Weeks ago, when cases and hospitalizations began to rise, I suggested (because of this thing called “data”) that COVID-19 hospitalizations went up because the bar for hospitalizations went down. Simply put, the numbers went up because hospitals lowered their standards for which COVID patients should be hospitalized. The study that The Atlantic published? It suggests that very thing.

So what has taken us so long to get to this point? Well, again, the problem falls on the CDC, NIH, and NIAID, who have not standardized data collection nationally for this pandemic. //

To this day, the CDC does not collect nationalized data for several factors which would help us better analyze how to approach this pandemic, including breakthrough cases and hospitalization case severity. That means that someone admitted to the hospital out of an abundance (and sometimes an overkill) of caution, is counted as the same hospitalization as someone with a much more severe case. To those making decisions at the top, a hospitalization, is a hospitalization, is a hospitalization. //

The federal government requires hospitals to report every patient who tests positive for COVID, yet the overall tallies of COVID hospitalizations, made available on various state and federal dashboards and widely reported on by the media, do not differentiate based on severity of illness. Some patients need extensive medical intervention, such as getting intubated. Others require supplemental oxygen or administration of the steroid dexamethasone. But there are many COVID patients in the hospital with fairly mild symptoms, too, who have been admitted for further observation on account of their comorbidities, or because they reported feeling short of breath. Another portion of the patients in this tally are in the hospital for something unrelated to COVID, and discovered that they were infected only because they were tested upon admission. How many patients fall into each category has been a topic of much speculation. //

Which was the primary motivation for the study, conducted by the VA Boston Healthcare System. The doctors who performed the study took it upon themselves to provide a line, which after a patient meets a certain amount of criteria, could classify them as a severe case. According to the study, (which has not as of yet been peer-reviewed), once patients had to be placed on supplemental oxygen to survive, they could be considered a moderate-to-severe case. What the study found was very interesting. Hospitalized patients, who required supplemental oxygen fell from 64% to 52%. That means that either alternative treatments were more effective, or (and as I have been saying for months) hospitals began admitting patients with less severe symptoms. To further confirm the point, the study found that up until January 2021, 36% of patients who were admitted to the hospital had mild or asymptomatic cases. That number rose to 48% by the end of June 2021.

So why would hospitals do this? The Atlantic article fails to question this, only to find ways that the study may be flawed by offering various caveats. Presumably, and very likely, this has to do with the fact that COVID hospitalizations are reimbursed at a higher rate than would say, your typical health insurance plan.