Colorado hospitals saw significant increases in their patient death rates during surges of COVID-19 cases, just one of the revealing findings contained within a new report produced by the state’s hospital association.
The report, released last week by the Colorado Hospital Association, uses discharge and claims data to paint a broad picture of how the pandemic affected patient admissions and patient outcomes. Because those data take time to assemble, the report looks only at the first 16 months of the pandemic, from March 2020 through June 2021.
It found that COVID patients admitted to the intensive care unit with COVID stayed twice as long in the unit as ICU patients who didn’t have COVID — about 14 days for COVID patients, compared to about seven days for non-COVID patients.
It also found that COVID patients had higher mortality rates than the patient population as a whole. In April 2020, during the virus’ first wave in the state, Colorado hospitals recorded a mortality rate for COVID patients of about 15 deaths per 100 hospitalizations, while the overall mortality rate among all patients was around three deaths per 100 hospitalizations. Mortality rates for COVID patients declined following the initial wave of infections, but increased again during subsequent waves.
So lethal was COVID in Colorado hospitals that it pushed up the overall patient death rate. During the first 16 months of the pandemic, the mortality rate for all patients was 2.3 per 100 hospitalizations. That’s a 35% increase from the previous, pre-pandemic 18 months, when the mortality rate was 1.7 per 100 hospitalizations.
The numbers underscore what health officials have been saying for months about the burden COVID has placed on hospitals and their staff — not just in terms of the sheer volume of patients, but also the severity of illness, the intensity of care required and the depth of grief felt when a patient doesn’t survive.
“It is important to acknowledge how hard our health care workers and first responders on the front line have been working, the stress they have been under, the impact that these hospitalizations have had on them,” Scott Bookman, the state’s COVID-19 incident commander, said Friday.
The Colorado Hospital Association says it is planning a follow-up report looking at the same trends during the latter months of the pandemic, when waves of cases caused by the delta and omicron variants stressed hospitals to their highest levels. But the report released last week already hints at some of the ongoing legacies the pandemic will have for the state’s health care system.
The report found that, during waves of infections, people stopped going to the hospital for other things. This was already well-known in the first wave of infections, but the pattern also re-emerged during subsequent waves.
During the infection spike in late fall and early winter of 2020 and 2021, total hospitalizations decreased by about 3%, even as COVID hospitalizations surged. The reason: non-COVID hospitalizations dropped by about 17% during that time.
“A decrease and displacement of non-COVID-19 hospitalizations and intensive care unit cases occurred posing questions about longer term implications of deteriorated patient health due to delayed or canceled care,” the report states.
Hospitals are already seeing some of this impact. The number of people hospitalized with COVID has been dropping and the state’s hospital capacity has been improving. But hospitals still remain quite full.
At UCHealth, for instance, one reason is because during the most recent wave of infection, the system’s hospitals had to postpone a large number of surgeries and other procedures that were important but not emergencies.
“So lots of those people are now being rescheduled, and we’re trying to get through that backlog,” said Dan Weaver, a spokesman for UCHealth.
Stephanie Sullivan, a spokeswoman for the HealthONE hospital system, said another problem has been finding places — such a rehab or skilled nursing facilities — to discharge patients to. That has kept patients in the hospital longer, leaving fewer available beds.
The backlog of delayed care also may not be resolved soon. Studies have found that the rates of Americans getting preventative screening procedures like mammograms or colonoscopies declined during the pandemic. Some of the consequences of these missed early interventions — late-stage cancers that could have been caught earlier, for instance — have already begun showing up in the state’s hospitals.
It all means that, even if the pandemic improves in Colorado as expected, the health consequences will likely stick around for some time to come.