Allocation of COVID-19 Relief Funding to Disproportionately Black Counties

Abstract

days).Among dead or discharged patients (n = 2252 [77.5%] overall; n = 774 in surge 1 and n = 1478 in surge 2), surge 2 inhospital mortality was significantly lower compared with that for surge 1 (5.1% vs 12.1%; difference, -7.07%; 95% CI, -9.63% to -4.51%).In-hospital mortality among discharged and deceased ICU-treated patients during surge 2 was not significantly lower than that during surge 1 (49/214 [22.9%] vs 81/295 [27.5%]; difference, -4.56%; 95% CI, -12.15% to 3.03%).The mean daily proportion of individuals with positive RT-PCR results during surge 1 was 13%, whereas it was 25% during surge 2.Discussion | An increase in COVID-19 hospitalizations was observed across a major health care system in the greater Houston area, which was temporally related to phased reopening.Throughout the reporting period, hospital admission guidelines were consistently based on risk stratification by evaluation of severity of symptoms, comorbidities, diagnostic findings, and pulse oximetry.During surge 2, the absolute number of RT-PCR tests performed increased, as did the proportion of positive results.Therefore, higher hospital census likely reflects higher rates of community COVID-19 prevalence.Surge 2 data indicated a demographic shift of the pandemic toward a younger, predominantly Hispanic, and lower socioeconomic patient population with an overall lower comorbidity burden, ICU admission rate, and in-hospital mortality.The demographic and socioeconomic shift may reflect return to work and relaxation of COVID-19 transmission mitigation practices.Additionally, in-hospital mortality among ICU-treated surge 2 patients was 4.6% lower than that in surge 1.The overall better outcomes during surge 2 may be explained by a combination of lower comorbidity burden, lesser disease severity, and better medical management.Limitations of the study include data from a single hospital system that may not be generalizable.The shift toward non-ICU resources implies that different staffing patterns and infection control practices may be needed.Lower acuity and ICU use and shorter lengths of stay may allow for increased capacity and less overall stress on health care resources.