4 ms·

Flattening the curve to preserve hospital beds, ,at least in the US, only really applied to NYC and northern New Jersey. Nowhere else in the country ever even c

by rpiguy 6y ago

Flattening the curve to preserve hospital beds, ,at least in the US, only really applied to NYC and northern New Jersey. Nowhere else in the country ever even came close to overwhelming the hospitals. If NJ and NYC had shut down public transportation the curve wouldn’t have been so bad - hotspots map 1:1 with subway and train stops. 40% of US counties haven’t had a single COVID death. Most hospitals are so under utilized they are losing money.

ajsnigrutin 6y ago
Slovenia has pretty-much opened up everything (masks still required indoors, nightclubs still closed, public events limited to 50 people, but everything else, from stores to gyms open). We did lose like 2 months of business, so if we knew what to expect, it might have gone better (but italy is our neighbor, so we went 'better safe than sorry' way). Closings should basically be linked to number of cases in that area.
downrightmike 6y ago
There was a point in Arizona that of the 1019 ICU beds, only 9 weren't being used.
dopylitty 6y ago
Birmingham Alabama's hospitals are currently overwhelmed[0]. This thing is going to get even uglier quickly as it tears through rural areas that have little to no nearby healthcare options. And as the people who are out mingling this weekend start to get ill in the next week and start to feel bad enough to need hospitalization in the next two to three weeks we're going to see some scenes just like in NYC with overwhelmed hospitals and morgues being replaced by air conditioned semi trucks (or worse, bodies piling up in the summer heat). It's already happening in some rural areas[1]. The only counties that have no deaths are those with very few people and/or no testing [2]. [0] https://www.businessinsider.com/dire-coronavirus-alabama-icu-no-beds-2020-5 https://www.businessinsider.com/dire-coronavirus-alabama-icu... [1] https://www.sfgate.com/news/article/A-deadly-checkerboard-Covid-19-s-new-surge-15292024.php https://www.sfgate.com/news/article/A-deadly-checkerboard-Co... [2] https://www.texasmonthly.com/news/coronavirus-spread-rural-counties-university-texas-researchers/ https://www.texasmonthly.com/news/coronavirus-spread-rural-c...
- odkamkfn 6y ago
  I like the slight, vague implication in your post that no testing means no deaths.
- rpiguy 6y ago
  According to the Alabama department of public health as of 5 hours ago there are only 571 people in ICU. https://www.alabamapublichealth.gov/covid19/assets/cov-al-cases-052420.pdf https://www.alabamapublichealth.gov/covid19/assets/cov-al-ca... According to CDC data, 81% of deaths from COVID-19 in the United States are people over 65 years old, most with preexisting conditions. If you add in 55-64-year-olds that number jumps to 93%. For those below age 55, preexisting conditions play a significant role, but the death rate is currently around 0.0022%, or one death per 45,000 people in this age range. Below 25 years old the fatality rate of COVID-19 is 0.00008%, or roughly one in 1.25 million. I am sure some hospitals will come close to capacity in some areas due to some case clusters, but Florida, Texas, and Georgia have been largely fine after opening up even in rural areas. I expect over the next two to three weeks we will continue to see drops in deaths.
- masonic 6y ago
  Opening of BI title: "Alabama hospitals are out of ICU beds" Actuality: the mayor of one city is saying this; nobody actually in medicine or in statewide government is.
0d9eooo 6y ago
The hospitals losing money part is complicated because most of them are losing money because of lost elective procedures. In many hospitals, especially private ones, those elective procedures are the main source of profit and underwrite the acute/ICU cases. So you could have a hospital that's at occupancy with intensive/acute care cases, and still losing a ton of money if electives are being canceled either to quarantine orders, or due to patients canceling them out of fear. There's also essentially a U-shaped curve between intensive care occupancy and profitability. As ICU/acute care cases decrease below some point, profits decrease, and as they increase they increase, but at some point the cases become overwhelming and the hospital loses money again. Beds are not all equal when it comes to profit/financial solvency at hospitals.
duckMuppet 6y ago
Yes but it wasn't about a virus, this was about control. https://mobile.twitter.com/EthicalSkeptic/status/1263662455219240962 https://mobile.twitter.com/EthicalSkeptic/status/12636624552...
- epakai 6y ago
  I tried to understand where these numbers were coming from. The 32,768,000 cases led me to seroprevalence studies (total infection estimates by sampling the population for antibodies). I think this wired article [1] really covers the signifigance of these results. Some of the issues are the results are not nationwide (Santa Clara County only), the studies weren't peer reviewed before the twitter analysis happened, there may be issues with testing method accuracy, etc. In any case these are fairly new results (April 11). Our decisions about lockdown were based on data available at the time which had a worse outlook in part due to lack of early action. I think it's also important to point out the CDC's planning scenarios state "sCFR: ... reflects existing standard of care". I presume this means our current ability, not our ability a month ago when fatalities peaked. [1] https://www.wired.com/story/new-covid-19-antibody-study-results-are-in-are-they-right/ https://www.wired.com/story/new-covid-19-antibody-study-resu...
  - elcritch 6y ago
    > I think this wired article [1] really covers the signifigance of these results. Some of the issues are the results are not nationwide (Santa Clara County only), the studies weren't peer reviewed before the twitter analysis happened, there may be issues with testing method accuracy, etc. For future consideration by others, while the Stanford paper was pre-peer review the deluge of Twitter and media articles denouncing the results based on those limitations is as bad or worse than the drawbacks of the original research. Given that multiple papers from groups around the world have produced similar or more drastic results from serological testing, it seems most likely the Stanford researchers were more correct than wrong and the Twitter crowd (included many scientists) were more incorrect. The wisdom of the crowds is not always that wise. It was largely people disagreeing with the Stanford results for various non-scientific reasons using the limitations as a way to invalidate the entirety of the results rather than understand that the issues would most probably only affect the range of the results but even accounting for that still indicated order of magnitude lower infection fatality rate than assumed from the known case rate at the time. The same reasoning should apply to the early research from Imperial College that had (IMHO) even more serious limitations, but even their results weren't completely invalidated and the current numbers are still within their estimated ranges. Similar logical failures happened when the WHO stated that there wasn't evidence that getting infected would result in immunity. While technically true and worth investigating, taking it as a justification to extend lockdown or denounce states planning to reopen was unfounded given the paucity of data showing people don't develop some degree of resistance to sars-cov-2 virus after infection. Given there are few viruses that can elude the immune system and prevent immunity, the prior knowledge by itself strongly indicates some level of immunity will be formed. None of the traits of a lingering viral infections were there, aside from a few anomalous results from Wuhan or South Korea. Luckily, later research showed those possible cases of relapse were due to false positives, but it was also a highly likely outcome based on the known of prior information about viruses and the immune system.

