As the number of coronavirus cases grows, so are fears that the U.S. has a shortage of intensive care beds. That's according to a new report by Kaiser Health News, which finds more than half the counties in America have no ICU beds, posing a unique threat to 7 million people ages 60 and up who are at high risk of serious illness or death from COVID-19, the disease caused by the coronavirus.
The worries extend to North Carolina, where 47 of the state's 100 counties have no ICU beds, according to an analysis by Kaiser Health News.
Fred Schulte helped report the story and spoke with WFAE's Nick de la Canal about what this could mean as the COVID-19 crisis escalates.
Nick de la Canal: I'd like to start by asking why we would need to focus on the number of intensive care beds at this moment?
Fred Schulte: Well what we found is that as the pandemic of COVID-19 spreads, we found that there's a wide variation around the country in access to intensive care unit beds — particularly for people over 60 years of age, who are the people most likely to be impacted by that and get really, severely ill.
And what we saw was that more than half of the counties in America have no intensive care beds, and 7 million people over 60 years old live in those counties. So there's concern that there might be a pretty acute shortage of these beds.
De la Canal: And you found most of these counties are in rural areas. Is that because they just never had a need for ICU beds before?
Schulte: Well, it could be. I mean, the lack of these beds is obviously a long-standing issue, but there's also disparities in urban areas. It's kind of a market-based system for health care in the U.S., and there have been more of these beds in areas that had the population and the resources to support them.
De la Canal: Is there anything that's now being done to help these hospitals become better prepared for possibly an influx of COVID-19 patients who would need critical care?
Schulte: Well, hospitals say they're planning -- there are a number of things that they're doing. The staffing is a critical issue, particularly with intensive care units. You need a lot of qualified staff, so one of the things they're doing is relaxing some requirements for practice and allowing doctors to cross state lines and practice, and things like that that will beef up the staff.
They're also trying to work out transfer agreements so that they can transfer patients to other hospitals that do have beds. And that can be really tricky, because in some cases people are too ill to be transfered.
De la Canal: So could that lead to doctors having to make some difficult decisions? And I'm also thinking, even if they can transfer patients to other counties with ICU beds, what happens if those counties' beds become filled up or at capacity?
Schulte: Well, many people think that's likely to happen, and yeah, rationing is not something that we have a lot of familiarity with, I think, in this country, fortunately. But many people that are in that high-risk group, I think, are worried about that.
One of our reporters, Liz Szabo, talked to a woman who's 60 years old and has had cancer for some time. And she's really worried about this because any kind of a viral respiratory illness could potentially be really dangerous to her, and she's worried that someone may make a decision that, well, she's expendable, because we have this rationing.
So, there very well could be some very tough decisions that have to be made, and it's not entirely clear who's going to make them and who will agree with them.
De la Canal: So we know that the number of coronavirus cases is growing pretty rapidly in North Carolina and all over the country. Generally, do you get the sense that hospitals are prepared to handle this?
Schulte: Well, hospitals say they're not, so I have to take them at their word. So, yeah, I guess the answer to that is no, they're not prepared. But then again, I don't know how you would be entirely, completely prepared for something as montrous as this that has sort of descended on us.
De la Canal: Fred Schulte with Kaiser Health News, I really appreciate your time. Thank you so much.
Schulte: OK. Good to talk with you, Nick.
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