Rising numbers of COVID-19 patients in U.S. hot spots could strain availability of critical care physicians and nurses, giving non-hospital providers "an instrumental role in the pandemic response," according to a Kaiser Family Foundation report.
To gauge availability of providers who can serve in a critical care capacity, KFF consulted data from the 2020 National Plan and Provider Enumeration System National Provider Identifier Registry.
1. The report identified approximately 16,600 intensivists and 67,900 critical care nurses, as well as nearly 116,000 "second-line" hospitalists, pulmonologists and anesthesiologists who are not formally trained in critical care but could care for critically ill patients.
2. California, Arizona and Texas are among several states with substantially lower per-population ratios of intensivists or critical care nurses than the national average ratios. They have also recently reported increasing COVID-19 cases.
3. While the number of second-line physicians far exceeds the number of intensivists in the U.S., it's unclear how many second-line providers could feasibly be redeployed to the intensive care unit setting for COVID-19 patients.
"Many hospitalists likely can be, since most practice in the hospital setting," concluded Eric Lopez, a member of KFF's ACA and Medicare Policy teams. "However, significant numbers of anesthesiologists and pulmonologists may primarily practice in non-hospital settings such as ambulatory surgery centers and outpatient physician offices, and may have little experience providing ICU-level care."
4. Still, recent COVID-19 surges in several states may justify redirecting second-line providers to critical-care roles and recruiting intensivists and critical care nurses from other regions.
5. Providers outside the hospital setting will "play instrumental roles in the pandemic response," Mr. Lopez said, "both by reducing strain on hospitals and by providing direct COVID-19 care." For this reason, it's vital to maintain sufficient numbers of primary and ambulatory care providers who can minimize avoidable hospitalizations and coordinate follow-up for recovering COVID-19 patients.