WICHITA, Kansas — Flatten the curve: A phrase that didn’t mean anything two months ago is now the driving factor behind social distancing, stay-at-home orders and limiting the number of people who can gather in one place.
The idea is to make sure hospitals aren’t overrun with severe COVID-19 cases, as well as help hospitals conserve limited resources such as personal protective equipment.
But in Kansas, there isn’t publicly available data on whether a hospital is close to filling up. And few are willing to share that information.
At this point, the Kansas Department of Health and Environment said 327 people have been hospitalized with COVID-19, but it doesn’t provide which hospitals or whether patients have gone home.
Stormont Vail in Topeka is a rare exception. Every day, the hospital publishes a dashboard with information like how many patients it's treating for COVID-19, ventilator usage and tests administered. While it strays from giving specific numbers of available beds, it does provide a percentage of how many of its hospital and intensive care beds are in use.
“It displaces rumor,” Stormont Vail CEO Dr. Rob Kenagy said of releasing the information. “It displaces fear.”
He said early on there were a lot of questions from the community and staff about whether the hospital would be the next Italy, Spain or New York City in terms of being overwhelmed. In their crisis plan, he said, transparency seemed like the best option.
The hospital is also providing a daily color-coded indicator of where they stand with personal protective equipment; green for good, yellow for getting low and red for critical need.
“If we were to get into a place where our capacity would be tested, we felt like it would be best for our community and our team members to know the detail of those capacity constraints,” Kenagy said.
Lawrence Memorial Hospital sends out a similar daily dashboard.
The University of Kansas Health System in Kansas City, Kansas, isn’t going quite that far. But it has provided a daily total of how many COVID-19 cases it's treating — hovering at about 30 for a few days.
“That’s really what’s telling us where we are on the curve because we haven't tested enough people out in the community,” said Dr. Steve Stites, the chief medical officer at the University of Kansas Health System. “We don’t have the same public health structure we once did. We don’t have the same testing we once had.”
In a news conference Tuesday, he said stagnant hospitalization numbers likely mean that the Kansas City area is flattening the curve.
Meanwhile, most other hospitals are keeping mum. Salina Regional Health Center, Saint Catherine Hospital in Garden City and the St. Luke’s Hospital system declined to provide capacity information. Ascension Via Christi in Wichita and HCA hospitals in the Kansas City metro did not respond to a request for data.
Some might not be used to giving out the information, others may be worried about competitors knowing any weaknesses. Either way, the information exists. It’s just not public.
The Kansas Hospital Association provides services for and lobbies on behalf of Kansas hospitals. In an emailed statement, KHA vice president Cindy Samuelson said its members are working with government officials on a daily basis to monitor and report system capacity, as well as planning for increased demand.
Predicting the future
The good news, if there is such a thing during a pandemic, is that one of the main models predicting hospital resource use shows Kansas will have plenty of capacity.
Kansas is expected to reach peak resource use on April 20, needing 485 beds for coronavirus patients, according to the Institute for Health Metrics and Evaluation. The organization’s model shows the state has enough capacity for 4,810 COVID-19 patients. (IMHE calculated capacity based on a hospital's total number of beds minus their historical average daily use for other types of patients.)
“Quite honestly, we’re not at capacity yet,” KDHE Secretary Lee Norman said. “We have a lot of ability to surge in terms of the beds and the type of beds.”
Even the worst-case scenario of the IMHE model predicts Kansas would need only about 1,500 hospital beds — again, well under the system’s total capacity.
But a model is only as good as its assumptions, and doesn’t represent the individual needs of each region or hospital.
“If you actually have real data, that trumps any kind of model,” said Amesh Adalja, an infectious disease physician and researcher at John Hopkins University. “We want our models to accurately reflect reality, but they’re not a substitute for reality.”
Local hospital administrators agreed that making sure the actual hospitalization numbers line up with the latest model depends on continued social distancing and staying at home efforts.
“The fact is that it has helped a tremendous amount,” Kenagy said. “And we will be able to weather the size of the surge.”
Correction: A previous version of this story incorrectly stated the name of the University of Kansas Health System.
Brian Grimmett reports on the environment, energy and natural resources for KMUW in Wichita and the Kansas News Service. You can follow him on Twitter @briangrimmett or email him at grimmett (at) kmuw (dot) org.
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