As the state braces for a surge in coronavirus patients, the Maine Center for Disease Control and Prevention hasn’t had a precise picture of critical care resources because some hospitals have not been regularly reporting key data.
The agency uses daily reports from hospitals to compile the total number of intensive care unit beds and ventilators available statewide and how many of them are available for use. But in his daily briefings this week, CDC director Nirav Shah has said the numbers have had to be adjusted because some hospitals have not been regularly filing the daily reports.
The variation has been significant. From March 27 to April 1, the CDC’s count of ICU beds increased from 164 to 272 and the number of ventilators from 308 to 348.
“You may have noticed that the numbers I have reported here have been going upward over the last several days,” Shah said in his Wednesday briefing. “And the reason for that is that more and more hospitals are continuing to report in to Maine CDC.
“I commend and thank the hospitals for reporting those numbers to us which are vital as we are doing our planning work.”
Some hospitals had apparently not been reporting this information to the CDC at all, potentially distorting state officials’ view of the locations and availability of resources that will be critical if the number of severely affected patients spikes.
CDC spokesman Robert Long would not say which hospitals had been failing to report regularly and did not respond to questions about how long the lapses in daily reporting had been. In email responses, Long said that much of the increase in ICU beds and ventilators occurred “because a major hospital that had not been reporting regularly did so.” He said the CDC had “zeroes listed for some facilities because they were not routinely responding.”
“Nearly every facility has responded to Maine CDC’s requests for information, though some have not submitted complete inventories or responded every day,” Long added via email Thursday evening.
Long also said that the CDC’s inventory system had been in place long before the pandemic, and that since February the agency has been “more aggressively encouraging them to report each day.”
Jeremy Youde, an expert on global health politics at the University of Minnesota Duluth, said having complete and up-to-date information on ICU capacity and ventilators is essential for planning.
“This is important information to have just for the state health department to have a sense of where they might have capacity and where they might have a lack of capacity and if there is the ability to move things around or transfer people to other locations,” said Youde, who studies the intersection of government and health policy.
Representatives of Maine’s largest hospital network, MaineHealth, which operates Maine Medical Center, said they have been complying with the daily emergency inventory requests.
A spokesperson for the second largest network, Northern Light Health, which operates Eastern Maine Medical Center in Bangor, did not directly answer the question of whether it had been responding to reports daily. “Northern Light Health and its member organizations make all attempts to comply with various agencies requests including those from the CDC,” spokesperson Suzanne Spruce said via email.
Both Spruce and MaineHealth spokesman John Porter said the numbers of ICU beds at a given hospital can change from time to time as they periodically reallocate resources to meet changing demands. Spruce said Northern Light had not recently changed the quantity of ICU beds.
At his briefing Thursday, Shah also said in response to a reporter’s question that the CDC had not been collecting information on how many occupied ICU beds and ventilators were being used to treat patients with COVID-19, the disease caused by the coronavirus.
“That’s a question we are looking at in terms of how to have hospitals report that information most efficiently for us,” he said.
Long said the CDC began asking for this COVID-19 patient information this week, but that the agency expects it will take time for hospitals to adapt to the new reporting requirements, given the pressures they face.
Youde said this would also be important information to have been collecting, even if it were not released publicly.
“You’d want to understand what the stresses are on the system by knowing how many of these ventilators are being used for COVID-19 patients,” he said.
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