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U.S. field hospitals stand down, most without treating any Covid-19 patients

344 points by hhs 7y ago

deleted 7y ago
[deleted]
krallja 7y ago
The good news: we flattened the curve enough that most of these field hospitals weren’t needed. The bad news: bureaucracy and mismanagement prevented hospitals who did need more space from using them. The awful news: NY recommended people to stay home from the hospital even if they needed care, probably causing extra deaths and complications.
- IG_Semmelweiss 7y ago
  ER admissions are down 50% or more depending in county. People did not magically recover from heart conditions during lockdown Those people died, or skipped on critical treatment that would have made their condition improve. One cannot help but wonder if those missing people are going to be swept under the COVID rug... Meanwhile, field hospitals sit empty...
  - lurquer 7y ago
    >ER admissions are down 50% or more depending in county. This isn't as significant as you might think... There is a large (very large in some communities) percentage of ER visits that aren't for real emergencies; rather, they are used for routine stuff, for which people with good insurance would go to their pediatrician or Urgent Care Clinic. If you are broke, have crappy or no insurance, and can't afford a scrip of antibiotics, when your kid gets a fever or sore throat, you go to the ER. That's routine for -- I would bet -- hundreds of thousands of people throughout the year.
    - taurath 7y ago
      OTOH, if I have a really nasty cold which doesn't share symptoms of coronavirus, I am absolutely NOT going to the ER or urgent care even though I normally would. The urgent care center near my house is full hazmat suits and a tent outside to do front line covid screening. I think the effect you're describing does exist, but its certainly not the whole story. The fact is as well there's PLENTY of actual data available on this so we need not even be extrapolating based on our assumptions. The problem is any data that doesn't line up with our assumptions gets discarded because we don't know which datasets are good and reliable.
      - neversmiling 7y ago
        "I am absolutely NOT going to the ER or urgent care even though I normally would" That's a very dangerous assumption to make. Most hospitals in US are not overwhelmed. People should not be scared to receive necessary healthcare. The public messaging from authorities (and the media) should reflect that. At the very least, contact ER or urgent care (or better yet, your primary care physician if you have one), and follow their direction.
        deleted 7y ago
        [deleted]
    - _-___________-_ 7y ago
      As far as I've seen, this is only routine in the USA. Everywhere else, people would go to their GP for this sort of thing.
- deedub 7y ago
  The awful news - This isn't just NY. This is around me too, where our hospitals have been damn near completely empty with next to 0 infections. I know very specifically of one death where the individual was told to stay home vs going into the empty hospital. He eventually got to the hospital, but it was too late.
- malandrew 7y ago
  I'm unsure why IG_Semmelweiss sibling comment is dead and why I can't vouch or reply to it, but even NPR is reporting on the exact same phenomena: https://www.npr.org/sections/health-shots/2020/05/06/850454989/eerie-emptiness-of-ers-worries-doctors-where-are-the-heart-attacks-and-strokes https://www.npr.org/sections/health-shots/2020/05/06/8504549... This concerns me because my dad has congestive heart failure and can't get proper medical support right now. What we should be doing is segregating hospitals, keeping some focused on COVID and others focused on non-COVID medical emergencies.
  - djsumdog 7y ago
    I've heard of some people getting stuff scheduled way out at suburban hospitals, often out of network, and clearing out their health savings accounts to get essential surgery. That's fucked up.
  - the-dude 7y ago
    Click the timestamp.
    - malandrew 7y ago
      That's what I did. Vouch didn't work nor was there a reply link.
      - zaroth 7y ago
        Just worked for me.
  - carapace 7y ago
    I just downvoted that comment because it opens with a fact (as reported by some news agencies): > ER admissions are down 50% or more depending in county. But then spins it into some kind of conspiracy BS: > ...missing people... ...swept under the COVID rug...
- djsumdog 7y ago
  The great irony is that, in trying to prevent hospitals from being overwhelmed leading to unnecessary deaths, we cleared out hospitals too soon, to prepare for a surge that never happened, and lead some people to unnecessary suffering and maybe death. People without jobs had to get surgery now, before their CORBA ran out.
- lostlogin 7y ago
  I can’t tell if you are joking - that NY curve was one of the least flat curves achieved anywhere. What am I missing?
  - pensatoio 7y ago
    The point isn’t that the curve didn’t exist or that it’s relative magnitude wasn’t higher in some cities. The point is that hospitals generally weren’t overrun, therefore, the measures we took effectively flattened the curve enough that all these overflow medical resources weren’t put to use.
    - ryankemper 7y ago
      And yet, a large part of the reason we weren't overrun is because our initial estimates of hospital beds and ventilators needed were far too high on a per-infected-person basis. So yes, we definitely cut down transmission, but it's not clear that we would have incurred excess deaths due to capacity overrun. The biggest botteleneck is the presence of people on invasive ventilation; other clinical outcomes result in either the individual dying quite quickly (imagine a nursing home patient with multiple comorbidities), or in the patient recovering in 1-2 weeks. But there's that uncanny valley of people healthy enough to not immediately die but in bad enough shape that they need these aggressive interventions. This is a big part of why I think we could have exposed much more people to the virus with only marginal increase in hospitalizations, by encouraging those who are not at risk to live as normally. It also makes it easier to centralize the resources where you do need it. For example it's much more feasible for government programs to handle food delivery, grocery delivery, and all these other logistical concerns when you only need to provide it for 10-40% of the country as opposed to 80% of it. Serology in NY has shown us that we have maybe 1/8 of the population with antibodies as of a few weeks ago, which does mean that there was room for another doubling or too before transmission started naturally slowing down to a noticeable extent. So we absolutely could have had a lot more patient volume, but again the # of hospitalizations/invasive ventilation cases is much more related to the # of vulnerable people infected as opposed to the number overall. (The classic argument here is that by fighting transmission in all members of the population, that the at-risk are better protected. For a number of reasons I think such an approach is misguided but I won't go into the full argument against that here)
pwinnski 7y ago
This is great news! "Shelter in place" orders flattened the curve as was predicted and as we hoped. We were ready (mostly) for the worst case, and people complying with these orders meant we never hit it. Next up, I hope we don't end up needing these field hospitals because of states re-opening things too soon.
- SketchySeaBeast 7y ago
  That's going to be the biggest challenge here - how do we transition from acute to chronic care of this pandemic. I hope someone is creating lessons learned and new operating plans for all this stuff so that they can react efficiently over the coming months and years to pocket outbreaks which are sure to occur.
  - vorpalhex 7y ago
    > pocket outbreaks which are sure to occur We don't know that, as weird as that sounds. We have no idea if there's significant or lasting immunity from having it, whether it's seasonal like the flu, or what the longterm behavior of the virus and it's likelihood to evolve is. Which makes having longterm plans very difficult because we don't know what we should be planning for.
    - SketchySeaBeast 7y ago
      There's still areas all over the world which have not been hit too badly solely by luck - for instance, here in Alberta Calgary has been hit with an order of magnitude more cases than Edmonton without a great reason why. Regardless of the potential of immunity, these lightly hit areas are still open for initial infection and community outbreaks. I can't see why they wouldn't occur - on a long enough timeline luck just runs out.
    - dehrmann 7y ago
      > likelihood to evolve We also don't know how lockdowns caused it to evolve.
someonehere 7y ago
I have a really good friend who works for one of the bigger hospital networks in Michigan. He says they are fortunate to have jobs because even though their hospitals are all empty. He told me staff isn’t being let go or furloughed for now but the staff spends their shift walking around and cleaning things. Even without rooms and equipment being used. Just to stay busy.
