BERKELEY (CBS SF) — University of California-Berkeley researchers have crunch the numbers surrounding the COVID-19 outbreak across the country and found that patients in the U.S. were enduring longer hospital stays and facing higher rates of intensive care unit admission than patients in China.
The new study released on Monday was led by researchers at the UC-Berkeley and Kaiser Permanente.
The researchers said the results suggest that some hospitals in the U.S. may have been harder hit by the coronavirus pandemic than initially thought, as many forecasts of disease burden — particularly the number of hospital beds and ICU units needed at the peak of infection — were based on data out of China.
“The hospital resources needed to meet the needs of severely ill patients are substantial,” said Joseph Lewnard, an assistant professor of epidemiology at UC Berkeley and lead author of the paper. “We found that observations from China may not provide a sufficient basis for anticipating the U.S. health care demand.”
The team analyzed the anonymized medical records of the nearly 9.6 million Kaiser Permanente members in Southern California, Northern California and Washington state. The study focused on 1,277 Kaiser Permanente members who were hospitalized with clinically- or laboratory-confirmed cases of COVID-19 between the start of the year and early April.
“Because Kaiser Permanente members receive comprehensive health care from a single provider network, we overcome many of the difficulties that arise in studies of diseases within the fragmented U.S. health care delivery system,” said Lewnard.
Despite the grim forecast for hospitals, the report does offer a glimmer of hope — estimates of transmission intensity, based on extrapolations of infection rates from hospitalization data, indicate that the social distancing measures in the region are succeeding at “flattening the curve” of contagion.
“When people engaged in protecting themselves and their communities through social distancing, their efforts translated into a substantial reduction in the transmissibility of the disease,” said Vincent Liu, a research scientist at the Kaiser Permanente Division of Research in Northern California. “Those efforts are going to be critical for this next phase, in which social distancing measures are gradually relaxed. We need our communities to stay really engaged, because these data show that even the actions of individuals and small groups can really impact the spread of the virus.”
Of the 1,277 Kaiser Permanente members who were hospitalized with COVID-19, 42% required care in the ICU, and 18% died from the disease. Modeling estimates based on observations in China usually assume that only about 30% of hospitalized patients would require ICU care.
Similarly, the data showed that hospital stays lasted an average of 10.7 days for survivors and 13.7 days for non-survivors, compared to an average of 7.5 days among non-survivors in China.
But 25% of patients need even longer hospital stays — treatments that lasted for 16 days or longer.
While the underlying reasons for these discrepancies remain unclear, the authors stress the need to collect data in different regions and under different health care settings and caution against heavy reliance on models based on data from other countries.
“The spread of COVID-19 and its impact on local health care systems show differences across the world,” Liu said. “Health care systems differ, and their capabilities and structure have an effect on the local response and the impact of the surge.”
Not surprisingly, the analysis also revealed that the virus tends to hit older people the hardest. Approximately 50% of hospitalizations were among adults aged 60 and older, and 25% were among adults aged 73 and older. Similarly, hospitalized men seemed to be hit harder than women: Hospitalized males over the age of 80 faced a 58% risk of death, and hospitalized females of the same age faced only a 32% risk of death.