The States Where a Coronavirus Spike Could Spell Disaster
WHY YOU SHOULD CARE
These Western states have the least hospital capacity for a potential crisis.
As reports of overrun New York City hospitals abound, with supplies waning and at least two city nurses dying alongside the patients they were first treating, it’s worth remembering that in many ways the Big Apple was the most prepared spot in the U.S. for a crisis like this. After all, the threat an outbreak posed to congested New Yorkers was never that abstract — and it didn’t hurt that they had northern neighbor Toronto’s SARS outbreak from 2003 as a nearby reminder.
With 4.6 physicians and 2.7 beds per 1,000 people, New York was ranked second-most prepared to meet hospital capacity in an outbreak, in an analysis by insurance comparison platform QuoteWizard. New Yorkers also had Syra Madad — the NYC Health and Hospitals senior director for its systemwide special pathogens program, and star of Netflix’s Pandemic docuseries — working on their behalf, even emailing warnings and preparedness strategies to colleagues in early January while in 17 hours of labor delivering her third child.
Yet if New York could be caught flat-footed despite its expertise and investment in hospital infrastructure, states with significantly less resources should be especially concerned as coronavirus cases reach their expected peak over the next few weeks.
Utah, Idaho and Nevada are the least pandemic-prepared when it comes to per capita hospital capacity.
That’s according to a QuoteWizard study that analyzed Kaiser Family Foundation data on hospital beds and physicians per 1,000 people. Its final rankings are a composite score of states’ preparedness in both areas. And while West Virginia and Pennsylvania both ranked in the top three along with New York for being most prepared to meet the coming demand for hospital beds and doctors, the three aforementioned Western states should be worried.
Utah had 2.11 physicians and 1.82 beds per 1,000 people, while Idaho had 1.69 and 1.98, respectively. Nevada had two physicians and two beds per thousand, to round out the bottom three. Those numbers are well below the nationwide average of 2.96 physicians and 2.4 hospital beds. And, for many of these places, the worst could be yet to come. The University of Washington has released a model predicting peak resource use by state, and it has all three peaking between April 14 and April 25. Meanwhile, a University of Utah expert has suggested her state’s peak could still be “months” away.
“It could be a disaster,” says Adam Johnson, a data analyst at QuoteWizard who conducted the study. “On one hand, it seems that coronavirus is spreading less quickly to rural areas than in urban places. But on the other hand, if an epidemic does break out in these places, they likely will be far less equipped to deal with it because of a lack of hospital beds and physicians.”
There are some reasons for skepticism in any study, including this one. The data set “seems to be biased toward places with higher population density,” Johnson says. So while it’s adjusted for population, it would seem that states with high urban populations look better in the model.
Still, the numbers do show a disparity in Western states between the number of people who may need to be treated and the resources available. Nine of the 10 least prepared states are Western states, from New Mexico and Arizona up to Oregon and Washington (Texas is the other).
Most Western states were also slow to respond. In a report released by WalletHub on how aggressively states have responded to coronavirus, Nevada and Utah ranked 41st and 43rd, respectively. Idaho Gov. Brad Little issued a stay-home order on March 25, but the damage may already have been done: Two days later, a Johns Hopkins study found that Idaho’s scenic Blaine County, known as a ski hot spot for celebrities, was found to have the highest per capita rates of infection outside the New York City area.
Social distancing will remain critical going forward … while most of these states aren’t completely overwhelmed yet, they may still have a chance to avoid the worst outcomes if residents stay home and avoid spreading the disease. That’s the case in Oregon, which has been more aggressive than most Western states in its response and sent 140 surplus ventilators to New York City. “Oregon doesn’t have everything we need to fight COVID-19 — we need more PPE and testing -— but we can help today with ventilators. We are all in this together,” tweeted Gov. Kate Brown when explaining the decision on April 4.
“Flattening the curve is so important, so you don’t see the number of patients just rise to a point where it completely overwhelms the hospital system,” Johnson says. Otherwise, these states may see “situations like in Seattle, where they are having to set up a triage station in the middle of a high school football field, or in New York, where medical tents are set up in Central Park.” These were all unimaginable sights to most Americans even a little more than a month ago.