- djsumdog 7y ago
  There are a number of people who didn't get the care they needed because surgeries for critical things like removing rotting teeth or even some heart surgery were marked as non-critical. They should have kept hospitals running, reprioritized their current schedules, and started cancelling once they saw the influx. The way this was executed was terrible. The whole point was that hospitals didn't get overloaded so people with critical needs can get treated. It's the absolute definition of irony that cancelling everything had the exact same effect.
  - ceejayoz 7y ago
    > cancelling once they saw the influx Incubation periods and exponential growth mean by the time you see the influx, it's potentially already too late to avoid becoming overwhelmed.
    - djsumdog 7y ago
      The priorities all major surgeries and try to work with patients to push off the ones in terms of severity. That way hospital could at least keep taking people. If they have to cancel everyone in a week; that's still better than not taking anything at all right now (and being overloaded this/next months as everyone comes in needing things)
- eiji 7y ago
  My wife is an operating room circulating nurse at Beaumont in Michigan (Metro Detroit). Lots of people without the title of nurse (RN) are furloughed or laid off. Entire hospitals are closed and covid19 patients transferred to other hospitals. Cleaning and supporting staff has been cut down to bare minimums to save costs. She is being sent home early most days due to low volume, impacting her pay too. She worked covid19 ER shifts receiving walk in patients coughing like hell. That dried up a month ago and she had the choice to stay home or work night shifts on the floor medicating and caring exclusively for covid19 patience. So she did night shifts for two weeks. Now she is back on her regular position, underemployed. She laughed about the field hospitals. Now, here in Michigan, we are all, including Nurses and hospitals, sitting around most of the day doing nothing and waiting for some miracle. There was never a capacity issue she knows of. Only shortages of PPE.
bwb 7y ago
Please don't shut these down, we might need them eventually. This is only inning 1 of the next 2 to 3 years.
- Jommi 7y ago
  Well not sure hurting them down is the only other option anyways. Tho 2-3 years sounds way overexaggerating
  - buzzkillington 7y ago
    The fastest projections for a vaccine I've read are 15 months to 'never'. When the economy reopens and people go back to work we will see a second wave of infections. Unless you think that we can continue dealing with a 20% unemployment rate.
  - bwb 7y ago
    I am curious, where do you think Covid is going to go :)? Social distancing will get us to less than R1, but then once we open back up it looks like it will grow past R1. It is going to be here until we get a vaccine or herd immunity.
    - Jommi 7y ago
      Do you mean where the virus is going to go, or where this situation will go? Yes, most likely it will not get burnt out in the US until we have vaccine, herd immunity or the 3rd option, which is coalition/state/county level containment. My comment reflected on the subject of these emergency field hospitals. Its A) not efficient to keep these up for the time being B) its unlikely we will be caught underestimating the virus the 2nd/3rd/xth time around. And something else to just reiterate. There are multiple steps between "keeping the field hospitals operational" and "shutting them down". Just like there are multiple steps between "social distancing" and "opening back up". :)
      - bwb 7y ago
        Gotcha. I was worried you thought Covid might just disappear or something magically :) Efficiency is not always the goal in situations like this. It might be wiser for them to be inefficient but prepared, and keep the hospitals up and running. Especially if they have to nationalize the entire health care system to prevent a collapse (even if its temporary).
jefftk 7y ago
The article is presenting this as some sort of scandal, that we spent a lot of money to urgently build things that we didn't end up needing. This way of thinking about things is why we are generally not well prepared for unlikely disasters: most work you put in will not be needed. Instead we should see this as really positive: we were working to make sure that if stay-at-home (which has cost far more than $600M) didn't work we would have space to treat people, and then we kept the infections low enough that we didn't need to use it.
- mc32 7y ago
  Right? Moreover they were lamenting that CN was building prefab hospitals in 10 days .. and we were unable to do that and that would leave us with a bed shortage...
- Consultant32452 7y ago
  I watched most of the Coronavirus Task Force briefings. Several times Trump suggested Dr. Birx was telling him that these things would not be needed. And she confirmed that she felt they weren't going to be necessary. So it appears the scientists/experts knew it wasn't necessary from a medical standpoint. One could argue whether or not it was politically/emotionally necessary. Edit: you can see from several posts here that building these things really did bring a lot of emotional comfort to people, which is an important part of dealing with a crisis. People really underestimate psychology in an emergency.
  - ceejayoz 7y ago
    Trump suggests all sorts of things, often directly contradictory, or contradicted shortly thereafter by his own experts. I'm not sure why you'd put any stock in those suggestions at this point.
    - Consultant32452 7y ago
      The expert in question was about 4 feet away from him and confirmed what he said immediately, and repeatedly.
sandworm101 7y ago
So I saw, am still seeing, all the doctors and nurses in NYC pleading for help. But there were thousands of empty covid-specific beds open in that state. Why where they not sending patients to these field hospitals? Is this about money? Would private hospitals loose out on payments if they transfered patients? I feel sorry for the frontline workers in NYC, but I don't know how to reconcile knowledge that there were open covid-specific beds availible just down the road.
- DanBC 7y ago
  .
  - sandworm101 7y ago
    >> "It was very disappointing," Gonzalez said. "Everybody was here, ready to work, ready to get patients in." Many of these hospitals treated literally zero patients. Hospitals weren't overwealmed by people in care homes. They were overwealmed by people in the hospital. I don't see why some subset of those patients couldn't have been shipped to these field hospitals. NY was asking for volunteers to come from all over the country to relieve their struggling hospital system. But there were federal hospitals standing idle a short drive away? Why weren't they loading the not-yet-crititcal patients into busses and taking them to Stony Brook (capacity 1038, patients treated 0)?
    - easytiger 7y ago
      The field hospital concept to increase capacity to reduce deaths was based on, in the UK, the Imperial paper which was based on, frankly a non realistic interpretation of the input data from China and Italy. Meaningless admission/overadmission rates which are clearly vastly wrong/misinterpreted and in turn based on a huge percentage of over 75s being hospitalised and a majority of them in turn needing ventilation. Except in reality patients of that age are rarely ventilated because they wouldn't survive such an invasive treatment and if they are the recovery is 6-8 months and long and painful and has poor recovery outcomes. That predicate was wrong in the paper. Secondly the field hospitals built could only receive patients who had no other underlying or exacerbating conditions because the FHs lack the staff and equipment to care for them. Given that practically every person who died from a respiratory covid infection had such issues it rendered them fairly pointless. The paper also didn't do much to deal with the fact this activity will cause a surge in deaths of non covid related fatalities. Whole other issue
ashtonkem 7y ago
Building a field hospital for a pandemic and not needing it is literally dead last in my list of wasteful government expenditures to be angry about. The rationale that lead to making the hospital was incredibly clear, and that we didn’t need said hospital is a source of relief more than anything else.
- jliptzin 7y ago
  Yea it’s like buying a fire extinguisher and then being mad that you never had to use it
  - calvinmorrison 7y ago
    I think people are more upset with the fact that they are unemployed and their states are locked down. The initial request from my governor was "2 weeks to flatten the curve". After two months, and hearing we never reached near capacity, and our local emergency hospital is also winding down, why are we still closed? Now we're told it could until June
    - ashtonkem 7y ago
      Because the metrics for “we don’t need this emergency hospital” and “the epidemic is beginning to burn out” are different.
      - jaywalk 7y ago
