A significant article from Wirepoints:

Here are the details on Covid-19 hospitalization numbers Illinois should have collected and published weeks ago

By: Ted Dabrowski and John Klingner

For more than a month now, Illinois’ public has largely been in the dark about the state health care system’s capacity to handle the Coronavirus crisis. Gov. J.B. Pritzker has never publicly released the state’s hospital resource data or the full range of predictions that are driving his decisions on public health and the shutdown of the state’s economy. 

Without data, the public can’t be sure about just how bad the situation really is.

Several groups, including Wirepoints, recently began asking for hospitalization information to be made public. Hospitalization numbers are some of the most important data Illinois needs to make intelligent decisions regarding the crisis and the economy.

The state finally began collecting and releasing data on April 3rd. But aside from a press release on April 7th, the data has not been publicly released on the IDPH COVID-19 data page. The data is seemingly available only upon request, though some charts of the data are now beginning to show up on Facebook and Twitter.

With the government’s new hospitalization data, Wirepoints is now able to compare Illinois’ health care system capacity to one of the more prominent projections of Coronavirus cases: that of the University of Washington’s Institute for Health Metrics and Evaluation (IHME).

Here are Wirepoints’ three key takeaways when comparing the governor’s data to IHME’s projections [The IHME’s projection is as of April 7th]:

• If Pritzker gets the 4,000 ventilators he wants from the federal government, then Illinois will have 4,700 more machines than needed under IHME’s projected requirements. Even under IHME’s worst-case scenario, Illinois would still have 2,280 more ventilators than needed.
• Illinois has the hospital beds it needs to care for COVID-19 patients if IHME’s projections as of April 7th are realized. Illinois does not have, however, the beds it would need under IHME’s worst-case scenario. But hospitalized cases over the next six days would have to grow 45 percent a day, instead of their current 6.2 percent, to reach that worst-case projection.
• Illinois has the Intensive Care Unit (ICU) beds it needs to care for COVID-19 patients under IHME’s projected requirements. Illinois does not have the ICU beds it needs under IHME’s worst-case scenario, but ICU cases over the next 6 days would have to grow 27 percent a day, instead of their current 3.9 percent, to reach that worst-case projection.

Importantly, Pritzker has also based Illinois projected needs for PPE – personal protection equipment such as masks and gowns – on the full number of beds available, even if unused. Accordingly, if the number of beds is overstated the needed PPE is also overstated.

There are many other projections than the IHME’s, but it’s one that’s prominently mentioned. It’s still unknown which other models Gov. Pritzker and Mayor Lightfoot use to consider their decisions. The Chicago Tribune reported on April 3rd that: “Neither the city nor state has responded to Tribune requests for specific details on their predictions.” The governor also failed to name another model in his conference on April 8.

It should be noted that the IHME’s projections have been significantly reduced regarding projected hospitalizations and need for beds and ventilators. Its numbers have been revised downward for most states and for national totals. If IHME’s projections remain too pessimistic, the oversupply discussed below is understated.

Illinois ventilators

The governor’s most recent health care system capacity report on April 8 shows that the state currently has 2,899 ventilators on hand. 

According to the IHME projection, Illinois will need 1,610 ventilators for COVID-19 patients on April 18th, when the IHME projects Illinois’ needs will peak (its projection as of April 7). Add to that the 520 ventilators currently being used by non-COVID patients, and you get a grand total of 2,130 ventilators needed.

In summary, Illinois has 769 more machines on hand than its projected needs.

On top of that, Pritzker says he’s ordered 4,000 additional ventilators from the federal government. If he gets what he wants, he’ll have nearly 6,900 ventilators in all. Fulfilling Pritzker’s request would result in Illinois having some 4,700 more ventilators than the state’s projected need.

Even if you take the IHME’s most extreme scenario, where Illinois would need just over 4,100 ventilators on April 14th, Illinois would have an excess of 2,280 machines if Pritzker receives the number of ventilators he’s ordered.

There is also now the possibility of pairing up patients on ventilators – which could greatly reduce the number of ventilators needed. However, sharing is only a potential option, with U.S. Department of Health and Human Services guidelines warning the practice has “significant technical challenges that must be overcome.”

Illinois hospital beds

Illinois has approximately 14,100 total hospital beds available for COVID patients, according to April 8 data provided by the governor’s office – 2,772 beds currently filled by COVID patients and another 11,366 open beds.

That’s far more than the 9,255 Illinois will need on April 16th, when the IHME projects Illinois resource needs for beds will peak (projections as of April 7). In all, Illinois is expected to have 4,883 more hospital beds than the state’s projected needs.

The IHME’s worst-case scenario for Illinois beds tops out at 26,000 on April 14. That’s a shortfall of 11,900 beds. However, reaching that worst-case need would require the number of COVID-19 patients needing beds to grow by 45 percent each day for the next 6 days. 

For comparison, the actual average growth rate of COVID-19 patients in hospital beds from April 3rd to April 8th, according to the governor’s reported numbers, was 6.2 percent daily. (Unfortunately, there is limited data to work with given the lack of earlier data releases by the government.)

In addition, the above data does not include the new ongoing build-out of 3,000 beds in McCormick Place. Wirepoints has not yet been able to ascertain how many of those beds would be categorized as ICU or regular hospital beds.

Illinois ICU beds

Illinois has approximately 1,958 total hospital beds available for COVID patients, according to April 8 data provided by the governor’s office – 1,132 beds currently filled by COVID patients and another 826 open beds.

That’s about 60 more than the 1,894 beds Illinois will need on April 16th, when the IHME projects Illinois resource needs for ICU beds will peak (projections as of April 7).

Illinois does not have enough ICU beds to meet the IHME’s worst-case scenario. Under the IHME’s projections, the state’s need for ICU beds could reach more than 4,800 on April 14th – 2,857 more than the state has.

However, reaching the need for 4,815 ICU beds would require the number of COVID-19 patients needing ICU beds to grow by 27 percent daily for the next 6 days.

For comparison, the actual average growth rate of COVID-19 patients in ICU beds from April 3rd to April 8th, according to the governor’s reported numbers, was 3.9 percent daily. (Unfortunately, there is limited data to work with given the lack of earlier data releases by the government.)

A growing number of Illinoisans have been hospitalized

The governor’s office has also provided to Wirepoints the number of COVID-19 patients currently hospitalized, beginning on April 3. That number has grown to 3,904 as of April 8th, a growth of 5.5 percent a day.

Hospitalization numbers aren’t important just for measuring how much capacity we need. They will also be essential for the difficult decision about when to end the stay-at-home order that has shut down most of our economy. Without knowing whether more or fewer people are actually getting sick from the virus, we cannot set that date rationally.

What next

Ideally, the governor’s office would release its range of crisis projections and compare those to the state’s available public health resources. The public deserves to know what projections the governor is basing the state’s public health decisions on, as well as those decisions that have shut down a majority of the state’s economy and led to stay-at-home orders.

It would also help the public understand why the governor constantly blames the federal government for providing insufficient materials – ventilators in particular.

Most importantly, it would help the public understand whether conditions are getting better or worse.

*The IHME data in this report is based on their projections from April 7, 2020. On April 8, IHME released new projections that show lower numbers of hospitalized COVID-19 patients. If those projections hold, the resource needs for Illinois will be significantly reduced.