Impact of coronavirus disease 2019 (COVID-19) on US Hospitals and Patients, April–July 2020

Abstract

Objective The rapid spread of SARS-CoV-2 throughout key regions of the United States (U.S.) in early 2020 placed a premium on timely, national surveillance of hospital patient censuses. To meet that need, the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN), the nation’s largest hospital surveillance system, launched a module for collecting hospital COVID-19 data. This paper presents time series estimates of the critical hospital capacity indicators during April 1–July 14, 2020. Design From March 27–July 14, 2020, NHSN collected daily data on hospital bed occupancy, number of hospitalized patients with COVID-19, and availability/use of mechanical ventilators. Time series were constructed using multiple imputation and survey weighting to allow near real-time daily national and state estimates to be computed. Results During the pandemic’s April peak in the United States, among an estimated 431,000 total inpatients, 84,000 (19%) had COVID-19. Although the number of inpatients with COVID-19 decreased during April to July, the proportion of occupied inpatient beds increased steadily. COVID-19 hospitalizations increased from mid-June in the South and Southwest after stay-at-home restrictions were eased. The proportion of inpatients with COVID-19 on ventilators decreased from April to July. Conclusions The NHSN hospital capacity estimates served as important, near-real time indicators of the pandemic’s magnitude, spread, and impact, providing quantitative guidance for the public health response. Use of the estimates detected the rise of hospitalizations in specific geographic regions in June after declining from a peak in April. Patient outcomes appeared to improve from early April to mid-July.

Ecological Analysis of the Decline in Incidence Rates of COVID-19 Among Nursing Home Residents Associated with Vaccination, United States, December 2020-January 2021

“…17,18 For the purposes of monitoring the pandemic, in collaboration with CMS, NHSN was able to rapidly expand from approximately 3000 nursing homes performing monthly reporting to receiving weekly reporting from the approximately 15,400 CMS-certified nursing homes and more than 1000 additional facilities for assisted living and intermediate care for individuals with intellectual disabilities. 9,19,20 The results of this study and others 7,8,21 demonstrate the importance of NHSN as a national surveillance infrastructure for nursing homes and other health care delivery populations. NHSN has the infrastructure to continue capturing vaccination coverage data after the PPP concludes to provide ongoing insight into the safety of this health care population.…”

The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections in 2020: A summary of data reported to the National Healthcare Safety Network

“…Almost all states previously identified by CDC with a high COVID-19 hospital admission burden observed increases in their 2020-Q2 CLABSI and VAE SIRs compared to 2019, most of which were statistically significant. 1 Preliminary data for 2020-Q4 showed a large increase of 34% in the national MRSA bacteremia SIR compared to 2019-Q4. There were 2,715 MRSA bacteremia events reported for 2020-Q4, which is 41% higher than the number of events reported by the same set of hospitals in 2019-Q4.…”

“…The CDC previously identified the states with a high number of hospitalized COVID-19 patients between April 1 and July 14, 2020. 1 To determine the impact of COVID-19 on HAI incidence in these states, the percentage change in state-level Q2 and Q3 SIRs were calculated for CLABSI, CAUTI, VAE, and MRSA bacteremia. For reference, supplemental data tables and interactive maps are provided on the NHSN website (https://www.cdc.gov/nhsn/datastat/ index.html) that provide a comparison between 2019 and 2020 quarterly SIRs for all states and all applicable HAI types, as well as a comparison of location-stratified national SIRs for DA infections.…”

“…As the coronavirus disease 2019 (COVID-19) pandemic swept through the United States, regions experienced peak cases and hospitalizations at various times in 2020. 1 The pandemic response placed burden on acute-care hospitals (ACHs), which may have altered staffing practices, increased critical care capacity, and modified use of personal protective equipment (PPE). 2,3 In the early stages of the pandemic, little was known about how COVID-19 hospitalizations would affect the incidence of healthcare-associated infections (HAIs).…”

Impact of COVID-19 pandemic on central-line–associated bloodstream infections during the early months of 2020, National Healthcare Safety Network

“…In particular, even though New York and New Jersey experienced increased hospitalizations during this time period, the Middle Northeast region did not demonstrate a significant increase in SIR, and this region had the largest decline in reporting of CLABSIs by 48%. 8 In contrast, the Southeast region had only a 12% drop in reporting of data on CLABSIs to NHSN, and the analyses were able to discern an increase in CLABSI SIR against the backdrop of an increase in hospitalizations due to COVID-19 during June 2020. 8 The analysis had several limitations.…”