        But the whole point of the lockdowns was to "flatten the curve" meaning to prevent the hospitals from becoming overwhelmed. That's been done.
        ashtonkem 7y ago
        The risk of a second wave is still known, and cases are still rising in quite a few states.
dv_dt 7y ago
The Navy hospital ship in LA was planned as a reserve for serious non-covid cases. I think because of the early statewide action we didn't need it, but better to plan reserves than to fall short. In any large complex system, you can't necessarily predict the bottlenecks, but if you want the system to guarantee a high capacity to handle issues, you need to broadly overresrouce the initial layout (esp if the resources take time to line up). This means by definition - even a good plan will have idle resources somewhere.
abduhl 7y ago
I’m sorry, but is anyone else getting a real “this is good for bitcoin” vibe from the comments here? It seems we are all attributing this to a successful lockdown rather than considering other scenarios. It feels very “rock that wards off tiger”-y to me.
- brlewis 7y ago
  A curve was trending exponential, and flattened with lockdown. What's the alternate scenario for what caused the curve to flatten?
  - pbhjpbhj 7y ago
    A possible alternative - and I'm categorically not saying this is true, not even likely - is that Covid19 is more infectious, and more widely infected people. But, that fewer people were susceptible, so there would be more asymptomatic carriers but fewer people hospitalised. If a virus runs out of people to infect then it will peak. You can prove that scenario wrong by testing (if number of 'already infected' is relatively low then this hypothesis would be wrong and the risk of further peaks is higher; I don't have enough data to attempt to disprove such a hypothesis.
    - lbeltrame 7y ago
      This is what (reliable, and I repeat reliable) serological testing might tell us.
  - deathgrips 7y ago
    We raised testing capacity exponentially, but weren't accurately tracking the spread until recently.
  - deleted 7y ago
    [deleted]
  - downshun 7y ago
    Wrong assumptions/data/conclusions from the epidemic model Misattribution of cause
outside1234 7y ago
So, in other words, we were successful in preventing this from becoming a disaster.
- djsumdog 7y ago
  or .. the numbers were wrong and we never needed half these facilities, or to bring the world economy to a grinding halt. Our European counterparts are probably fine, but low-income Americans have lost a lot.. more than we can repay.
  - jhwang5 7y ago
    exactly. they panic hired a bunch of contractors with no real operating plan on how to utilize them, and now taxpayers are footing the bill for the contracting company CEO's third mansion.
  - Delmania 7y ago
    No, that's not what the article says. It says there was no planning or coordination between the hospitals and the field hospitals to get patients in.
  - ilikehurdles 7y ago
    Which numbers were wrong, and when? You can actually see a leveling off of the deaths and hospitalizations in CO within the 2 weeks following the initial stay-at-home order. I would take any numbers regarding "infections" with a grain of salt because those are so susceptible to the number of people able and willing to get tested, and how those test results are reported back up to the state. Every state seems to have differences in that approach.
  - esoterica 7y ago
    The lockdown isn't causing the economic crisis, the pandemic is. The economy would grind to a halt anyway without lockdown measures if the pandemic were spreading unchecked and a million [1] people were dying in the space of a few months. Everyone would be barricading themselves in their homes and not going out to restaurants and movie theaters. [1] (70% infected to get herd immunity * 0.5% fatality rate * 330 million people = >1 million people).
jariel 7y ago
100 temporary beds for $100M dollars cost to the government. Oh that makes so much sense.
- kevin_thibedeau 7y ago
  Wait until they start fighting over free antibody testing.
- kindatrue 7y ago
  Just wait until you look at defense department contractor rates.
  - rwmurrayVT 7y ago
    The CLIN rates on contracts like Seaport-e/NxG are not extremely high. I would agree that AECOM made out like a bandit on their field hospital contracts.
- simonh 7y ago
  I knew there's be at least one. A similar thing happened here in the UK, we converted an exhibition centre (actually several in different cities) into Covid facilities. In the end we only used a few hundred beds and soon shut them down. What made the difference wasnt that we already had enough beds, but that other mitigating contingencies such as converting other smaller facilities into emergency hospitals happened fast enough, and moving patients out to less heavily hit areas softened the crunch more than anticipated. I don't think preparing these extra facilities was a mistake at all. There are tons of unknowns and random variables in the progression of an epidemic, if we had needed those beds and din't have them more people would have died, possibly a lot of people. Complaining about waste is exactly like complaining about there being any empty beds in any hospital at any time. We plan for peak demand, including contingencies which may never come. It's like complaining that the military have any soldiers at all that never shot at an enemy, or bullets that never killed anyone. If we'd gone through the epidemic and there hadn't been any spare capacity, we'd used exactly as many beds as we had, that would have been bad preparation.
s_y_n_t_a_x 7y ago
Wow, those prices are staggering. Taxpayer money wasted on a knee-jerk reaction by an emotional governor. Glad he didn't get the 30k ventilators he wanted as well. edit: Many people told him he didn't need that many before the fact. I think it's perfectly fine to be critical of a governor if we're critical of our president. A leader should have some sort of vision into the future.
- nojito 7y ago
  Hindsight is 20/20. It's easy to make criticisms like this after the fact... However, no one knew if the shelter in place order would even work.
- ilikehurdles 7y ago
  One development that the medical community discovered later on was that putting patients on the ventilator increased their mortality rate, and they moved toward treating patients as long as possible without relying on a ventilator. See: https://www.modernhealthcare.com/safety-quality/some-doctors-moving-away-ventilators-virus-patients https://www.modernhealthcare.com/safety-quality/some-doctors... This information simply didn't exist and was highly hypothetical at the time ventilators were being requested.
- projektfu 7y ago
  We have spent 1/10000 of the money spent on this crisis for field hospitals.
  - s_y_n_t_a_x 7y ago
    Don't worry, I'm not thrilled how the rest of it was spent either. Doesn't mean I can't take issue with this. That 1/10000th of the budget could have went to nursing homes or other critical areas. No matter how much a trillion is, several hundred million dollars is still a lot of money...
nojito 7y ago
Field Hospitals are designed for Trauma patients. They were never designed to handle infectious disease case loads. The plan was to help take on non-covid case load from primary hospitals in the region that they were deployed to.
- ilikehurdles 7y ago
  Surprised to see this comment come so late. It's true. The regular hospitals were hotbeds for covid infections, so it made sense to keep the non-covid patients as separate as possible from the covid ones. Hence, the field hospitals. It would be terrible to come into the hospital with a broken bone and come out of it with the virus. It makes sense to avoid transporting infected patients whenever possible because it could lead to a new outbreak in a different location.
  - lastres0rt 7y ago
    The kicker is that in order to be transferred to the non-covid hospitals, you still had to be TESTED for covid and come up negative. THAT'S why these hospitals were all empty in the first place. It all comes back to what a shitshow testing is in this country.
xiphias2 7y ago
These beds look just plain ugly and too small for relaxation that is needed for healing when somebody's sick. I'm extra scared about the virus, because I know that I would get to a place like this, and I don't have the confidence that I would get the right treatment. I have heared of other people as well who would rather stay at home as much as they can, even if they can't breathe well. But then when somebody needs the ICU, he really needs it fast, and at that time it's too late to go to hospital.
kindatrue 7y ago
Something the article doesn't do a great job of covering is how overall emergency medical incidents went way down more than expected - which is what some of these field hospitals (and the Navy ships) were for. The head of a local hospital network has tweeted wondering where all the heart attack and stroke patients went - both in my lightly impacted region and in disaster NYC. Did the rate go down? Or did people just die at home afraid to go to the hospital? In SF in normal times, over 50% of trauma cases are from car accidents. My completely unscientific theory is that commuting/traffic is way more stressful and physically taxing than people think. https://www.sfexaminer.com/news/half-of-injuries-treated-at-sf-general-hospital-are-from-traffic-collisions/ https://www.sfexaminer.com/news/half-of-injuries-treated-at-...
