Florida Healthcare System Stressed

Carter Mecher MD -- Medical Advisor
August 12, 2021

Nearly 49% of the ICU beds in Florida are occupied by COVID patients. That is astounding, since that is nearly half the ICU beds. Even if the Florida outbreak peaks within the next week, there is an inertia associated with the hospitalized and ICU curves since COVID patients have significant hospital lengths of stay--especially the ICU patients.

Those curves will continue to ascend even if the case curve peaks. That means if Florida's numbers continue to grow at 30% per week for just another week, the healthcare system in Florida will be in real trouble over the coming weeks. During non-pandemic periods, those ICU beds are filled with seriously ill trauma patients (gunshot wounds, motor vehicle accidents, etc.), patients with heart attacks or other cardiac emergencies, strokes, other serious infections (sepsis and septic shock), drug overdose, near drownings, respiratory failure from causes other than COVID, etc.  Those baseline non-COVID health emergencies don't disappear during a pandemic.

Florida is now managing that baseline non-COVID health burden with half the ICU capacity it normally has. As challenging as that is now, it will become progressively more difficult over the next couple of weeks. The result is lengthening queues--full ICUs backing up patients in ERs, so longer ER dwell times for critically ill patients who are now waiting for an ICU bed to become available, hospitals going on diversion because of overcrowded ERs and overcrowded hospitals/ICUs, longer and longer dwell times of patients in EMS/ambulances as they travel greater and greater distances trying to find a hospital not on diversion, and that will translate to a decrease in the effective capacity of pre-hospital care for emergencies (sluggish response from EMS/911). That will translate to non-COVID spillover deaths, including out-of-hospital deaths.  Those numbers won't show up in the daily COVID deaths. They will show up when we look at excess deaths. That is what FL is facing.

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