Report Of Drop In Hospitalizations Sounds Like Good News, But There's A Catch


Could it really be true that hospitalizations of patients with COVID-19-like symptoms actually dropped 20 percent last week in Washington, according to state numbers reported last night by the Seattle Times?

In San Francisco, hospitalizations are rising, but not as steeply as feared, leading to speculation that the perceived "stability" could allow the re-opening of other medical services that had been put on hold. UCSF Medical Center is re-starting some of the surgeries that had previously been put on hold in anticipation of the wave of COVID-19 patients.

But there's reason to think the relative calm in some hospitals is deceptive.

First, those Washington State figures are not complete. Not all hospitals reported, and even those that did likely didn't include many patients who were admitted with other kinds of symptoms, and subsequently tested positive for the coronavirus.

In the Seattle area, University of Washington hospitals are still seeing steep increases in the total number of admitted patients who are coronavirus-positive. According to an internal patient "census," they had 56 such patients on March 23. One week later, that number had reached 97.

Hospitals are also more reluctant to admit patients with respiratory symptoms, which may be holding down COVID-19 in-patient totals.

"Our threshold is going up," says a Seattle-area primary care physician, who's not being named here because the physician's employer doesn't allow such interviews. "With all the telehealth we're doing, we ask more, 'Can you manage at home?'"

This is part of the broader strategy to preserve hospital resources. But some doctors worry that it may go too far, especially when patients with symptoms that might otherwise get them admitted are now being asked to shelter at home.

For now, hospital administrators in Seattle are assuming the worst of the wave is still coming, possibly in two to three weeks, and they expect emergency resources and staff to be stretched to the limit.

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