- easytiger 7y ago
  > Or did people just die at home afraid to go to the hospital? Probably yes. In the UK there is a significant surge in non covid related deaths above historical stats. Bear in mind also the definition of a covid 19 related death is, err, generous in the first place https://www.spectator.co.uk/article/non-covid-deaths-are-also-surging https://www.spectator.co.uk/article/non-covid-deaths-are-als...
  - thebruce87m 7y ago
    Not saying you’re wrong, I do think there would be some of that but I am looking at a way to quantify it, especially since my friend is convinced that the lockdown is worse than the virus. Here is something I found interesting: Spain has a “hard lockdown” too. Their excess mortality has returned to a normal level according to momo: https://www.euromomo.eu/graphs-and-maps/ https://www.euromomo.eu/graphs-and-maps/ Now I realise that some people that would normally die are not (car accidents etc), but at the same time if the lockdown itself was causing significant mortality you wouldn’t expect the excess mortality to drop to normal levels, would you? You would expect a small offset from 0 unless the savings from car crashes are exactly the same compared to “lockdown deaths” - and if they are, and the lockdown is saving “extra” lives then is it not still worth it? We have to wait and see for England to see if it falls back to normal or below normal levels.
Ididntdothis 7y ago
I think it’s pretty clear that a lot of things have been going wrong in this effort and there was probably a lot of waste. This is to be expected when it’s required to act quickly with lack of good data. I only hope the political systems will allow a serious retrospective of the measures and learning from that. I am very afraid that the partisans and conspiracy theorists will take over soon and no rational decisions for the future will be made so we will stay unprepared for the next pandemic.
narogab 7y ago
I told you so, I told you so, I told you so: \https://news.ycombinator.com/threads?id=narogab https://news.ycombinator.com/threads?id=narogab In that discussion I somehow lost whatever karma I had on this BB. Despite being polite and reasonable I was blasted into oblivion by some jerk(s). But with my now (-2) karma I am not above being jerky myself by pointing out that I was right, crooked-v was wrong, and any "field hospitals" the US Army made would indeed be, as I stated then, _field_ _hospitals_ and nothing like what "crooked-v" (https://news.ycombinator.com/user?id=crooked-v https://news.ycombinator.com/user?id=crooked-v ) envisioned: "Making these spaces fit the physical needs of these hospitals (massive power requirements for equipment, hallways and elevators with certain amounts of clearance for transporting patients, extremely well-controlled ventilation systems, sanitizable surfaces everywhere, rooms laid out with central access for doctors and nurses) would take so much time and effort that it would be more money- and time-efficient to build new buildings with the expertise of a group practiced in building new, reasonably high-quality buildings as fast as possible... like, say, the Army...These need to be modern hospitals, not 19th-century sanitariums where patients just get dumped into a bed and left to die or recover on their own." - crooked-v, being wrong, wrong, wrong - narogab, being a jerk and an asshole (but almost always, a _correct asshole).[God, it feels good to let go of that knife].
mensetmanusman 7y ago
Fear of covid killing more than covid? Happening in Australia apparently. Sociologists are learning a lot from this situation
- xoxoy 7y ago
  It’s governments overreacting not the people. I haven’t met a single person who is actually “scared.”
  - folkhack 7y ago
    I'm higher-risk due to past lung disease and have been taking this incredibly seriously due to not wanting to go through pneumonia again. I've been taking the social distancing stuff seriously, wearing a mask every time I go out, and have taken steps to get deliveries when I can to ensure I maximize the time at home. The sky's not falling but I am a bit "scared" as you put it.
  - brenden2 7y ago
    Scroll through /r/coronavirus if you want to see what how scared many people are.
  - gtaylor 7y ago
    Hello. I'm Greg and I'm scared. Well met.
  - alistairSH 7y ago
    :raises hand: I'm scared. Not enough to be curled in a ball in the corner, but enough to be taking social distancing seriously. My wife has medical history that puts her at higher risk, plus she's in her 50s (and me in my 40s) so we're both at slightly higher risk just based on age.
  - astronautjones 7y ago
    People should be scared. This isn't over, and this idiotic preemptive celebration/busines reopening is going to render a lot of our sacrifices in vain.
yufeng66 7y ago
The idea of field hospital is to move non covid related patients to the file hospitals and let the regular hospital to be covid only. This way there is much smaller chance to get covid while getting routine medical care. Reliable source told me medical facility utilization rates aredown more than 50% in non covid hot spot area. People are simply deferring non emergency medical service. They are also not so sure if they need to quarantine non symptomatic covid case away from home, like china did. So the field hospitals are built as an option if needed.
- taurath 7y ago
  Its not that people are deferring medical service, they are being deferred. I have a friend who needs brain surgery to remove a cancerous tumor, and its deferred until non-emergency surgeries can open up.
  - sjg007 7y ago
    Weird, cancerous brain tumor should be an emergency one would think.
  - astronautjones 7y ago
    Lots of people that just lost their jobs & insurance (and can't afford COBRA) are deferring medical service.
jijji 7y ago
After speaking with a few doctors who worked setting up these hospitals, it was almost like a parade or a show rather than anything serious. The doctors who worked there were ready to take on the patients, but the decisions came from the top not to allow it to happen...
RobLach 7y ago
Great use of money and commendations across the board to the Army Corp of Engineers who put this together so quickly. $690m is bargain for putting a ceiling on the situations these would have been necessary for.
ridewinter 7y ago
It's incredible the amount of unknowns even at this point in the epidemic. Anyone who claims to understand what's going on is just frontin. That's my big takeaway so far.
solarengineer 7y ago
“ The plan was for the Javits Center to take patients from overwhelmed hospitals in the city. But in practice it wasn't that easy. Some hospitals complained that the intake process was too complicated. And they sent few patients to Javits — even as they resorted to treating patients in the hallways” What does it mean for an intake process to be complicated? Isn’t it straight forward like loading the patient + printouts of medical records into an ambulance, driving to the new place, and then transferring them into a bed?
mleonhard 7y ago
I'm happy about this.
jpollock 7y ago
A late reaction typically requires overcompensation and wasted resources because you don't have sufficient positive control to tell where things are headed. That leads to overcorrection and lots of cost.
tehjoker 7y ago
I guess it's true that hospital utilization for non-COVID cases declined, but in NYC hospitals, they were still stuffing people in the hallways while these sites idled. Is that not a scandal? Some contractors made a lot of money building these sites. Did the people building them know before-hand that they didn't fulfill the list of features for actual utilization when they signed the contracts that were evaluated under an accelerated, non-competitive review? I don't want to diminish the efforts of the people that built these sites and stood ready to treat patients. That's heroic. My skepticism is aimed at the bosses.
urda 7y ago
Yeah I'm totally OK with this. Medical facilities aren't exactly "autoscale", and by the time you change your mind it's already too late. It's great to hear they weren't used heavily. It was great that they were set up too.
mydongle 7y ago
Does this mean we won't get anymore nurse tiktok videos? That was money well spent.
acokeaday 7y ago
Biggest scam in the history of the world! And like good little sheep we fell and are still falling for this bullshit!!! For a country that supposedly holds personal freedom in high esteem... it’s so fucking pitiful the powers that be must be laughing all the way to their new powers and wealth, almost disappointed how easy it was.
mirimir 7y ago
FYI: https://www.wbur.org/npr/851712311/u-s-field-hospitals-stand-down-most-without-treating-any-covid-19-patients https://www.wbur.org/npr/851712311/u-s-field-hospitals-stand...

