The Flu, the Coronavirus, and Hospital Beds
Did you hear about the 2017-2018 U.S. flu season? How about the 2017-18 flu season overwhelming the hospitals and creating bed and ICU bed shortages?
Neither did I, but it was the worst flu season in recent years.
During the 2017-2018 flu season the CDC’s preliminary estimate is that 810,000 patients were hospitalized. It is still a preliminary estimate, so that the upper range of uncertainty is 1.4 million hospitalizations due to the flu during the 2017-2018 season. That flu season also had the highest peak hospitalizations in recent years.
That hospitalization peak was the highest in recent years ran from the last week of December through the third or fourth week of January. Based on numbers from graphs at Advisory.com, one can estimate that in the last week of December 2017, 29,430 people were hospitalized due to the flu. The first week of January the estimated number of people hospitalized peaked at 33,354. The next week, the second week of January, the number tapered off a bit to 32,046 hospitalizations. The final week of the four-week peak saw 29,193 hospitalizations due to the flu. In total during the four-week peak of the 2017-2018 flu season, 123,093 people were hospitalized for flu. If you want to add the fourth week of January, when it was estimated that 27,795 patients were hospitalized with the flu, the U.S. hospital system handled 151,728 patients during a five-week period.
Shutting down the economy was sold to the public as “flattening the curve” to avoid overwhelming hospitals and intensive care units, not avoiding an unavoidable disease that some of us will get. Flattening the curve does not mean not getting the disease, but rather not all of us getting the disease at once.
We have seen that just two years ago the U.S. hospital system was able to handle around 30,000 patients a week for four or five weeks. Of course, perhaps the issue this year in the people who are dying. The age profile of mortality from the flu in 2017-2018 appears quite to be similar to the age profile of the coronavirus. The preliminary CDC estimate is that 61,000 people died with an upper range of uncertainty of 95,000. That flu was particularly hard on the elderly. About 83% of the deaths were among people 65+. About 11% of the deaths were people 49 to 64. About less than 5% of the deaths were people 18 to 49. The other 1% of the deaths were people age 0 to 17 with the group age 0 to 4 making up 0.2% or 0.002 of the deaths. This to me sounds very much like the same reported age profile with the Wuhan coronavirus this year.
The data for the most recent week indicates that there are now about 7,920 flu patients in the hospital in the U.S. Based on the past flu hospitalization peak of 33,354, hospitals should have had capacity for at least 25,434 additional hospitalized coronavirus patients.
I have not found much reported data on hospitalizations in the U.S. from the coronavirus. Over the last nine flu seasons the hospitalization rate ranged from about .025 to about .03 per person who sought medical treatment. The reported number of cases of coronavirus is likely a good measure of people who have sought treatment, since you are not generally tested for coronavirus unless you have symptoms enough to call your doctor and get referred for testing. As I write, the U.S. has about 315,500 active cases of corona virus. (The recovered are unlikely to be hospitalized, but they could be for another condition.) If three times as many of them require hospitalization compared to the flu in the last nine seasons, that would require 31,550 hospital beds. According to the American Hospital Association, the U.S. has over 924,000 staffed hospital beds.
The reason for flattening the curve was not to overwhelm the number of hospital beds or ICU beds or ventilators. There is less information about the number of coronavirus or flu patients in different years who have had to be moved to ICU beds or put on ventilators. There are also the issues of how many days a patient with coronavirus stays in the hospital or ICU compared to the flu and local overwhelming of the hospital system in hotspots like NYC. So perhaps hospital beds or ICU beds are in shortage locally, though anectoal reports from NYC indicate that is not the case yet even there. The bottom line is that we didn’t hear about the U.S. hospital system being overwhelmed during the peak of the 2017-2018 flu season. It has handled surprisingly big influxes of patients then and seems to be doing so again this time.
James L. Swofford is a Professor of Economics in the Department of Economics, Finance and Real Estate of the Mitchell College of Business at the University of South Alabama.