. And researchers have been criticizing them for this, saying it's super important to know what's going on at a local level.
HHS says they've decided to release the nationwide data now because COVID-19 hospitalizations have increased so much in the past two months. And they say they now think that the people who are responding to the crisis need this information and that the general public does, too. So now, with this release, anyone with a computer and Internet access can go to healthdata.gov and see the situation at their local hospitals and other ones around the country.
KING: That is fascinating. That sounds like a win for people who are interested in transparency or just in knowing what's going on.
HUANG: Yeah. Absolutely. This is something that public health experts have been pushing for, to see more of that data publicly. And they say this is something to celebrate. Here's Ryan Panchadsaram. He co-founded the website COVID Exit Strategy.
RYAN PANCHADSARAM: Our hospitals are under so much stress. And so when we're thinking about how serious we should be taking this crisis, this open data release is helping provide the data that's needed to help people make the right decisions.
HUANG: These are decisions like whether local officials need to impose things like mask mandates or stay-at-home orders for their areas to avoid overwhelming hospitals. And for individual people, it might help them decide to cancel holiday gatherings or get them to stay home if they're not feeling well. And this hospital data is really important. And it's been the missing piece of public data for a lot of the pandemic. Researchers often talk about the trinity of case data, hospitalizations and deaths. And these are the three numbers that give a clear sense of what the situation looks like in a given area.
KING: OK. So how often will the data be updated?
HUANG: Well, they expect to post a new data set every Monday. So you can keep track of how your local hospital is doing every week. And I also wanted to say that HHS did stress that they do not want this to discourage people from going to the hospital if they need to. They say that if you're sick, you should still absolutely seek care.
KING: NPR's Pien Huang. Thank you so much for this.
HUANG: Thanks for having me. Transcript provided by NPR, Copyright NPR.