344 points by hhs 7y ago

deleted 7y ago

[deleted]

The good news: we flattened the curve enough that most of these field hospitals weren’t needed. The bad news: bureaucracy and mismanagement prevented hospitals who did need more space from using them. The awful news: NY recommended people to stay home from the hospital even if they needed care, probably causing extra deaths and complications.

IG_Semmelweiss 7y ago
ER admissions are down 50% or more depending in county. People did not magically recover from heart conditions during lockdown Those people died, or skipped on critical treatment that would have made their condition improve. One cannot help but wonder if those missing people are going to be swept under the COVID rug... Meanwhile, field hospitals sit empty...
- lurquer 7y ago
  >ER admissions are down 50% or more depending in county. This isn't as significant as you might think... There is a large (very large in some communities) percentage of ER visits that aren't for real emergencies; rather, they are used for routine stuff, for which people with good insurance would go to their pediatrician or Urgent Care Clinic. If you are broke, have crappy or no insurance, and can't afford a scrip of antibiotics, when your kid gets a fever or sore throat, you go to the ER. That's routine for -- I would bet -- hundreds of thousands of people throughout the year.
  - taurath 7y ago
    OTOH, if I have a really nasty cold which doesn't share symptoms of coronavirus, I am absolutely NOT going to the ER or urgent care even though I normally would. The urgent care center near my house is full hazmat suits and a tent outside to do front line covid screening. I think the effect you're describing does exist, but its certainly not the whole story. The fact is as well there's PLENTY of actual data available on this so we need not even be extrapolating based on our assumptions. The problem is any data that doesn't line up with our assumptions gets discarded because we don't know which datasets are good and reliable.
    - neversmiling 7y ago
      "I am absolutely NOT going to the ER or urgent care even though I normally would" That's a very dangerous assumption to make. Most hospitals in US are not overwhelmed. People should not be scared to receive necessary healthcare. The public messaging from authorities (and the media) should reflect that. At the very least, contact ER or urgent care (or better yet, your primary care physician if you have one), and follow their direction.
      - deleted 7y ago
        [deleted]
  - _-___________-_ 7y ago
    As far as I've seen, this is only routine in the USA. Everywhere else, people would go to their GP for this sort of thing.
deedub 7y ago
The awful news - This isn't just NY. This is around me too, where our hospitals have been damn near completely empty with next to 0 infections. I know very specifically of one death where the individual was told to stay home vs going into the empty hospital. He eventually got to the hospital, but it was too late.
malandrew 7y ago
I'm unsure why IG_Semmelweiss sibling comment is dead and why I can't vouch or reply to it, but even NPR is reporting on the exact same phenomena: https://www.npr.org/sections/health-shots/2020/05/06/850454989/eerie-emptiness-of-ers-worries-doctors-where-are-the-heart-attacks-and-strokes https://www.npr.org/sections/health-shots/2020/05/06/8504549... This concerns me because my dad has congestive heart failure and can't get proper medical support right now. What we should be doing is segregating hospitals, keeping some focused on COVID and others focused on non-COVID medical emergencies.
- djsumdog 7y ago
  I've heard of some people getting stuff scheduled way out at suburban hospitals, often out of network, and clearing out their health savings accounts to get essential surgery. That's fucked up.
- the-dude 7y ago
  Click the timestamp.
  - malandrew 7y ago
    That's what I did. Vouch didn't work nor was there a reply link.
    - zaroth 7y ago
      Just worked for me.
- carapace 7y ago
  I just downvoted that comment because it opens with a fact (as reported by some news agencies): > ER admissions are down 50% or more depending in county. But then spins it into some kind of conspiracy BS: > ...missing people... ...swept under the COVID rug...
djsumdog 7y ago
The great irony is that, in trying to prevent hospitals from being overwhelmed leading to unnecessary deaths, we cleared out hospitals too soon, to prepare for a surge that never happened, and lead some people to unnecessary suffering and maybe death. People without jobs had to get surgery now, before their CORBA ran out.
lostlogin 7y ago
I can’t tell if you are joking - that NY curve was one of the least flat curves achieved anywhere. What am I missing?
- pensatoio 7y ago
  The point isn’t that the curve didn’t exist or that it’s relative magnitude wasn’t higher in some cities. The point is that hospitals generally weren’t overrun, therefore, the measures we took effectively flattened the curve enough that all these overflow medical resources weren’t put to use.
  - ryankemper 7y ago
    And yet, a large part of the reason we weren't overrun is because our initial estimates of hospital beds and ventilators needed were far too high on a per-infected-person basis. So yes, we definitely cut down transmission, but it's not clear that we would have incurred excess deaths due to capacity overrun. The biggest botteleneck is the presence of people on invasive ventilation; other clinical outcomes result in either the individual dying quite quickly (imagine a nursing home patient with multiple comorbidities), or in the patient recovering in 1-2 weeks. But there's that uncanny valley of people healthy enough to not immediately die but in bad enough shape that they need these aggressive interventions. This is a big part of why I think we could have exposed much more people to the virus with only marginal increase in hospitalizations, by encouraging those who are not at risk to live as normally. It also makes it easier to centralize the resources where you do need it. For example it's much more feasible for government programs to handle food delivery, grocery delivery, and all these other logistical concerns when you only need to provide it for 10-40% of the country as opposed to 80% of it. Serology in NY has shown us that we have maybe 1/8 of the population with antibodies as of a few weeks ago, which does mean that there was room for another doubling or too before transmission started naturally slowing down to a noticeable extent. So we absolutely could have had a lot more patient volume, but again the # of hospitalizations/invasive ventilation cases is much more related to the # of vulnerable people infected as opposed to the number overall. (The classic argument here is that by fighting transmission in all members of the population, that the at-risk are better protected. For a number of reasons I think such an approach is misguided but I won't go into the full argument against that here)

pwinnski 7y ago

This is great news! "Shelter in place" orders flattened the curve as was predicted and as we hoped. We were ready (mostly) for the worst case, and people complying with these orders meant we never hit it. Next up, I hope we don't end up needing these field hospitals because of states re-opening things too soon.

SketchySeaBeast 7y ago
That's going to be the biggest challenge here - how do we transition from acute to chronic care of this pandemic. I hope someone is creating lessons learned and new operating plans for all this stuff so that they can react efficiently over the coming months and years to pocket outbreaks which are sure to occur.
- vorpalhex 7y ago
  > pocket outbreaks which are sure to occur We don't know that, as weird as that sounds. We have no idea if there's significant or lasting immunity from having it, whether it's seasonal like the flu, or what the longterm behavior of the virus and it's likelihood to evolve is. Which makes having longterm plans very difficult because we don't know what we should be planning for.
  - SketchySeaBeast 7y ago
    There's still areas all over the world which have not been hit too badly solely by luck - for instance, here in Alberta Calgary has been hit with an order of magnitude more cases than Edmonton without a great reason why. Regardless of the potential of immunity, these lightly hit areas are still open for initial infection and community outbreaks. I can't see why they wouldn't occur - on a long enough timeline luck just runs out.
  - dehrmann 7y ago
    > likelihood to evolve We also don't know how lockdowns caused it to evolve.

someonehere 7y ago

I have a really good friend who works for one of the bigger hospital networks in Michigan. He says they are fortunate to have jobs because even though their hospitals are all empty. He told me staff isn’t being let go or furloughed for now but the staff spends their shift walking around and cleaning things. Even without rooms and equipment being used. Just to stay busy.

