Jordan Ellis
The COVID-19 pandemic has resulted in a high number of hospitalizations worldwide. In the United States, the number of hospitalizations has fluctuated over time, with surges in different states at various points during the pandemic. California, for instance, experienced a record-high number of hospitalizations in late 2021, with over 3,700 patients hospitalized with COVID-19. Similarly, Texas and Florida witnessed high hospitalization rates, with Houston, Texas, reporting over 2,200 hospitalized COVID-19 patients. During the same period, the Midwest saw a decline in hospitalizations, indicating a recovery in that region. Overall, the pandemic has disproportionately impacted specific racial groups, with American Indian or Alaska Native people hospitalized at 4.1 times the rate of white people, and Black people at 3.9 times the rate.
| Characteristics | Values |
|---|---|
| Location with highest hospitalization rate | California |
| Location with second-highest hospitalization rate | Texas |
| Location with third-highest hospitalization rate | Florida |
| Number of hospitalized patients in California | 3,702 |
| Number of hospitalized patients in the US | 100,000+ |
| Rate of hospitalization for American Indian/Alaska Native people | 4.1 times the rate for white people |
| Rate of hospitalization for Black people | 3.9 times the rate for white people |
| Number of patients in intensive care units in California | 14 out of 49 |
| Number of patients in hospitals in Houston | 2,200+ |
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What You'll Learn
California hospitalizations soar
The California Department of Public Health (CDPH) reported 5,790 total hospitalizations, including both patients with lab-confirmed virus infections and suspected cases. About 1,500 patients were admitted to intensive care units (ICU) throughout California, with about 630 in Los Angeles County alone. The number of those patients in intensive care units has been trending upward, but more slowly.
Counties reporting the greatest increases are mostly concentrated in Southern California and the Central Valley, with elevated caseloads in Riverside, Kern, and San Joaquin counties. Among the reasons for the surge are outbreaks in nursing homes, the reopening of businesses, large gatherings, and more routine testing of patients coming to hospitals for other ailments.
Los Angeles County, in particular, is approaching its highest daily total of confirmed COVID-19 hospitalizations, with 1,893 patients with confirmed infections as of Tuesday. The rate of positive coronavirus tests in L.A. County is now at 8.4%, and the county has announced additional coronavirus-related deaths and new cases for the fourth day in a row.
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Texas and Florida worst-hit
As of August 2021, Florida is the only state with at least 25% of its hospital beds occupied by coronavirus patients. This is a significant increase from previous waves of the pandemic, with hospitals in Northeast Florida reporting numbers approaching or exceeding previous peaks. Jacksonville hospitals, in particular, have been overwhelmed, with some reporting that 90% to 98% of their COVID-19 patients are unvaccinated. Furthermore, the median age of hospitalized patients has decreased to 49, with 44% in their 40s or younger, indicating a younger demographic being affected by the Delta variant.
Florida is not alone in this surge, as other states like California have also witnessed record-breaking hospitalizations. However, the focus remains on Florida and Texas, which have been the worst-hit states. In Texas, the situation is equally dire, with hospitals overwhelmed and ICUs at maximum capacity. The state has consistently reported one of the highest numbers of COVID-19 hospitalizations in the country, with a substantial number of patients requiring intensive care.
The surge in hospitalizations in Texas has placed immense pressure on the state's healthcare system, leading to staffing and resource shortages. According to reports, some hospitals in Texas have been forced to set up overflow tents to accommodate the influx of patients. The situation is particularly critical in larger cities like Houston and Dallas, where hospitals have been consistently operating at or near capacity.
The high hospitalization rates in Texas have been attributed to a combination of factors, including the highly contagious Delta variant, low vaccination rates in certain regions, and the state's large population. Additionally, the state's decision to lift mask mandates and other restrictions earlier in the year may have contributed to the surge. As a result, Texas has had to reimpose some restrictions and focus on increasing vaccination rates to curb the spread of the virus.
In summary, Texas and Florida have been the worst-hit states in terms of COVID-19 hospitalizations, with both states witnessing record-breaking numbers and overwhelmed healthcare systems. The surge in cases, driven by the Delta variant and low vaccination rates, has resulted in increased pressure on hospitals and a subsequent strain on resources. The median age of hospitalized patients has also decreased, indicating a shift towards younger individuals being hospitalized. As a result, both states have had to adapt and implement measures to address the surge and protect their residents.
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Racial disparities in hospitalization rates
As of November 2020, more than 11 million confirmed coronavirus cases had been recorded in the United States, with 166,555 new cases in the last day and 1,266 new deaths. Studies have shown that racial disparities exist in hospitalization rates related to the coronavirus pandemic, with people of color experiencing worse outcomes than white patients.
