. The SARS-CoV-2 virus has resulted in hundreds of thousands of deaths across the globe and overwhelmed many health systems. In Massachusetts alone, there have been over five thousand deaths over a two month period attributable directly to COVID-19, i.e., the disease resulting from viral infection. Lacking a vaccine or definitive treatment, slowing disease spread such that daily demand falls within the capacity of local medical systems is the immediate priority for this outbreak, but the changes involved with such mitigation efforts could be costly. For example, many hospitals have implemented changes to increase capacity for COVID-19 patients, e.g., delaying elective procedures and shifting resources across service lines, which could impact care for other conditions requiring time-sensitive care, e.g., strokes or heart attacks. There currently is limited information on the impact of the outbreak on non-infection, acute medical conditions. There also is little information on how hospital responses impact patient outcomes. Given concerns about future outbreaks in other states, as well as additional repeat outbreaks (or waves of disease transmission), there is a critical need for these types of information. In this project, we will address two aims: 1) to examine the impact of the COVID-19 demand shock on acute medical care received in the Emergency Department (ED) or hospital; and 2) to examine hospital responses to the demand shock and their impact on clinical event rates. We will use novel, linked real-time data sources to address these questions overall and for vulnerable population subgroups such as patient with dementia. Indeed, the early reports suggest that the elderly are disproportionally affected by COVID-19 itself and potentially the health system?s changes in response to the outbreak. These data could inform preparation for future COVID-19 outbreak waves occurring later this year, as well as future transmissible disease outbreaks.
. The COVID-19 outbreak has impacted patients, families, and health systems in dramatic ways. For example, the large and sudden increase in numbers of patients who require hospitalization after being infected has overwhelmed the capacity of hospitals in other countries. In the US, many hospitals have shifted their beds and staff towards meeting this surge of COVID-19 patients, but these efforts could limit their ability to provide other types of care. This project will examine what happens when the numbers of hospitalized COVID- 19 patients surge, and the potential impact on patients with other medical needs.