djsumdog 7y ago
There are a number of people who didn't get the care they needed because surgeries for critical things like removing rotting teeth or even some heart surgery were marked as non-critical. They should have kept hospitals running, reprioritized their current schedules, and started cancelling once they saw the influx. The way this was executed was terrible. The whole point was that hospitals didn't get overloaded so people with critical needs can get treated. It's the absolute definition of irony that cancelling everything had the exact same effect.
- ceejayoz 7y ago
  > cancelling once they saw the influx Incubation periods and exponential growth mean by the time you see the influx, it's potentially already too late to avoid becoming overwhelmed.
  - djsumdog 7y ago
    The priorities all major surgeries and try to work with patients to push off the ones in terms of severity. That way hospital could at least keep taking people. If they have to cancel everyone in a week; that's still better than not taking anything at all right now (and being overloaded this/next months as everyone comes in needing things)
eiji 7y ago
My wife is an operating room circulating nurse at Beaumont in Michigan (Metro Detroit). Lots of people without the title of nurse (RN) are furloughed or laid off. Entire hospitals are closed and covid19 patients transferred to other hospitals. Cleaning and supporting staff has been cut down to bare minimums to save costs. She is being sent home early most days due to low volume, impacting her pay too. She worked covid19 ER shifts receiving walk in patients coughing like hell. That dried up a month ago and she had the choice to stay home or work night shifts on the floor medicating and caring exclusively for covid19 patience. So she did night shifts for two weeks. Now she is back on her regular position, underemployed. She laughed about the field hospitals. Now, here in Michigan, we are all, including Nurses and hospitals, sitting around most of the day doing nothing and waiting for some miracle. There was never a capacity issue she knows of. Only shortages of PPE.

bwb 7y ago

Please don't shut these down, we might need them eventually. This is only inning 1 of the next 2 to 3 years.

Jommi 7y ago
Well not sure hurting them down is the only other option anyways. Tho 2-3 years sounds way overexaggerating
- buzzkillington 7y ago
  The fastest projections for a vaccine I've read are 15 months to 'never'. When the economy reopens and people go back to work we will see a second wave of infections. Unless you think that we can continue dealing with a 20% unemployment rate.
- bwb 7y ago
  I am curious, where do you think Covid is going to go :)? Social distancing will get us to less than R1, but then once we open back up it looks like it will grow past R1. It is going to be here until we get a vaccine or herd immunity.
  - Jommi 7y ago
    Do you mean where the virus is going to go, or where this situation will go? Yes, most likely it will not get burnt out in the US until we have vaccine, herd immunity or the 3rd option, which is coalition/state/county level containment. My comment reflected on the subject of these emergency field hospitals. Its A) not efficient to keep these up for the time being B) its unlikely we will be caught underestimating the virus the 2nd/3rd/xth time around. And something else to just reiterate. There are multiple steps between "keeping the field hospitals operational" and "shutting them down". Just like there are multiple steps between "social distancing" and "opening back up". :)
    - bwb 7y ago
      Gotcha. I was worried you thought Covid might just disappear or something magically :) Efficiency is not always the goal in situations like this. It might be wiser for them to be inefficient but prepared, and keep the hospitals up and running. Especially if they have to nationalize the entire health care system to prevent a collapse (even if its temporary).

jefftk 7y ago

The article is presenting this as some sort of scandal, that we spent a lot of money to urgently build things that we didn't end up needing. This way of thinking about things is why we are generally not well prepared for unlikely disasters: most work you put in will not be needed. Instead we should see this as really positive: we were working to make sure that if stay-at-home (which has cost far more than $600M) didn't work we would have space to treat people, and then we kept the infections low enough that we didn't need to use it.

mc32 7y ago
Right? Moreover they were lamenting that CN was building prefab hospitals in 10 days .. and we were unable to do that and that would leave us with a bed shortage...
Consultant32452 7y ago
I watched most of the Coronavirus Task Force briefings. Several times Trump suggested Dr. Birx was telling him that these things would not be needed. And she confirmed that she felt they weren't going to be necessary. So it appears the scientists/experts knew it wasn't necessary from a medical standpoint. One could argue whether or not it was politically/emotionally necessary. Edit: you can see from several posts here that building these things really did bring a lot of emotional comfort to people, which is an important part of dealing with a crisis. People really underestimate psychology in an emergency.
- ceejayoz 7y ago
  Trump suggests all sorts of things, often directly contradictory, or contradicted shortly thereafter by his own experts. I'm not sure why you'd put any stock in those suggestions at this point.
  - Consultant32452 7y ago
    The expert in question was about 4 feet away from him and confirmed what he said immediately, and repeatedly.

sandworm101 7y ago

So I saw, am still seeing, all the doctors and nurses in NYC pleading for help. But there were thousands of empty covid-specific beds open in that state. Why where they not sending patients to these field hospitals? Is this about money? Would private hospitals loose out on payments if they transfered patients? I feel sorry for the frontline workers in NYC, but I don't know how to reconcile knowledge that there were open covid-specific beds availible just down the road.

DanBC 7y ago
.
- sandworm101 7y ago
  >> "It was very disappointing," Gonzalez said. "Everybody was here, ready to work, ready to get patients in." Many of these hospitals treated literally zero patients. Hospitals weren't overwealmed by people in care homes. They were overwealmed by people in the hospital. I don't see why some subset of those patients couldn't have been shipped to these field hospitals. NY was asking for volunteers to come from all over the country to relieve their struggling hospital system. But there were federal hospitals standing idle a short drive away? Why weren't they loading the not-yet-crititcal patients into busses and taking them to Stony Brook (capacity 1038, patients treated 0)?
  - easytiger 7y ago
    The field hospital concept to increase capacity to reduce deaths was based on, in the UK, the Imperial paper which was based on, frankly a non realistic interpretation of the input data from China and Italy. Meaningless admission/overadmission rates which are clearly vastly wrong/misinterpreted and in turn based on a huge percentage of over 75s being hospitalised and a majority of them in turn needing ventilation. Except in reality patients of that age are rarely ventilated because they wouldn't survive such an invasive treatment and if they are the recovery is 6-8 months and long and painful and has poor recovery outcomes. That predicate was wrong in the paper. Secondly the field hospitals built could only receive patients who had no other underlying or exacerbating conditions because the FHs lack the staff and equipment to care for them. Given that practically every person who died from a respiratory covid infection had such issues it rendered them fairly pointless. The paper also didn't do much to deal with the fact this activity will cause a surge in deaths of non covid related fatalities. Whole other issue

ashtonkem 7y ago

Building a field hospital for a pandemic and not needing it is literally dead last in my list of wasteful government expenditures to be angry about. The rationale that lead to making the hospital was incredibly clear, and that we didn’t need said hospital is a source of relief more than anything else.

jliptzin 7y ago
Yea it’s like buying a fire extinguisher and then being mad that you never had to use it
- calvinmorrison 7y ago
  I think people are more upset with the fact that they are unemployed and their states are locked down. The initial request from my governor was "2 weeks to flatten the curve". After two months, and hearing we never reached near capacity, and our local emergency hospital is also winding down, why are we still closed? Now we're told it could until June
  - ashtonkem 7y ago
    Because the metrics for “we don’t need this emergency hospital” and “the epidemic is beginning to burn out” are different.
    - jaywalk 7y ago
      But the whole point of the lockdowns was to "flatten the curve" meaning to prevent the hospitals from becoming overwhelmed. That's been done.
      - ashtonkem 7y ago
        The risk of a second wave is still known, and cases are still rising in quite a few states.