by rpiguy 6y ago

ajsnigrutin 6y ago

Slovenia has pretty-much opened up everything (masks still required indoors, nightclubs still closed, public events limited to 50 people, but everything else, from stores to gyms open). We did lose like 2 months of business, so if we knew what to expect, it might have gone better (but italy is our neighbor, so we went 'better safe than sorry' way). Closings should basically be linked to number of cases in that area.

downrightmike 6y ago

There was a point in Arizona that of the 1019 ICU beds, only 9 weren't being used.

dopylitty 6y ago

Birmingham Alabama's hospitals are currently overwhelmed[0]. This thing is going to get even uglier quickly as it tears through rural areas that have little to no nearby healthcare options. And as the people who are out mingling this weekend start to get ill in the next week and start to feel bad enough to need hospitalization in the next two to three weeks we're going to see some scenes just like in NYC with overwhelmed hospitals and morgues being replaced by air conditioned semi trucks (or worse, bodies piling up in the summer heat). It's already happening in some rural areas[1]. The only counties that have no deaths are those with very few people and/or no testing [2]. [0] https://www.businessinsider.com/dire-coronavirus-alabama-icu-no-beds-2020-5 https://www.businessinsider.com/dire-coronavirus-alabama-icu... [1] https://www.sfgate.com/news/article/A-deadly-checkerboard-Covid-19-s-new-surge-15292024.php https://www.sfgate.com/news/article/A-deadly-checkerboard-Co... [2] https://www.texasmonthly.com/news/coronavirus-spread-rural-counties-university-texas-researchers/ https://www.texasmonthly.com/news/coronavirus-spread-rural-c...