A study by the Kaiser Family Foundation analyzed the electronic health records of 50 million patients and found that although testing rates varied little by race and ethnicity, black, Hispanic, and Asian patients were 2–3 times more likely to test positive for SARS-CoV-2. These minority groups were also at least twice as likely to be hospitalized and die due to COVID-19. Similarly, an analysis by the Epic Health Research Network and KFF revealed that people of color were more likely to test positive for COVID-19 and require a higher level of care at the time of diagnosis compared to white patients. They were also more likely to be hospitalized and die from the disease.
The disparities in hospitalization rates are evident across multiple states. For example, in California, a study by Azar, Shen, and Romanelli examined disparities in outcomes among COVID-19 patients in a large healthcare system. Additionally, studies by the US Centers for Disease Control and Prevention found racial and ethnic disparities in coronavirus emergency room visits and hospitalizations in 13 states, including Massachusetts. Hispanic and Native American people had 1.7 times the rate of emergency room visits compared to white people, while Black people had 1.4 times the rate.
These disparities are driven by various factors, including systemic inequities that affect the health of racial and ethnic minority groups. Racism and discrimination have been identified as key drivers of the health inequities, increasing the risk of infection and delaying medical care for affected communities. The disparities were found to be most pronounced early in the pandemic, from April to July 2020, but they continued to persist among racial and ethnic minority groups even as COVID-19 hospitalizations increased among white patients.
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ICU patients increase
The number of people hospitalized with COVID-19 varies across different regions and time periods. For example, in late April 2021, California experienced a surge in hospitalizations, exceeding previous records. Similarly, during a 28-day period from January to February 2025, an increase in hospitalizations and intensive care unit (ICU) admissions was observed in multiple countries.
Focusing on ICU patients, several studies have investigated the factors associated with cross-infections and mortality in this vulnerable population. In a Tunisian intensive care unit, a longitudinal study identified various risk factors for cross-infections, including renal replacement therapy, prolonged ICU stay, and empirical use of broad-spectrum antibiotics. Additionally, age above 75, chronic obstructive pulmonary disease (COPD), and venous catheter use were associated with increased infection risk.
Another study analyzed pre-vaccine data from the Centers for Disease Control and Prevention (CDC) in the United States. It found that 44% of COVID-19 patients admitted to the ICU died, with wide variations among different groups. This high mortality rate was also observed in an earlier meta-analysis, which reported a significantly increased risk of death in ICU patients with hypertension. The presence of comorbidities, such as obesity, cardiovascular disease, and chronic kidney disease, likely contributes to the higher mortality rates in this subgroup.
The increase in ICU patients during surges of COVID-19 cases can strain healthcare resources and impact the quality of care provided. The high mortality rate among these patients underscores the importance of preventive measures, early detection, and effective treatments to reduce the need for intensive care admissions.
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Hospitalization rates and local data
As of December 2020, more than 100,000 people were hospitalized with coronavirus in the United States, according to the COVID Tracking Project. This number doubled in a month. The West saw an all-time high for hospitalizations, with California being the worst-hit state. The South witnessed hospitalization rates approaching the peak of July, and the Northeast saw numbers not experienced since May. However, the Midwest's hospitalizations seemed to be decreasing.
During the same month, California experienced a record number of hospitalizations. On Sunday, 3,702 patients were hospitalized statewide, breaking the previous day's record of 3,547 hospitalized COVID patients. This surge in California was attributed to various factors, including outbreaks in nursing homes, the reopening of businesses, large gatherings, and increased routine testing.
Prior to this, in July 2020, Texas and Florida were among the worst-hit states, with hospitalization rates reaching the peaks previously seen in New York, New Orleans, and Chicago. Houston, in particular, had over 2,200 COVID-19 patients in hospitals, making it the county with the most coronavirus patients in Texas. Additionally, six of the top ten places with the most severe coronavirus hospitalization rates were in Texas, with Imperial County being the first in California to revert to a stay-at-home order due to soaring cases.
The availability of detailed local data on hospitalization rates is crucial for understanding the epidemic. However, federal officials have not made this information public, making it challenging to grasp the precise hospital situation in certain states, such as Arizona. Public health experts emphasize the importance of real-time data that is independent of testing levels to accurately comprehend the impact of the virus in different regions.
Racial disparities in hospitalization rates have also been evident, with American Indian or Alaska Native people hospitalized at 4.1 times the rate of white people, and Black people at 3.9 times the rate, according to data from November 2020.
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Frequently asked questions
California hit an all-time high of 3,702 hospitalizations on Sunday, breaking the previous record of 3,547 set on Saturday.
States with the highest number of hospitalizations include California, Texas, Florida, and Louisiana.
Yes, American Indian or Alaska Native people have been hospitalized at 4.1 times the rate of white people, and Black people have been hospitalized at 3.9 times the rate of white people.
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