dv_dt 7y ago

The Navy hospital ship in LA was planned as a reserve for serious non-covid cases. I think because of the early statewide action we didn't need it, but better to plan reserves than to fall short. In any large complex system, you can't necessarily predict the bottlenecks, but if you want the system to guarantee a high capacity to handle issues, you need to broadly overresrouce the initial layout (esp if the resources take time to line up). This means by definition - even a good plan will have idle resources somewhere.

abduhl 7y ago

I’m sorry, but is anyone else getting a real “this is good for bitcoin” vibe from the comments here? It seems we are all attributing this to a successful lockdown rather than considering other scenarios. It feels very “rock that wards off tiger”-y to me.

brlewis 7y ago
A curve was trending exponential, and flattened with lockdown. What's the alternate scenario for what caused the curve to flatten?
- pbhjpbhj 7y ago
  A possible alternative - and I'm categorically not saying this is true, not even likely - is that Covid19 is more infectious, and more widely infected people. But, that fewer people were susceptible, so there would be more asymptomatic carriers but fewer people hospitalised. If a virus runs out of people to infect then it will peak. You can prove that scenario wrong by testing (if number of 'already infected' is relatively low then this hypothesis would be wrong and the risk of further peaks is higher; I don't have enough data to attempt to disprove such a hypothesis.
  - lbeltrame 7y ago
    This is what (reliable, and I repeat reliable) serological testing might tell us.
- deathgrips 7y ago
  We raised testing capacity exponentially, but weren't accurately tracking the spread until recently.
- deleted 7y ago
  [deleted]
- downshun 7y ago
  Wrong assumptions/data/conclusions from the epidemic model Misattribution of cause

outside1234 7y ago

So, in other words, we were successful in preventing this from becoming a disaster.

djsumdog 7y ago
or .. the numbers were wrong and we never needed half these facilities, or to bring the world economy to a grinding halt. Our European counterparts are probably fine, but low-income Americans have lost a lot.. more than we can repay.
- jhwang5 7y ago
  exactly. they panic hired a bunch of contractors with no real operating plan on how to utilize them, and now taxpayers are footing the bill for the contracting company CEO's third mansion.
- Delmania 7y ago
  No, that's not what the article says. It says there was no planning or coordination between the hospitals and the field hospitals to get patients in.
- ilikehurdles 7y ago
  Which numbers were wrong, and when? You can actually see a leveling off of the deaths and hospitalizations in CO within the 2 weeks following the initial stay-at-home order. I would take any numbers regarding "infections" with a grain of salt because those are so susceptible to the number of people able and willing to get tested, and how those test results are reported back up to the state. Every state seems to have differences in that approach.
- esoterica 7y ago
  The lockdown isn't causing the economic crisis, the pandemic is. The economy would grind to a halt anyway without lockdown measures if the pandemic were spreading unchecked and a million [1] people were dying in the space of a few months. Everyone would be barricading themselves in their homes and not going out to restaurants and movie theaters. [1] (70% infected to get herd immunity * 0.5% fatality rate * 330 million people = >1 million people).

jariel 7y ago

100 temporary beds for $100M dollars cost to the government. Oh that makes so much sense.

kevin_thibedeau 7y ago
Wait until they start fighting over free antibody testing.
kindatrue 7y ago
Just wait until you look at defense department contractor rates.
- rwmurrayVT 7y ago
  The CLIN rates on contracts like Seaport-e/NxG are not extremely high. I would agree that AECOM made out like a bandit on their field hospital contracts.
simonh 7y ago
I knew there's be at least one. A similar thing happened here in the UK, we converted an exhibition centre (actually several in different cities) into Covid facilities. In the end we only used a few hundred beds and soon shut them down. What made the difference wasnt that we already had enough beds, but that other mitigating contingencies such as converting other smaller facilities into emergency hospitals happened fast enough, and moving patients out to less heavily hit areas softened the crunch more than anticipated. I don't think preparing these extra facilities was a mistake at all. There are tons of unknowns and random variables in the progression of an epidemic, if we had needed those beds and din't have them more people would have died, possibly a lot of people. Complaining about waste is exactly like complaining about there being any empty beds in any hospital at any time. We plan for peak demand, including contingencies which may never come. It's like complaining that the military have any soldiers at all that never shot at an enemy, or bullets that never killed anyone. If we'd gone through the epidemic and there hadn't been any spare capacity, we'd used exactly as many beds as we had, that would have been bad preparation.

s_y_n_t_a_x 7y ago

Wow, those prices are staggering. Taxpayer money wasted on a knee-jerk reaction by an emotional governor. Glad he didn't get the 30k ventilators he wanted as well. edit: Many people told him he didn't need that many before the fact. I think it's perfectly fine to be critical of a governor if we're critical of our president. A leader should have some sort of vision into the future.

nojito 7y ago
Hindsight is 20/20. It's easy to make criticisms like this after the fact... However, no one knew if the shelter in place order would even work.
ilikehurdles 7y ago
One development that the medical community discovered later on was that putting patients on the ventilator increased their mortality rate, and they moved toward treating patients as long as possible without relying on a ventilator. See: https://www.modernhealthcare.com/safety-quality/some-doctors-moving-away-ventilators-virus-patients https://www.modernhealthcare.com/safety-quality/some-doctors... This information simply didn't exist and was highly hypothetical at the time ventilators were being requested.
projektfu 7y ago
We have spent 1/10000 of the money spent on this crisis for field hospitals.
- s_y_n_t_a_x 7y ago
  Don't worry, I'm not thrilled how the rest of it was spent either. Doesn't mean I can't take issue with this. That 1/10000th of the budget could have went to nursing homes or other critical areas. No matter how much a trillion is, several hundred million dollars is still a lot of money...

nojito 7y ago

Field Hospitals are designed for Trauma patients. They were never designed to handle infectious disease case loads. The plan was to help take on non-covid case load from primary hospitals in the region that they were deployed to.

ilikehurdles 7y ago
Surprised to see this comment come so late. It's true. The regular hospitals were hotbeds for covid infections, so it made sense to keep the non-covid patients as separate as possible from the covid ones. Hence, the field hospitals. It would be terrible to come into the hospital with a broken bone and come out of it with the virus. It makes sense to avoid transporting infected patients whenever possible because it could lead to a new outbreak in a different location.
- lastres0rt 7y ago
  The kicker is that in order to be transferred to the non-covid hospitals, you still had to be TESTED for covid and come up negative. THAT'S why these hospitals were all empty in the first place. It all comes back to what a shitshow testing is in this country.

xiphias2 7y ago

These beds look just plain ugly and too small for relaxation that is needed for healing when somebody's sick. I'm extra scared about the virus, because I know that I would get to a place like this, and I don't have the confidence that I would get the right treatment. I have heared of other people as well who would rather stay at home as much as they can, even if they can't breathe well. But then when somebody needs the ICU, he really needs it fast, and at that time it's too late to go to hospital.

kindatrue 7y ago

Something the article doesn't do a great job of covering is how overall emergency medical incidents went way down more than expected - which is what some of these field hospitals (and the Navy ships) were for. The head of a local hospital network has tweeted wondering where all the heart attack and stroke patients went - both in my lightly impacted region and in disaster NYC. Did the rate go down? Or did people just die at home afraid to go to the hospital? In SF in normal times, over 50% of trauma cases are from car accidents. My completely unscientific theory is that commuting/traffic is way more stressful and physically taxing than people think. https://www.sfexaminer.com/news/half-of-injuries-treated-at-sf-general-hospital-are-from-traffic-collisions/ https://www.sfexaminer.com/news/half-of-injuries-treated-at-...

