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. 2022 Jul-Aug;137(4):796-802.
doi: 10.1177/00333549221091781. Epub 2022 Jun 1.

Emergency Department and Intensive Care Unit Overcrowding and Ventilator Shortages in US Hospitals During the COVID-19 Pandemic, 2020-2021

Paramjit Sandhu  1 , Ami B Shah  2 , Farida B Ahmad  1 , Justin Kerr  3 , Hanna B Demeke  1 , Ellie Graeden  3 , Suzanne Marks  1 , Hollie Clark  1 , Jennifer M Bombard  1 , Michele Bolduc  1   4 , Kendra Hatfield-Timajchy  1 , Erica Tindall  1 , Antonio Neri  1 , Kelsey Smith  3 , Chantelle Owens  1 , Tonya Martin  1 , Frank V Strona  1
Affiliations

Emergency Department and Intensive Care Unit Overcrowding and Ventilator Shortages in US Hospitals During the COVID-19 Pandemic, 2020-2021

Paramjit Sandhu et al. Public Health Rep. 2022 Jul-Aug.

Abstract

Objective: In 2020, the COVID-19 pandemic overburdened the US health care system because of extended and unprecedented patient surges and supply shortages in hospitals. We investigated the extent to which several US hospitals experienced emergency department (ED) and intensive care unit (ICU) overcrowding and ventilator shortages during the COVID-19 pandemic.

Methods: We analyzed Health Pulse data to assess the extent to which US hospitals reported alerts when experiencing ED overcrowding, ICU overcrowding, and ventilator shortages from March 7, 2020, through April 30, 2021.

Results: Of 625 participating hospitals in 29 states, 393 (63%) reported at least 1 hospital alert during the study period: 246 (63%) reported ED overcrowding, 239 (61%) reported ICU overcrowding, and 48 (12%) reported ventilator shortages. The number of alerts for overcrowding in EDs and ICUs increased as the number of COVID-19 cases surged.

Conclusions: Timely assessment and communication about critical factors such as ED and ICU overcrowding and ventilator shortages during public health emergencies can guide public health response efforts in supporting federal, state, and local public health agencies.

Keywords: COVID-19 pandemic; emergency department overcrowding; health care systems; hospital alerts; intensive care unit overcrowding; public health emergencies; real-time data; ventilator shortages.

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Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure.
Figure.
Trends in alerts for ED and ICU overcrowding and ventilator shortages at 625 hospitals in 29 states, Health Pulse, March 7, 2020–April 30, 2021. Note: Each data point (colored lines and bars) represents a 7-day average, plotted on the end date of the 7-day window. Data sources: Alert data are from Health Pulse based on data shared by state and health care system partners. Case data are from US COVID-19 Cases and Deaths by State at data.cdc.gov for the 29 states included in this study. Abbreviations: ED, emergency department; ICU, intensive care unit.
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