The deaths from a hantavirus outbreak on a cruise ship have set off an international scramble over the past month to trace hundreds of passengers. But the question we should be asking is not whether the hantavirus outbreak becomes the next pandemic. It is whether hospitals could be better prepared than they were in 2020 when COVID-19 struck. The answer, right now, is no.
During the height of the pandemic, more than 15,000 deaths from COVID could have been prevented in April 2020 if those patients had access to an ICU bed. Those beds existed. The patients were simply in the wrong hospital, invisible to the facilities drowning in patients nearby. And the tools to fix that invisibility already existed, too.
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This problem is known as load imbalance: different hospitals in a region simultaneously at overcapacity and undercapacity with no systems to match patients to available resources. From July 2020 to March 2022, more than half of the 290 hospital referral regions analyzed experienced at least one week of load imbalance. In January 2022, three Houston hospitals were overwhelmed while 23 others in the same region had capacity to spare.
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Why did this happen? Inadequate federal guidance. Hospitals were required to transmit data about dwindling resources to federal authorities only once a week, leaving governments and hospitals without the real-time information needed to direct patients to the appropriate sites. Patients paid the price, and the burden did not fall equally. Rural communities, black patients, lower-income residents, and those with chronic conditions suffered the worst of it.
The system failed due to the lack of incentives for coordination, information, and the analytical tools to act. Understandably, hospitals overwhelmed with emergency cases transmitted only the data required.
The fix is straightforward: Congress should require hospitals to share real-time data on ICU bed availability and maintain pre-planned regional transfer strategies so that when any facility nears capacity, the surrounding system responds. Health systems can then accurately anticipate demand, direct patient flow, and redistribute critical resources to avoid overwhelming individual hospitals
Congress now has a concrete vehicle to make this happen. Reps. Jay Obernolte (R-CA) and Debbie Dingell (D-MI) have introduced the ICU Bed Act, which would require Medicare-participating hospitals to join a regional, real-time data-sharing system and maintain patient transfer strategies. The Department of Health and Human Services would define the regions based on geography, population, and travel time. All data shared would be de-identified, with no mandatory reporting to the Centers for Medicare & Medicaid Services, the Centers for Disease Control and Prevention, or any other federal agency. This is a locally controlled solution, not a federal surveillance mandate.
This bipartisan legislation reflects Obernolte and Dingell’s unique expertise and credibility in technology, data infrastructure, and health policy. At a time of extreme partisanship, these members should be celebrated for their willingness to work together to save lives.
The legislation is also a fiscally responsible solution because the system it requires can also improve internal efficiency. GE HealthCare’s Oregon statewide capacity system saved an estimated $3 million by automating 45,000 hours of manual data entry. The Queen’s Health Systems in Hawaii reported $20 million in savings using its command center strategy to better manage capacity, length of stay, and reduce patient boarding in the emergency department. Tampa General Hospital attributed $40 million in savings to reduced length of stay and fewer emergency room diversions through its CareComm system.
Hospitals also need not pay alone: The bill explicitly authorizes federal Hospital Preparedness Program grants for this purpose and extends the preparedness funding through 2031.
The hantavirus outbreak may remain contained, but it sends a warning we cannot afford to ignore.
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When the next health emergency occurs, will regional ICU bed capacity be strategically leveraged to save lives, or will it remain siloed and unavailable?
As Congress takes up reauthorization of the Pandemic and All-Hazards Preparedness Act, it has a ready-made opportunity to embed these requirements into law. The ICU Bed Act is bipartisan and proven to work. The next health crisis will not wait, and neither should Congress. Lives depend on it.
Regina E. Herzlinger is a professor of business administration at Harvard Business School and a pioneer in consumer-driven healthcare. Her research on ICU bed availability and hospital transparency has been published in Health Affairs and the Harvard Business Review.
