Friday, May 2, 2008

How Many Ventilators Does New York Really Have?

A couple of weeks ago, I posted a piece on how hard it is to get good numbers on the quantity of ventilators available. I checked through some documents from the New York State Workgroup on Ventilator Allocation in an Influenza Pandemic. Last year they published some preliminary information and asked for public input on setting up guidelines for ventilator use in a pandemic or similar emergency. I sent in some information to them about the Pandemic Ventilator Project and some of my ideas about how to expand the availability of ventilators and clinical capacity in a crisis, but they never asked me for more details. They recently published some guidelines based on that exercise in Disaster Medicine and Public Health Preparedness. I will have to see about getting a copy of that article and reviewing it.

Anyway, I found two documents by the same workgroup stating the number of ventilators in New York. Unfortunately they quote two different numbers. One is 60% higher than the other. Here are the details:

First we have:
Allocation of Ventilators in an Influenza Pandemic: Planning Document
NYS Workgroup on Ventilator Allocation in an Influenza Pandemic
NYS DOH/ NYS Task Force on Life & the Law
Feb 13, 2007 (listed access date)
Available here:

On page 9, it states:
  • the population of New York State is approximately 19 million,
  • there are currently 3,981 adult and pediatric ICU beds staffed,
  • 15% of the admitted patients with pandemic influenza will require intensive care,
  • 7.5% of the admitted patients with pandemic influenza will require ventilators,
  • there are currently 6,100 ventilators in acute care settings in New York State,
  • at any given time, 85% of the ventilators in acute care settings are in use, and
  • 70% of deaths related to pandemic influenza are projected to occur in a hospital.

And then we have:
New York State Workgroup on Ventilator Allocation in an Influenza Pandemic
New York State Department of Health/ New York State Task Force on Life & the Law
March 15, 2007
Available here:


On page 1, it states:

a) Community Demographics
New York State has an estimated population of 19,254,630, which represent 6.5% of the total United States population. Approximately 13% of New Yorkers are age 65 or older; an estimated 18%of the state population over the age of 5 is disabled.

b) State & Local Public Health Infrastructure
NYSDOH is empowered to issue voluntary, non-binding guidelines for health care workers and facilities; NYSDOH is also empowered to issue binding regulations for hospitals that would app to standards of care during a pandemic.

c) Health Care Delivery System
There are more than 650 nursing homes in New York State housing 120,000 beds. Of the 240 hospitals in the state, 44 are classified as trauma centers, and 13 are classified as critical access hospitals (CAH) in rural areas. There are 3,981 adult and pediatric staffed intensive care unit beds throughout the state. There are currently 3,861 mechanical ventilators in acute care settings in New York State; at any given time, 85% of these ventilators are in use.


So here we have 2 documents. Both are produced by the same workgroup on ventilator allocation. Both of these documents list Gus Birkhead and Tia Powell as contributors. One of the documents says that New York State has 6,100 ventilators in acute care settings, and the other document says that they have 3,861 ventilators in acute care settings. Both of them say that they have 3,981 ICU beds.

It is hard to know what numbers to believe. As I said before, how can you know how many ventilators you have to stockpile if you are not even sure how many you have now? How can you know how far you can extend your resources and clinical skills capacity if you are not even sure how many ventilators those workers are supporting now? A definitive census is needed with plans that list actual (validated) numbers of ventilators that exist, how many will be added for surge capacity and how far it is possible to stretch clinical support capacity.

Maybe in their latest article, Powell and Birkhead can tell us which numbers are the real ones.

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