Today, there were several stories addressing Secretary Azar’s comments that many states with higher levels of COVID infection are now seeing fewer new cases. He was quoted remarking that in states reducing social restrictions increases in COVID cases aren’t being seen.
The reasons behind this may be complex but important to verify. Since reduced social restrictions are a new phenomenon, I decided not to look at changes in deaths, but to examine changes in hospitalizations which would occur first. One mechanism to examine this is to look at percentage of hospital admissions from COVID, one of the first markers to change. These were available in a report from Axios.
COVID hospitalizations as a percentage of all hospitalizations are falling dramatically in many states, but not all. The fall in COVID vs all hospital admissions is particularly impressive in states that had high COVID hospitalizations to begin with. When one examines states like New Jersey, New York, Massachusetts, Michigan, and Connecticut, the reductions are 50-75% of peak levels seen only a few weeks ago; truly impressive.
The reasons behind this are multiple, however part of this is because the states were restricted from admitting non COVID-19 patients, because of the COVID crisis. Hospitals are now beginning to admit patients with other diseases as the number of patients with COVID-19 in these states’ hospitals have decreased dramatically. Many hospitals had so few patients that their utilization was low — 60 to 70% bed occupancy as compared to greater than 90% normally observed.
In contrast, all increases in COVID hospitalization rates seen in the past two weeks were mainly in smaller states with extremely low levels of COVID infection. These also tend to be states, such as South and North Dakota, where populations are more rural and have fewer urban areas to spread the virus.
The most interesting thing, however, is the states where COVID hospitalizations have been stable. Some of these states retain significant levels of hospitalizations, such as Delaware, Illinois, Virginia, and California despite social distancing remaining in effect. Other states like Arizona, North Carolina, Wisconsin, and Texas, maintained low but steady levels of COVID hospitalizations despite reductions in social distancing rules.
These numbers are impressive because they are overall very positive and more reliable than other COVID reporting measures (prior posts from this blog identified problems with reporting COVID in Virginia and other states). It may also be that in states like Arizona, Texas, and Wisconsin that are easing their social restrictions, individuals at high risk of illness from COVID have continued to social distance.
All this seems like very good news in the push to end social restrictions. With the Memorial Day weekend approaching, however, we will need to monitor these rates to make sure that the positive trends remain in effect.