ArticleMMWR. Morbidity and mortality weekly report2021
Impact of Hospital Strain on Excess Deaths During the COVID-19 Pandemic - United States, July 2020-July 2021.
Article in MMWR. Morbidity and mortality weekly report, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 88 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
88 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Meta-analysis: percutaneous versus surgical VA-ECMO decannulation demonstrates no clear differences in most outcomes, with a signal toward lower infection.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2026Pooled it
- A systematic review and meta-analysis, investigating dose and time of fluvoxamine treatment efficacy for COVID-19 clinical deterioration, death, and Long-COVID complications.Scientific reports · 2024Pooled it
- Efficacy of SARS-CoV-2 vaccines and the dose-response relationship with three major antibodies: a systematic review and meta-analysis of randomised controlled trials.The Lancet. Microbe · 2023Pooled it
- Trial
- Remdesivir for the treatment of patients in hospital with COVID-19 in Canada: a randomized controlled trial.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022Trial
- Development and Validation of an Electronic Health Record-Derived Prediction Model for Preventing COVID-19 Hospitalization and Death.Prevention science : the official journal of the Society for Prevention Research · 2026Article
- The Overlap of Maternal and Neonatal Critical Care Admission in the United States: Trends and Risk Factors in 2016-2024.Journal of clinical medicine · 2026Article
- Mortality risk during the COVID-19 pandemic is shaped by human development.BMC global and public health · 2026Article
- Spatiotemporal and Demographic Patterns of West Nile Neuroinvasive Disease in Vojvodina, Serbia, 2012-2025.Viruses · 2026Article
- Reconstructing the incidence rate and immune fraction of the population via a single snapshot survey: A case study of COVID-19 in Japan.PLoS computational biology · 2026Article
- Robust COVID-19 Mortality Risk Assessment: Validation of a Two-Step Algorithm From the National COVID Cohort Collaborative.The Journal of infectious diseases · 2026Article
- Partisan differences in health behaviors can impact respiratory disease dynamics.medRxiv : the preprint server for health sciences · 2026Article
- Changes in life expectancy and life span equality during the COVID-19 epidemic in 2020-22 in Japan.PloS one · 2026Article
- Baseline medication profile and risk of CYP3A4 mediated drug-drug interactions among COVID-19 hospitalized patients in Spain.BMC infectious diseases · 2025Observational
- Demographic Analysis of Mortality Changes Associated With the COVID-19 Pandemic in Japan, 2020-2022.Influenza and other respiratory viruses · 2025Article
- Statewide Transfer Coordination and Patient Transfer Rates Among Hospitals During Occupancy Stress.JAMA network open · 2025Article
- Forecasting COVID-19 inpatient mortality using fundamental parameters in resource-constrained settings: a countrywide multi-center cohort study.BMC infectious diseases · 2025Article
- Improving containment and prevention strategies using a patient transfer network representative of patients with multidrug-resistant organisms.Infection control and hospital epidemiology · 2025Article
- The Need to Incorporate Post-Acute Care Entities Into the National Disaster Medical System.Journal of the American College of Emergency Physicians open · 2025Review
- Temporal Trends in Pulmonary Embolism Mortality Associated with COVID-19 in the United States: A 5-Year Retrospective Analysis.The International journal of angiology : official publication of the International College of Angiology, Inc · 2025Article
28 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Surges in COVID-19 cases have stressed hospital systems, negatively affected health care and public health infrastructures, and degraded national critical functions (1,2). Resource limitations, such as available hospital space, staffing, and supplies led some facilities to adopt crisis standards of care, the most extreme operating condition for hospitals, in which the focus of medical decision-making shifted from achieving the best outcomes for individual patients to addressing the immediate care needs of larger groups of patients (3). When hospitals deviated from conventional standards of care, many preventive and elective procedures were suspended, leading to the progression of serious conditions among some persons who would have benefitted from earlier diagnosis and intervention (4). During March-May 2020, U.S. emergency department visits declined by 23% for heart attacks, 20% for strokes, and 10% for diabetic emergencies (5). The Cybersecurity & Infrastructure Security Agency (CISA) COVID Task Force* examined the relationship between hospital strain and excess deaths during July 4, 2020-July 10, 2021, to assess the impact of COVID-19 surges on hospital system operations and potential effects on other critical infrastructure sectors and national critical functions. The study period included the months during which the highly transmissible SARS-CoV-2 B.1.617.2 (Delta) variant became predominant in the United States.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.