5 ms·

If it halves hospitalizations, it'll have a pretty drastic effect on overwhelmed ICUs but there's probably still a ways to go before ICU levels return to normal

If it halves hospitalizations, it'll have a pretty drastic effect on overwhelmed ICUs but there's probably still a ways to go before ICU levels return to normal and we can skip mandates.

_3u10 5y ago
Norway, Sweden, and the UK no longer have mandates, it's a political question not a medical question.
- jeltz 5y ago
  We, Sweden, lifted the mandate 2 days ago and after a clear trend of the small fourth wave not increasing.
  - _3u10 5y ago
    Precisely. Also congrats on having sane politicians. Sweden has 10x the hospitalization rates of many countries that still have mandates, thus it is a political question, not a medical one.
    - jeltz 5y ago
      What countries? Show me the data. Edit: Deleting most of my post since Sweden does not track hospitalizations, only ICU admissions so I compared incorrectly. Here is the graph for ICU, judge for yoruselves if there are any with a 1/10 of Sweden's numbers. https://ourworldindata.org/grapher/weekly-icu-admissions-covid-per-million https://ourworldindata.org/grapher/weekly-icu-admissions-cov...
      - _3u10 5y ago
        I misspoke, it was deaths, not hospitalizations. Norway has 1/10th the deaths per capita of Sweden. Canada has 1/2 of what Sweden has, and we are still have mandates and restrictions.
- kwhitefoot 5y ago
  > it's a political question not a medical question. Not as much here in Norway as it is in the UK. Our death rate per unit population is one tenth of the UK and local authorities remain prepared to reinstate restrictions. Here we have been living pretty much normally for months already anyway. And while the government has occasionally overreacted both the government and population have mostly followed the Norwegian Public Health Institute (FHI) advice.
  - dham 5y ago
    > it's a political question not a medical question. >> Our death rate per unit population is one tenth of the UK and local authorities It's a fat question at the end of the day. Norway doesn't have many fat people.
    - kwhitefoot 5y ago
      It has a lot more now than it did when I arrived here in 1986. Dramatically more so.
- KaiserPro 5y ago
  given the UK's death rate, I wouldn't use it as a data point for success.
mrfusion 5y ago
If we’re worried about hospital capacity why are we firing healthcare workers?
- _3u10 5y ago
  Because it helps reduce capacity which increases the political will for mandates.
- loeg 5y ago
  We have vaccine mandates because infected healthcare workers spreading COVID reduce capacity even more. We haven't actually fired many workers, because the vast majority just get the vaccine (mostly before the mandates).
  - LurkingPenguin 5y ago
    1. You need to account for the fact that some percentage (perhaps large) of healthcare workers already survived COVID and have natural immunity. Since the science is demonstrating that natural immunity is as durable and robust as vaccine immunity (if not more durable and robust), one would have to ask what the rationale is for firing workers who have natural immunity (as verified by a past COVID diagnosis or presence of antibodies) and do not want to be vaccinated. 2. The science is clear that vaccinated individuals can contract and spread the virus. While this doesn't mean that the vaccines aren't useful (they absolutely are), we need to be realistic about this in high-risk settings.
    - zdragnar 5y ago
      Healthcare workers have been on the front line, unvaccinated, for going on two years. To mandate it or risk being fired has absolutely pissed off quite a few that I know of... My wife has gotten it, and even she is offended. The hyperbole around this very serious situation just makes all the policies seem even more like theater. To your second point, there was just a new report I saw yesterday that there is no difference in viral load between asymptomatic vaccinated and unvaccinated individuals.
smnrchrds 5y ago
Alberta has 173 normal ICU beds. As of this Monday, there were 312 Albertans in ICUs, 265 of whom for COVID [1]. The extra 139 beds were surge capacity, created by shutting down other services, postponing surgeries, and diverting resources to COVID ICU treatments. Even if the number of COVID patients in ICUs halved, we would have 132 people in the ICU with COVID, or 179 patients in total for all causes. It would still be over capacity and need surge beds, but it would still be much better than the current state. What this tells me is that whether we can skip mandates depends a lot on healthcare capacity in your region. Maybe the US with its higher population-adjusted ICU beds can get back to normal sooner than Canada. [1] https://www.cbc.ca/news/canada/edmonton/alberta-health-care-covid-patients-icu-1.6191057 https://www.cbc.ca/news/canada/edmonton/alberta-health-care-...
- shrubble 5y ago
  Alberta has 4.4 mln or so people. Colorado, with 5.8 mln people, has over 1700 ICU beds. Alberta's been 'running on fumes' re: ICU beds and they got caught out...
  - smnrchrds 5y ago
    I don't think the two jurisdictions count ICU beds the same. Alberta (and Canada in general) have about half as many ICU beds per capita as the US, not 1/10th. If I had to guess, I would say the number for Colorado includes other types of ICU (neonatal, cardiac, etc.) that the Albertan number doesn't. Alberta has 8,513 acute care beds. How many of those would be counted as ICU beds per the Colorado definition, I don't know. https://www.albertahealthservices.ca/about/about.aspx https://www.albertahealthservices.ca/about/about.aspx
  - PaulDavisThe1st 5y ago
    Arguably, most of the world's industrial economies have been running on fumes increasingly over the last 30-40 years, as "fat has been trimmed", JIT supply chains have taken over, and "efficiency via merger-then-closure" have been common themes in national economies.
logicalmonster 5y ago
What are normal ICU levels and is this a goalpost that can ever be achieved? Long before Covid, it was well-known that hospital ICUs were designed to run fairly close to 100% capacity because it wasn't profitable to pay for staff that weren't truly needed at any given time. Is there any hospital that is going to pay for far more staff than they need and somehow manufacture many ICU beds out of nowhere? I feel like this is a goalpost intentionally designed to never be achievable. As further evidence, if the situation was actually so dire, would unvaccinated people (many of whom already had Covid) be on the chopping block in so many locations?
- easytiger 5y ago
  Not to mention standardised admission criteria and ICU eligibility criteria were chucked out the window in many countries when covid became a thing Edit downvotes and no discussion. This place is getting worse
- crooked-v 5y ago
  > and is this a goalpost that can ever be achieved? It could absolutely be achieved. Literally the only thing keeping things from going back to more-or-less normal conditions right now is that there are many unvaccinated people getting extremely ill from COVID and filling up ICUs.
  - logicalmonster 5y ago
    Again, what are normal ICU levels? As far as I'm aware, ICU staffing is modified to achieve close to 100% capacity at all times with minimal spare beds, whether pre-Covid or post-Covid. If this is the case, then there's no scenario possible, regardless of what happens with Covid, where hospitals report anything but "few ICU beds are available".
    - PaulDavisThe1st 5y ago
      The data collected in the US by the Department of Health has routinely shown ICU availability in my county (Santa Fe, NM). That data has generally indicated that roughly half the available ICU beds are filled, with 1 or 2 patients there due to COVID. p.s. according to our local newspaper, this data is incorrect.
KaiserPro 5y ago
remember that in exponential growth, halving the people going to hospital buys you one extra doubling time. (ie, if numbers increase every two weeks, halving the growth buys you two extra weeks.) You need to make sure that the growth has stopped, not just halved.
- _3u10 5y ago
  Yup, and with an R value for delta between 5 and 8 on a two week infection cycle... well thats about 3 days... even with 100% of people vaccinated it will buy about a month, assuming the vaccine numbers hold and 1/35th of the vaxxed vs unvaxxed get hospitalized.

