Infectious Disease Specialists Nonexistent in 80% of U.S. Counties

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Health Editor’s Note: The U.S. sorely lacks in numbers of infectious disease specialists.  With the coronavirus pandemic, the ability to address this easily spread virus with more infectious disease specialists would have increased infectious disease intervention which would be reflected in positive improvement in outcomes, which includes lower numbers of deaths and shorten length of hospital stay, which produces lower health care spending. Eighty % of the U.S., nearly two thirds of Americans, live in areas (mostly rural) with below-average or no infectious disease physician access….Carol

Where Is the ID (infectious disease) in COVID-19?

Annals of Internal Medicine

Author, Article and Disclosure Information

https://doi.org/10.7326/M20-2684

 

Background: The coronavirus disease 2019 (COVID-19) pandemic has challenged all of medicine. However, in recent weeks, the nation’s need for more infectious disease (ID) expertise has become a clear focal point. As the virus swept across the country, distress over constraints—tests, swabs, personal protective equipment, and ventilators—dominated the discussion. There is more to the story.

Objective: To examine how the distribution of ID specialists matches the needs of the COVID-19 pandemic across the United States.

Methods: We determined county-level ID physician densities—the number of ID physicians per 100 000 persons—by using 2017 Medicare Provider Utilization and Payment Data (3). We calculated the U.S. national average of ID physician density, assigning each county to 1 of 3 categories: ID physician density above the national average, ID physician density below the national average, and no ID physicians.

Findings: In 2017, the national average density was 1.76 ID physicians per 100 000 persons; the distribution is geographically skewed (Figure 1). Of the 3142 U.S. counties, 331 (10.5%) and 312 (9.9%) have above- and below-average ID physician densities, respectively; 2499 counties (79.5%) do not have a single ID physician. Therefore, 208 million citizens live in counties with no or below-average ID physician coverage.

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