Pahnwat Taweesedt, MD
Pulmonary/Critical Care Fellow
James J Peters VA Medical Center, United States
Disclosure information not submitted.
Aiza Mominkhawaja, n/a
Student
Tompkins High School, Texas, United States
Disclosure information not submitted.
Salim Surani, MD, M.P.H., MSHM
Adjunct Clinical Professor
Executive Medical Clinic, United States
Disclosure information not submitted.
Iqbal Ratnani, MD, FCCP,FCCM
Dr.
DeBakey Heart and Vascular Center, United States
Disclosure information not submitted.
Title: Covid-19-related Death Rates and Number of Icu Beds: an Actual Association or a Myth?
INTRODUCTION: The healthcare systems around the world have been overwhelmed by the disproportionate impact of the coronavirus pandemic. One of the reasons for poor patient outcomes is presumed to be the scarcity of ICU beds. There is a total of 85,247 ICU beds in the United States. District of Columbia has the highest (6.0) and Hawaii has the lowest (1.6) beds per 10,000 population. We hypothesized that the states having a lower number of ICU beds had more COVID-related deaths when compared to the states that had a higher number of ICU beds.
METHODS: Data from all the 50 US states were reviewed from March 1st, 2020 - June 30th, 2021. COVID-19 death rates and the number of ICU beds per 10,000 population, both stratified by states were used to determine the pattern of correlation. COVID-19 death rates were sourced from ‘The NY Times database’ as it provided real-time information collected from the US Department of Health and Human Services, CDC, and Census Bureau. The number of ICU beds was sourced from the Kaiser Family Foundation. Limitations of the study included a lack of standardized reporting timeline across the states, differences in state-based vaccination rates, the emergence of more potent delta variant, and time-lag in contemporaneous database update.
Results: Pearson Correlation Coefficient was used for ICU beds and COVID deaths per 10,000 population each for all the US states. Using beds=x-rank & death=y-rank, our data resulted in an R of 0.29 which means no inverse correlation was found. Our value of R2, the coefficient of determination, was 0.0858. We re-confirmed our results with Spearman's Rho (rs) using the same x and y ranks, our rs=0.3 which re-confirmed our findings of Pearson Correlation Coefficient for each state, hence our hypothesized association between ICU beds & COVID-19 deaths were monotonic i.e., no inverse correlation between low ICU beds and high COVID-19 deaths/10,000, or vice versa.
Conclusion: Our results failed to confirm the conventional belief that high COVID-19 deaths result from a lack of ICU beds or vice versa. It implies that physical ICU beds do not have a role in determining the number of COVID-related deaths and other constraints such as less staffing, lack of medical supplies (ventilators and PPE) should be evaluated for potential implications on poor patients' outcomes.