Fact check: Hospitals across the country are both overrun and understaffed

Ella Lee, USA TODAY

September 24, 2021 at 2:41 PM·6 min read

The claim: Hospitals aren’t ‘overrun’ by COVID-19; they’re understaffed

As the COVID-19 delta variant continues to pound the country, hospitals are struggling to keep up. But some on social media say the virus isn’t all to blame.

“Hospitals are not being ‘overrun’ - they are understaffed,” an Aug. 31 Facebook post reads. "Perhaps threatening to fire more of them isn’t the best strategy?”

The post was shared more than 600 times in two days.

While it’s true that many hospitals across the country are understaffed, that doesn’t mean they’re not also overrun, largely thanks to increasing numbers of COVID-19 patients, experts say. The two variables are burdening hospitals in tandem.

Tyler Miller, who runs the page that made the post, told USA TODAY that he made the claim based on a combination of hospital capacity data for Washington state and personal conversations with doctors, nurses and hospital staff.

"I shared this data with several people that I know in the healthcare industry, and all of them have responded by telling me that this data is not as straightforward as it appears, because there are not enough staff to fully man most of these hospitals," Miller said.

The original post did not indicate the author was referring to Washington state.

Hospitals are filling up nationwide

The surging delta variant is creating capacity issues at hospitals across the country.

As of Sept. 2, more than 78% of inpatient beds nationwide are occupied, nearly 14% of which are in use for COVID-19, according to data from the U.S. Department of Health and Human Services. That's more than 101,807 beds taken by COVID-19 patients. HHS' database does not indicate whether its inpatient bed data is measured by total beds available or the total beds for which staffing is available, and the agency did not respond to numerous messages requesting clarification.

Intensive care unit beds were even harder to come by, with more than 80% in use nationwide as of Sept. 2, about 31% of which are occupied by COVID-19 patients. ICU beds are measured by the total number of staffed beds in use.

Because of the nature of the virus, COVID-19 patients also often end up needing special attention, according to Dr. Georges Benjamin, executive director of the American Public Health Association.

Fact check: Hospitals staff near max capacity, but COVID-19 isn't business as usual

"These patients are much, much sicker and require much more respiratory support," Benjamin told USA TODAY in August. "We also don’t, in the normal course of business, have to set up intensive care beds in holding rooms, tents and operating rooms. During the peak of the pandemic, we were doing that, and many hospitals are on the brink of doing this again."

According to NPR’s COVID-19 tracker, 58% of hospitals nationwide were under high or extreme stress during the week of Aug. 27-Sept. 2 when this post was published.

Of the 50 states, 40 have 70% or more of their inpatient beds occupied. Nine others have between 60% and 69.9% of their beds occupied.

Florida and Texas are among the states hit the hardest by delta’s surge. HHS data showed 94% of ICU beds in use in Florida and 81% in Texas.

The hospitals remained strained into late September, as more than 78% of inpatient beds nationwide were occupied, 11% of them by COVID-19 patients as of Sept. 24.

Understaffing affects hospital burdens

The burden of increasing numbers of hospitalized COVID-19 patients is made worse by hospitals short of staff.

Hospitals sometimes have more physical beds than they are reporting, but those beds can't be used by patients because there isn't enough staff to tend to them.

"Hospital capacity is determined by the availability of all the resources that are necessary to treat and care for that patient," Carri Chan, faculty director of Columbia University's Healthcare and Pharmaceutical Management Program, told USA TODAY in an email. "That includes beds, nurses, physicians, lab techs, phlebotomists and any other ancillary resources that are needed."

In almost every state, at least a few hospitals have reported to HHS that they are experiencing “critical staffing shortages,” according to data updated daily.

More: The delta variant is 'ripping through the unvaccinated' and crowding hospitals in Florida, Texas

But the shortage of staff doesn't mean hospitals aren't also overrun.

"It is true that hospitals are overrun and cannot take more patients," Chan said. "After 18 months of this pandemic, our providers are burned out. Many are leaving the profession because it is impacting their mental and physical health. Demand for hospital care due to COVID-19 patients has grown substantially in the last few months and, unfortunately, appears to continue to increase in a number of states. It is this imbalance between supply of hospital resources and increasing demand of more patients that is resulting in the strain on hospitals."

Susan Dentzer, a senior policy fellow at Duke University's Margolis Center for Health Policy, said hospitals can be both understaffed and overrun or they could be one or the other. But the pandemic has made it so the former is more often true.

"In the hot spot areas of the country now it is generally both that are true: They have run out of capacity to add new beds and they cannot fully staff the beds they already have," Dentzer said.

The mix has created a "perfect storm," according to Dr. Peter Viccellio, vice chair of Stony Brook University's department of emergency medicine.

"From everything I’ve read, and in talking with colleagues around the country, we are experiencing a perfect storm of high volume of critically ill patients with severe staffing shortages," Viccellio said. "Staffing was better with the first big wave because everything else was shut down, so you could pull additional nurses from doctor offices, ambulatory surgery, etc., and beds were not being also filled with elective admissions. Not this go round."

Our rating: Partly false

The claim that hospitals aren’t "overrun" by COVID-19, they’re understaffed, is PARTLY FALSE, based on our research. Hospitals across the country are spread thin by both COVID-19 and understaffing; the two variables work together to create the burdens hospitals are facing, experts say.