odkamkfn 6y ago
I like the slight, vague implication in your post that no testing means no deaths.
rpiguy 6y ago
According to the Alabama department of public health as of 5 hours ago there are only 571 people in ICU. https://www.alabamapublichealth.gov/covid19/assets/cov-al-cases-052420.pdf https://www.alabamapublichealth.gov/covid19/assets/cov-al-ca... According to CDC data, 81% of deaths from COVID-19 in the United States are people over 65 years old, most with preexisting conditions. If you add in 55-64-year-olds that number jumps to 93%. For those below age 55, preexisting conditions play a significant role, but the death rate is currently around 0.0022%, or one death per 45,000 people in this age range. Below 25 years old the fatality rate of COVID-19 is 0.00008%, or roughly one in 1.25 million. I am sure some hospitals will come close to capacity in some areas due to some case clusters, but Florida, Texas, and Georgia have been largely fine after opening up even in rural areas. I expect over the next two to three weeks we will continue to see drops in deaths.
masonic 6y ago
Opening of BI title: "Alabama hospitals are out of ICU beds" Actuality: the mayor of one city is saying this; nobody actually in medicine or in statewide government is.

0d9eooo 6y ago

The hospitals losing money part is complicated because most of them are losing money because of lost elective procedures. In many hospitals, especially private ones, those elective procedures are the main source of profit and underwrite the acute/ICU cases. So you could have a hospital that's at occupancy with intensive/acute care cases, and still losing a ton of money if electives are being canceled either to quarantine orders, or due to patients canceling them out of fear. There's also essentially a U-shaped curve between intensive care occupancy and profitability. As ICU/acute care cases decrease below some point, profits decrease, and as they increase they increase, but at some point the cases become overwhelming and the hospital loses money again. Beds are not all equal when it comes to profit/financial solvency at hospitals.

duckMuppet 6y ago

Yes but it wasn't about a virus, this was about control. https://mobile.twitter.com/EthicalSkeptic/status/1263662455219240962 https://mobile.twitter.com/EthicalSkeptic/status/12636624552...

epakai 6y ago
I tried to understand where these numbers were coming from. The 32,768,000 cases led me to seroprevalence studies (total infection estimates by sampling the population for antibodies). I think this wired article [1] really covers the signifigance of these results. Some of the issues are the results are not nationwide (Santa Clara County only), the studies weren't peer reviewed before the twitter analysis happened, there may be issues with testing method accuracy, etc. In any case these are fairly new results (April 11). Our decisions about lockdown were based on data available at the time which had a worse outlook in part due to lack of early action. I think it's also important to point out the CDC's planning scenarios state "sCFR: ... reflects existing standard of care". I presume this means our current ability, not our ability a month ago when fatalities peaked. [1] https://www.wired.com/story/new-covid-19-antibody-study-results-are-in-are-they-right/ https://www.wired.com/story/new-covid-19-antibody-study-resu...
- elcritch 6y ago
  > I think this wired article [1] really covers the signifigance of these results. Some of the issues are the results are not nationwide (Santa Clara County only), the studies weren't peer reviewed before the twitter analysis happened, there may be issues with testing method accuracy, etc. For future consideration by others, while the Stanford paper was pre-peer review the deluge of Twitter and media articles denouncing the results based on those limitations is as bad or worse than the drawbacks of the original research. Given that multiple papers from groups around the world have produced similar or more drastic results from serological testing, it seems most likely the Stanford researchers were more correct than wrong and the Twitter crowd (included many scientists) were more incorrect. The wisdom of the crowds is not always that wise. It was largely people disagreeing with the Stanford results for various non-scientific reasons using the limitations as a way to invalidate the entirety of the results rather than understand that the issues would most probably only affect the range of the results but even accounting for that still indicated order of magnitude lower infection fatality rate than assumed from the known case rate at the time. The same reasoning should apply to the early research from Imperial College that had (IMHO) even more serious limitations, but even their results weren't completely invalidated and the current numbers are still within their estimated ranges. Similar logical failures happened when the WHO stated that there wasn't evidence that getting infected would result in immunity. While technically true and worth investigating, taking it as a justification to extend lockdown or denounce states planning to reopen was unfounded given the paucity of data showing people don't develop some degree of resistance to sars-cov-2 virus after infection. Given there are few viruses that can elude the immune system and prevent immunity, the prior knowledge by itself strongly indicates some level of immunity will be formed. None of the traits of a lingering viral infections were there, aside from a few anomalous results from Wuhan or South Korea. Luckily, later research showed those possible cases of relapse were due to false positives, but it was also a highly likely outcome based on the known of prior information about viruses and the immune system.