Would the United States Have Had Too Few Beds for Universal Emergency Care in the Event of a More Widespread Covid-19 Epidemic?

Abstract

(1) Background: To evaluate the level of hospital bed numbers in U.S. states relative to other countries using a new method for evaluating bed numbers, and to determine if this is sufficient for universal health care during a major Covid-19 epidemic in all states (2) Methods: Hospital bed numbers in each state were compared using a new international comparison methodology. Covid-19 deaths per 100 hospital beds were used as a proxy for bed capacity pressures. (3) Results: Hospital bed numbers show large variation between U.S. states and half of the states have equivalent beds to those in developing countries. Relatively low population density in over half of US states appeared to have limited the spread of Covid-19 thus averting a potential major hospital capacity crisis. (4) Conclusions: Many U.S. states had too few beds to cope with a major Covid-19 epidemic, but this was averted by low population density in many states, which seemed to limit the spread of the virus.

Keywords: Covid-19; capacity pressures; excess deaths; hospital bed numbers; international comparison; methods; population density.

Figure 1

A comparison of U.S. states for beds per 1000 deaths versus beds per 1000 population.

Figure 2

Details of total hospital bed availability in U.S. states in 2018 compared to international norms.

Figure 3

Covid-19 confirmed “excess” deaths (as at 9th June 2020) relative to 2018 as the base year versus county-level weighted state population density.

Figure 4

Covid-19 confirmed deaths per total hospital beds versus Covid-19 excess mortality relative to 2018 as the base year.