easytiger 7y ago
> Or did people just die at home afraid to go to the hospital? Probably yes. In the UK there is a significant surge in non covid related deaths above historical stats. Bear in mind also the definition of a covid 19 related death is, err, generous in the first place https://www.spectator.co.uk/article/non-covid-deaths-are-also-surging https://www.spectator.co.uk/article/non-covid-deaths-are-als...
- thebruce87m 7y ago
  Not saying you’re wrong, I do think there would be some of that but I am looking at a way to quantify it, especially since my friend is convinced that the lockdown is worse than the virus. Here is something I found interesting: Spain has a “hard lockdown” too. Their excess mortality has returned to a normal level according to momo: https://www.euromomo.eu/graphs-and-maps/ https://www.euromomo.eu/graphs-and-maps/ Now I realise that some people that would normally die are not (car accidents etc), but at the same time if the lockdown itself was causing significant mortality you wouldn’t expect the excess mortality to drop to normal levels, would you? You would expect a small offset from 0 unless the savings from car crashes are exactly the same compared to “lockdown deaths” - and if they are, and the lockdown is saving “extra” lives then is it not still worth it? We have to wait and see for England to see if it falls back to normal or below normal levels.

Ididntdothis 7y ago

I think it’s pretty clear that a lot of things have been going wrong in this effort and there was probably a lot of waste. This is to be expected when it’s required to act quickly with lack of good data. I only hope the political systems will allow a serious retrospective of the measures and learning from that. I am very afraid that the partisans and conspiracy theorists will take over soon and no rational decisions for the future will be made so we will stay unprepared for the next pandemic.

narogab 7y ago

I told you so, I told you so, I told you so: \https://news.ycombinator.com/threads?id=narogab https://news.ycombinator.com/threads?id=narogab In that discussion I somehow lost whatever karma I had on this BB. Despite being polite and reasonable I was blasted into oblivion by some jerk(s). But with my now (-2) karma I am not above being jerky myself by pointing out that I was right, crooked-v was wrong, and any "field hospitals" the US Army made would indeed be, as I stated then, _field_ _hospitals_ and nothing like what "crooked-v" (https://news.ycombinator.com/user?id=crooked-v https://news.ycombinator.com/user?id=crooked-v ) envisioned: "Making these spaces fit the physical needs of these hospitals (massive power requirements for equipment, hallways and elevators with certain amounts of clearance for transporting patients, extremely well-controlled ventilation systems, sanitizable surfaces everywhere, rooms laid out with central access for doctors and nurses) would take so much time and effort that it would be more money- and time-efficient to build new buildings with the expertise of a group practiced in building new, reasonably high-quality buildings as fast as possible... like, say, the Army...These need to be modern hospitals, not 19th-century sanitariums where patients just get dumped into a bed and left to die or recover on their own." - crooked-v, being wrong, wrong, wrong - narogab, being a jerk and an asshole (but almost always, a _correct asshole).[God, it feels good to let go of that knife].

mensetmanusman 7y ago

Fear of covid killing more than covid? Happening in Australia apparently. Sociologists are learning a lot from this situation

xoxoy 7y ago
It’s governments overreacting not the people. I haven’t met a single person who is actually “scared.”
- folkhack 7y ago
  I'm higher-risk due to past lung disease and have been taking this incredibly seriously due to not wanting to go through pneumonia again. I've been taking the social distancing stuff seriously, wearing a mask every time I go out, and have taken steps to get deliveries when I can to ensure I maximize the time at home. The sky's not falling but I am a bit "scared" as you put it.
- brenden2 7y ago
  Scroll through /r/coronavirus if you want to see what how scared many people are.
- gtaylor 7y ago
  Hello. I'm Greg and I'm scared. Well met.
- alistairSH 7y ago
  :raises hand: I'm scared. Not enough to be curled in a ball in the corner, but enough to be taking social distancing seriously. My wife has medical history that puts her at higher risk, plus she's in her 50s (and me in my 40s) so we're both at slightly higher risk just based on age.
- astronautjones 7y ago
  People should be scared. This isn't over, and this idiotic preemptive celebration/busines reopening is going to render a lot of our sacrifices in vain.

yufeng66 7y ago

The idea of field hospital is to move non covid related patients to the file hospitals and let the regular hospital to be covid only. This way there is much smaller chance to get covid while getting routine medical care. Reliable source told me medical facility utilization rates aredown more than 50% in non covid hot spot area. People are simply deferring non emergency medical service. They are also not so sure if they need to quarantine non symptomatic covid case away from home, like china did. So the field hospitals are built as an option if needed.

taurath 7y ago
Its not that people are deferring medical service, they are being deferred. I have a friend who needs brain surgery to remove a cancerous tumor, and its deferred until non-emergency surgeries can open up.
- sjg007 7y ago
  Weird, cancerous brain tumor should be an emergency one would think.
- astronautjones 7y ago
  Lots of people that just lost their jobs & insurance (and can't afford COBRA) are deferring medical service.

jijji 7y ago

After speaking with a few doctors who worked setting up these hospitals, it was almost like a parade or a show rather than anything serious. The doctors who worked there were ready to take on the patients, but the decisions came from the top not to allow it to happen...

RobLach 7y ago

Great use of money and commendations across the board to the Army Corp of Engineers who put this together so quickly. $690m is bargain for putting a ceiling on the situations these would have been necessary for.

ridewinter 7y ago

It's incredible the amount of unknowns even at this point in the epidemic. Anyone who claims to understand what's going on is just frontin. That's my big takeaway so far.

solarengineer 7y ago

“ The plan was for the Javits Center to take patients from overwhelmed hospitals in the city. But in practice it wasn't that easy. Some hospitals complained that the intake process was too complicated. And they sent few patients to Javits — even as they resorted to treating patients in the hallways” What does it mean for an intake process to be complicated? Isn’t it straight forward like loading the patient + printouts of medical records into an ambulance, driving to the new place, and then transferring them into a bed?

mleonhard 7y ago

I'm happy about this.

jpollock 7y ago

A late reaction typically requires overcompensation and wasted resources because you don't have sufficient positive control to tell where things are headed. That leads to overcorrection and lots of cost.

tehjoker 7y ago

I guess it's true that hospital utilization for non-COVID cases declined, but in NYC hospitals, they were still stuffing people in the hallways while these sites idled. Is that not a scandal? Some contractors made a lot of money building these sites. Did the people building them know before-hand that they didn't fulfill the list of features for actual utilization when they signed the contracts that were evaluated under an accelerated, non-competitive review? I don't want to diminish the efforts of the people that built these sites and stood ready to treat patients. That's heroic. My skepticism is aimed at the bosses.

urda 7y ago

Yeah I'm totally OK with this. Medical facilities aren't exactly "autoscale", and by the time you change your mind it's already too late. It's great to hear they weren't used heavily. It was great that they were set up too.

mydongle 7y ago

Does this mean we won't get anymore nurse tiktok videos? That was money well spent.

acokeaday 7y ago

Biggest scam in the history of the world! And like good little sheep we fell and are still falling for this bullshit!!! For a country that supposedly holds personal freedom in high esteem... it’s so fucking pitiful the powers that be must be laughing all the way to their new powers and wealth, almost disappointed how easy it was.

mirimir 7y ago

FYI: https://www.wbur.org/npr/851712311/u-s-field-hospitals-stand-down-most-without-treating-any-covid-19-patients https://www.wbur.org/npr/851712311/u-s-field-hospitals-stand...