Quote Originally Posted by king183 View Post
There is no misconnect, but I can understand why this is confusing because the ICU count is a function of a relatively complicated mix of variables. To boil it down as much as possible, the number of available ICU beds is dependent on 1) the actual bed/room and 2) the number of clinically appropriate staff available to attend to a patient in that room. When cases start rising, hospitals will “create” bed capacity through a number of strategies, including shifting staff from other parts of the hospital to ICU duty, purchasing temporary contracting staff, and using federal augmentation. Thus, at the peak of cases, hospitals are dependent on staff that are not normally working an ICU and are expected to be temporarily assigned to the ICU. When cases are falling, hospitals can slowly transition staff back—but in many cases, contracts expire, augmentation is rotated out, etc. And, remember, the ICU has all kinds of non-COVID patients because other diseases, accidents, etc. didn’t stop because of the pandemic, thus further reducing COVID ICU bed availability. In sum, the hospital may not have the literal beds/rooms available, but even when they do, they may not have the appropriate staff to work the beds, so they cannot claim that capacity. When their temporary augmentations measures expire, they extra capacity temporarily created also expires.

In a related situation, most people know OU Health recently built that brand new tower, but many don’t know that dozens of those brand new beds/room have remained empty and not operational because OU cannot find the staff to work them. This is just an example of where someone may walk through the building and say, “Look at all these beds! They’re saying there’s no room for patients!” without considering there is no one there to take care of the patients.
It's my understanding also that not all beds are created equal. Some rooms simply do not have the capability to be ICU beds.

In normal times, ICUs typically run at roughly 70% to 80% capacity, a sweet spot where a unit can maintain enough resources to run, without being overstaffed, and still allow wiggle room for additional patients.