Why are Italy’s Hospitals Overwhelmed?

We’ve all seen the relentless reporting about how Italian hospitals are overrun with Wuhan Virus victims.

But the data from Italy begs the question; why?

As of 1400 CDT today, Italy has recorded a total of 64,000 infections.  Approximately 3,000 of those are listed as serious or critical.  This 5% rate is similar to the global numbers, BTW.

If we assume every single one of those ‘serious’ cases are hospitalized, why is this a problem?  Italy is a country of 60 million people.  They have 3.2 beds per 1,000 residents (compared to the US number of 2.8), which means they have 192,000 hospital beds.

Let’s assume for the sake of absurdity that Italy’s actual rate of hospitalization exceeds those cases identified as ‘serious’ by 100%.  This means that if ALL of the serious cases are hospitalized at once, 6,000 patients would need beds.

This is but 3% of the total inventory.

Perhaps you’ll say that the crisis is about the anticipated needs.  Let’s say that every serious case needs to be hospitalized for 30 days AND the number of serious cases will double in that same time frame (this is contrary to the trend, but ok), then we would add another 6,000 to the hospitalization.

That would put us at 6% of the total bed space in Italy…and assumes no one has died, recovered or left the hospital during that time.

How is this a crisis?

Is it possible that like other Marxist schemes the medical system in Italy has padded their numbers and is ill equipped to handle even the minor contagion (1/10th of 1% of the population infected), that they are presently dealing with?

Update:  A reader submitted this criticism:

The U.S. has 3 million hospital beds, but only 300,000 ICU beds. I think we have right now about 50,000 free ICU beds. The coronavirus requires approx. 20 days in the ICU to treat. Italy has more total hospital beds per capita than the U.S., but far fewer ICU beds per capita than the U.S.

My response:

I would assume hospital staff have already been adding beds to the inventory. In fact, I’ve seen many photos on social media of them doing just that. If every hospital in the US added just 10 beds to the supply, that would double the available bed space. Pictures I’ve seen imply it will be much more than that.

If we experience the same hospitalization rate as Italy (this seems extremely unlikely given the difference in populations), then we would need to have 2 million infected people to utilize the 100,000 ICU beds.

A more likely scenario based on current data; we could easily support 5 million infected before we use 100,000 ICU beds.

In Italy, they have 2.6 ICU beds per 1,000 or 15,000 beds. Some data suggests it’s even less than that. But with 3,000 ‘serious’ cases in Italy, it STILL doesn’t add up.

Update 2:  A reader writes with criticism:

Your blog post takes simple math and attempts to apply it to a complex issue. The physical number of beds is only 1 facet of the problem. Lets look at your presumed 50,000 beds. How about the sheer number of staff necessary to care for those 50,000 ICU patients? ICU nurses care for 2 patients; Intensivists/pulmonologists care for 10-20 ICU patients; Hospitalists docs, Infectious Disease docs, phlebotomists, rad tecs, housekeeping… Keeping a pt in ICU for 20 days is a huge drain on manpower. The physical bed is not the issue. What about the fact that all ICU beds are not the same? you aren’t going to admit a coronavirus pt into a burn, cancer, transplant, or surgical unit. Also, who is going to pay for 20 days in the ICU?

I find your post uninformed and inflammatory. If you want to discuss a topic and not appear to just post to incite commentary, at least put a little more research into your work before you post.

The list of problems can go on and on. Those “Empty ICU beds” are constantly in flux. Placing someone who needs a prolonged ICU stay prevents those 1-2 day post surgical pts, emergent admits (pneumonia/sepsis from other viral causes, strokes, MIs, traumas, etc), and more acutely ill patients from using that “bed.” For arguments sake, lets say the average ICU stay (Impossible to say for sure, due to the wide spectrum of ICU patient comorbidities) is 3 days. That’s about 6 patients you are preventing from using that bed.

I respond:

i understand that you don’t like my commentary and don’t agree with the data or the analysis. I encourage you to post your own data here to refute what I’ve presented.

Yes, I understand that available bed space is ‘in flux’. That helps, not hurts, because if beds are being vacated by patients (either those who have healed or those beds that were given up by other patients of lesser urgency), that’s a good thing.

Elective procedures will be postponed. Physicians and nurses will use their high intellect, extraordinary ingenuity and vast experience to adapt, as they have done elsewhere (such as with learning how to treat two patients with one ventilator, effectively doubling capacity).

Physicians who do not normally work ER will shift from other less important duties. Nurses who might have been in admin duties will jump in to help. Retired physicians and those who’ve been in personnel roles will rush to their colleagues’ sides to help as needed.

I know you’re under pressure. Everyone feels it in one way or another, but panic is not solution. Now is the time you trained for, this is the time to prove what you are made of. What is it to be a great nurse or physician when things are normal and easy? Every nurse, PA and physician in this country volunteered for this duty. It’s an awesome calling. Prove that you are worthy of the work that God has called you to. I have faith in you and in our entire medical establishment, not just because it’s the best trained, best funded, best organized and highest performing in the history of mankind, but because our people are devoted, persevering and sacrificial.

Beyond this, place your trust in God. He created you from nothing and sustains you with His grace every moment of your existence. He has foreordained the time, manner and place of your death. Don’t fear suffering or death and encourage anyone you meet who does.
Deus Vult.