Short Supply: The Availability of Healthcare Resources During the COVID-19 Pandemic

The novel coronavirus (COVID-19) pandemic has already strained healthcare resources in New York City. Healthcare systems, hospitals, and local area officials around the United States are preparing to care for COVID-19 patients. In this paper, we find that many states will have capacity in the near term, but demand is expected to outstrip supply in most states in ninety days.

Leveraging the Penn Medicine COVID-19 Hospital Impact Model for Epidemics (the CHIME Model), we project state-level COVID-19 resource needs and supply shortfalls at fifteen, thirty, sixty, and ninety days across best-case (5 percent of cases need hospitalizations) and worst-case (20 percent of cases need hospitalization) scenarios. Reflecting recent guidance from the Centers for Medicare & Medicaid Services, the projection model accounts for the cancelling of elective procedures to better account for hospital, intensive care unit (ICU), and ventilator availability. Projection models are subject to the limitations of available data and the best research on the nature and severity of COVID-19 infections. We estimated low, middle, and high scenarios to provide a sense of uncertainty around the estimates, and it should be noted that uncertainty increases with long time frames.

Key findings include:

• On April 15, 2020, COVID-19–related hospital bed demand will be within current capacity under the low-hospitalization rate scenario, but it could exceed current supply in New York in the high scenario. Similarly, ICU bed demand will fall within current availability in the low scenario, but will exceed supply in six states in the high scenario. We expect New York to face the greatest demand, ranging from 0.4 of current inpatient bed supply to 1.5 times current supply, and ICU bed demand up to 3.6 times current supply.
• On June 29, 2020 (ninety days), COVID-19–related hospital bed demand is projected to exceed current supply in between forty-four states (low) and fifty states (high) and is projected to be ten times higher than available supply in between eight states (low) and thirty-nine states (high).
• Ventilators, which have a much lower baseline availability, are projected to be in short supply for between twenty states (low) and forty-nine states (high) as of April 15, 2020. All states and Washington, DC, are expected to have a deficit of ventilators as of June 29, 2020, in the low and high scenarios.

Policymakers should consider inpatient bed expansion plans. In addition, other strategies would include using telehealth programs to reduce COVID-19 patients from using emergency department services and hospital-at-home programs to help provide sufficiently stable COVID-19 patients with care at home.