BUFFALO, N.Y. — It's proven to be one of the more stubborn of the benchmarks to meet in Western New York’s quest to begin re-opening its economy: a 14-day decline in net hospitalizations or a three-day average fewer than 15 new hospitalizations per day.
For purposes of lifting his coronavirus related shutdown orders, Governor Cuomo set seven benchmarks for a region to meet.
Cuomo considers the Western Region to include Erie, Niagara, Chautauqua, Cattaraugus and Allegany counties.
As of this date, the region meets only four of the seven benchmarks.
Barrier to a Benchmark
Net coronavirus hospitalizations include both the number of patients admitted minus those discharged on a given day.
And that number has gone up slightly in the region in recent days, much to the disappointment of local officials, after a downward trend prior to that.
According to Erie County’s Health Commissioner it may have to do with the state's recently changed position on an issue involving the many patients who arrive at hospitals from nursing homes.
“They are taking up a lot of the hospital beds, especially accounting for new hospitalizations,” Dr. Gale Burstein.
The state’s about face
In late March, the state health department issued a memo to nursing homes, ordering them to accept patients from hospitals -- even they had the virus.
This resulted in a firestorm when infections and deaths within nursing homes, which house the population most endangered by the virus, subsequently began to soar.
Following an outcry, Governor Cuomo then recently reversed the order, allowing nursing home to refuse those intakes.
“Now, with the new governor’s order that allows nursing homes and long-term acute care facilities to refuse to accept patients who have been diagnosed with COVID-19 back into their facility, that's going to increase the number of (hospital) admissions,” Burstein.
It also figures to reduce the number of discharges, perhaps making it harder for the region to lower its net hospitalizations, keeping them on the high side and impacting its ability to meet all the benchmarks for re-opening as set forth by the state.
Put another way, the number of hospitalizations doesn’t necessarily reflect an increase in new cases, but rather a longer stay by existing patients who, despite recovering, are having to extend their hospital stay.
“Even the hospitals have told me there are people who they could discharge, but they don't have a place to send them back to because the nursing homes are refusing to take them,” Burstein said.
“This will increase the number (of COVID-19) hospitalizations because you have this backlog of people that could be discharged who are not (going home), on top of any new cases,” she said.
While Erie County represents the overwhelming number of positive coronavirus cases, hospitalizations and deaths, Cuomo says the counties within the region cannot be considered individually when it comes to a phased in re-opening. The region must be considered in its entirety.