Arizona hospital ventilators, beds adequate for coronavirus surge, new data shows

Arizona hospitals appear to have enough beds and ventilators to handle an anticipated surge in COVID-19 patients, new data and analysis shows.

Since Arizona began to see its first infections from the virus that causes COVID-19 in March, the public’s concern has been mostly about whether the state has enough hospital beds and ventilators for patients that might need them.

It’s information that’s been hard to come by until this week, when both the Arizona Department of Health Services and a medical researcher with the University of Arizona’s College of Public Health delivered this promising message: We should be OK.

This is a shift from late March, when Arizona Gov. Doug Ducey ordered the state’s hospitals to come up with plans to increase bed capacity by 50% within the next month, and to have half of those new beds ready by April 10.

Ducey’s executive order came a day after state health director Dr. Cara Christ said the number of hospital beds at the time was unlikely to meet the anticipated need of this first surge, expected to come toward the end of April.

The state at that time also did not know how many ventilators were in circulation because reporting by hospitals was not mandatory. At one point earlier in March, Christ said there were only 172 ventilators known to the state, with 100% of those in use at the time.

Christ announced on Wednesday, April 15, that of the 1,500 ventilators they now know are in Arizona’s hospitals, 75% are available, with COVID-19 patients accounting for 50% of the ones that are currently in use.

This is considerably more reassuring, she said. However, depending on the surge and how many people become seriously ill, more ventilators may still be needed.

Christ said that’s something the state is monitoring regularly.

A new statewide hospital reporting dashboard shows the number of beds available and in use by day, the number of ventilators available and in use by day, and other hospitalization data specific to COVID-19.

With more data available and a better grasp on how the virus is spreading here based on emergency-room visits and hospital admissions, predictions about hospital capacity are also more positive.

Dr. Joe K. Gerald, an associate professor with the UA’s Zuckerman College of Public Health, has been analyzing related data from the Institute for Health Metrics and Evaluation (IMHE) and, in recent days, found Arizona’s bed capacity adequate.

There are a couple of reasons for that, he explains.

“We got off the exponential growth train fairly early,” he said, adding that Arizona’s head start was partly luck, with the outbreak starting later here, and partly due to beginning social distancing in time.

The result, he said, is that Arizona’s surge will likely be more like walking up a hill than ascending a sharp mountain peak.

“I think we’re getting close to the worst of it,” he said, adding that it’s “still important to practice social distancing.”

The IHME estimates Gerald used show that approximately 1,460 beds will be needed during the surge here while there are 6,017 hospital beds available in the state. In addition, there are 508 ICU beds of which 293 are estimated to be needed during Arizona’s peak.

“These projections align reasonably well with our hospitals’ self-reporting of their own utilization and capacity,” Gerald said, referring to data on the state’s health department site.

Based on the data he’s been studying, Gerald predicts hospitalizations will peak here April 26 or 27, although the state’s health agency is predicting it may be closer to the very end of the month.

Will Humble, director of the Arizona Public Health Association, wrote about Gerald’s findings in a blog post Tuesday.

“These models assume that we continue to maintain our social distancing efforts over the coming weeks,” he wrote.

It’s a point Humble emphasized because, according to Gerald’s analysis, the lag between new infections and hospitalizations and ICU admissions means that the pace of these outcomes will increase for the next one to three weeks before slowing.

“Over the next two weeks, hospitals should prepare for a continued increase in admissions until a peak around April 27th,” Humble wrote, “The strain is likely to be greater in critical care settings than general floor beds, but there appears to be adequate capacity to meet demand.”

Christ said the data on inpatient beds and ICU beds shows that over 25% of both ICU beds and inpatient beds statewide are currently available. With the governor’s order for surge capacity factored in, that increases to 40% availability for inpatient beds and up to 50% for ICU beds.

Currently, COVID-19 patients occupy only 15% to 18% of the ICU beds in use statewide and less than 10% of the inpatient beds, she said.

There has also been a “downward trend” in patients with coronavirus-like illness — fever, dry cough, shortness of breath — coming into both emergency rooms and inpatient settings, Christ said.

“This is encouraging data, but it does not indicate that we have stopped the outbreak,” she said. “Everyone needs to remain vigilant about being physically distant.”