Ideally, no one would have to wait for access to a life-saving device, such as a ventilator. But during the coronavirus disease 2019 (COVID-19) crisis, many hospitals have run short of ventilators-as well as respiratory therapists (RTs) who are trained to operate them-while other facilities scramble to prepare for the coming demand surge. Any patient who needs a ventilator might not be able to get one, imperiling their survival. Mathematically, the delay that a patient may experience depends on the number of ventilators at the hospital, the number of patients who need them, and the average time that patients spend on them. COVID-19 increases the arrival rate of ventilator patients at hospitals, and these patients have longer lengths of stay, resulting in the sharp rise in demand for ventilators. Hospitals need to estimate how many ventilators they will need to respond to this crisis, accounting for increased, uncertain patient arrival rates and lengths of stay. At the same time, regional coordinators want to know which hospitals have the greatest need for the next spare ventilator or available capacity for the next ventilator patient.

Understanding the rate and clinical features associated with vaccine breakthrough infections (VBT) is of critical public health importance. Recent evidence on VBT in Barnstable County, Massachusetts, has prompted guidance on masking for vaccinated individuals in areas of high community-level transmission. Additional data is needed to better understand the prevalence and rate of VBT infections. Using detailed disease investigation data from Washoe County, Nevada we sought to assess the rate of symptomatic infection and serious illness among VBT cases compared to non-vaccinated individuals with COVID-19. From February 12 - July 29, 2021, the Washoe County Health District identified and traced 6,128 out of 6,399 reported cases across the sample period. 338 (5.5%) of all cases were identified as breakthrough infections, and 289 (86%) vaccinated individuals had symptomatic infections. Severe clinical outcomes were infrequent with 17 hospitalizations (5% of VBT) and no deaths. Cycle threshold values were not statistically different between vaccinated and unvaccinated individuals.