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As Pandemic Overwhelms Hospitals, 1/3 of Americans Live in Areas Where ICUs Close to Capacity

The declining rate of hospitalizations as ICUs fill up "suggests that there's some rationing and stricter triage criteria about who gets admitted," said Dr. Thomas Tsai. 

Medical staff member Susan Paradela measures blood sugar levels of a patient in the Covid-19 intensive care unit (ICU) at the United Memorial Medical Center on December 7, 2020 in Houston, Texas. Texas has exceeded more than 1.35 million cases of Covid-19, with more than 23,200 deaths. (Photo: Go Nakamura/Getty Images)

Public health officials say there is evidence that healthcare workers are beginning to ration care for Covid-19 patients—and at least one state governor is expected to announce that care-rationing must begin to save the lives of those most likely to survive the disease—as intensive care unit beds across the country approach capacity.

The New York Times reported Wednesday that more than a third of Americans are living in areas where hospitals are running critically short on ICU beds, while one in 10 people are served by medical centers where fewer than 5% of beds are currently available. 

According to the outlet's interactive map, in places including Lake Havasu City, Arizona and Ogden, Utah, zero ICU beds are available. 

The news comes as the Department of Health and Human Services, for the first time during the coronavirus pandemic that began in March, published detailed geographic data about Covid-10 hospitalizations. 

Public health experts have for months called on the federal government to release such information, to better help officials understand where the pandemic has hit the hardest.

Last week, the Santa Fe New Mexican reported that Democratic Gov. Michelle Lujan Grisham is expected to allow hospitals to begin rationing care based on which patients have the greatest chance of survival if they receive treatment. The Times reported that in Albuquerque, New Mexico, 116% of ICU beds are now occupied, with healthcare workers using 32 extra hospital beds to treat severely ill Covid-19 patients.

March for Our Lives activist Yas Mendoza tweeted Tuesday that her city of Fresno, California is facing similar statistics, noting that patients who need intensive care for non-coronavirus emergencies are increasingly unable to use ICU beds. 

In New Mexico, Dr. Jason Mitchell, chief medical officer of one of the state's largest hospital systems called on residents to help healthcare workers avoid having to make gut-wrenching decisions about who should receive care.

"This is an incredibly concerning time for our entire community, and especially for our clinicians and staff," Mitchell said Saturday. "We will care for our patients as safely and effectively as possible. We urge our fellow New Mexicans to prevent further spread of Covid-19 by limiting gatherings, practicing social distancing, masking up and staying home whenever possible."

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Dr. Thomas Tsai, an assistant professor of health policy at Harvard University, told the Times that there's been evidence of other hospitals rationing care in recent weeks, by making decisions about which Covid-19 patients can be hospitalized. The rate of overall hospitalizations has decreased over the past several weeks as ICUs have approached capacity.

"That suggests that there's some rationing and stricter triage criteria about who gets admitted as hospitals remain full," Tsai told the Times. 

Meanwhile, public health officials say a surge in infections—linked to Thanksgiving gatherings and travel—is likely to emerge in the coming days. Traffic on Thanksgiving Day was down only 5% from 2019, indicating that many families gathered in enclosed spaces and have since been out in their communities. 

On social media, Dr. Abraar Karan of Brigham and Women's Hospital in Boston implored the public to continue following public health protocols and avoid enclosed gathering spaces like restaurants—even though they are allowed to be open in many states.

"Is this recommendation I am making fair to restaurants and staff?" he wrote. "What's actually most unfair to them is that they are forced to remain open and send workers in high-risk settings because they aren't receiving enough [financial] protections in a runaway pandemic."

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