Nearly half of COVID hospitalizations called ‘incidental’

Patients have COVID but are being treated primarily for some other issue

CLOSE TO HALF of the patients being hospitalized in Massachusetts for COVID-19 are incidental cases, meaning they tested positive for the virus while being treated primarily for other issues.

The new information, released for the first time on Thursday, suggests the wave of COVID-19 cases filling up hospitals may not be as severe a problem as previously thought. The patients entering hospitals are still filling up beds and requiring care, but nearly half of them are there for reasons other than COVID.

Physicians in recent weeks say they have noticed more and more of these incidental cases — people coming in after being injured in a car crash or suffering a heart attack and learning their COVID status only when the hospital tested them upon admission. Doctors have also said beds tend to fill with homeless or dialysis patients who have tested positive for COVID and can’t return to shelters or dialysis centers because of their COVID status.

The state Department of Public Health began gathering the new data from hospitals on January 10 and statewide results were released on Thursday for the period January 13-18. Each day’s patient totals were slightly different, but the pattern was consistent, with 50 to 52 percent of the patients being treated primarily for COVID-19 and 48 to 49 percent being treated primarily for some other health issue.

The determination as to whether a patient is being treated primarily for COVID is based on administration of the medication dexamethasone, an anti-inflammatory steroid used to treat at least 90 percent of COVID-19 patients who are hospitalized.

On Tuesday, according to the just-released state numbers, a total of 3,187 patients were hospitalized statewide for COVID, with 1,624, or 51 percent, treated primarily for COVID-19 and 1,563, or 49 percent, treated primarily for something else.

State statistics indicate 475 of the COVID patients on that day were in hospital intensive care units and 284 were intubated. The latest data doesn’t indicate how many of those patients were incidental.

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Bruce Mohl

Editor, CommonWealth

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

About Bruce Mohl

Bruce Mohl is the editor of CommonWealth magazine. Bruce came to CommonWealth from the Boston Globe, where he spent nearly 30 years in a wide variety of positions covering business and politics. He covered the Massachusetts State House and served as the Globe’s State House bureau chief in the late 1980s. He also reported for the Globe’s Spotlight Team, winning a Loeb award in 1992 for coverage of conflicts of interest in the state’s pension system. He served as the Globe’s political editor in 1994 and went on to cover consumer issues for the newspaper. At CommonWealth, Bruce helped launch the magazine’s website and has written about a wide range of issues with a special focus on politics, tax policy, energy, and gambling. Bruce is a graduate of Ohio Wesleyan University and the Fletcher School of Law and Diplomacy at Tufts University. He lives in Dorchester.

Paul Hattis, a senior fellow at the Lown Institute, said the numbers could provide policymakers with valuable information. He gave the hypothetical example of two 300-bed hospitals, each 95 percent occupied and serving roughly the same size communities. Both have 100 COVID patients, but the first hospital has 10 that are incidental and the second hospital has 40 that are incidental.

“If you ask me, knowing nothing else, which hospital is likely to be overwhelmed with patients in the next few weeks, the answer is the first hospital because it has 90 sick COVID patients that may not be leaving very soon,” Hattis said. “Also, the fact that is has only 10 percent incidental means it is very likely located in a lower-vaccinated community and more at risk of getting higher numbers of sick COVID patients coming to it.”