If it halves hospitalizations, it'll have a pretty drastic effect on overwhelmed ICUs but there's probably still a ways to go before ICU levels return to normal and we can skip mandates.

_3u10 5y ago

Norway, Sweden, and the UK no longer have mandates, it's a political question not a medical question.

jeltz 5y ago
We, Sweden, lifted the mandate 2 days ago and after a clear trend of the small fourth wave not increasing.
- _3u10 5y ago
  Precisely. Also congrats on having sane politicians. Sweden has 10x the hospitalization rates of many countries that still have mandates, thus it is a political question, not a medical one.
  - jeltz 5y ago
    What countries? Show me the data. Edit: Deleting most of my post since Sweden does not track hospitalizations, only ICU admissions so I compared incorrectly. Here is the graph for ICU, judge for yoruselves if there are any with a 1/10 of Sweden's numbers. https://ourworldindata.org/grapher/weekly-icu-admissions-covid-per-million https://ourworldindata.org/grapher/weekly-icu-admissions-cov...
    - _3u10 5y ago
      I misspoke, it was deaths, not hospitalizations. Norway has 1/10th the deaths per capita of Sweden. Canada has 1/2 of what Sweden has, and we are still have mandates and restrictions.
kwhitefoot 5y ago
> it's a political question not a medical question. Not as much here in Norway as it is in the UK. Our death rate per unit population is one tenth of the UK and local authorities remain prepared to reinstate restrictions. Here we have been living pretty much normally for months already anyway. And while the government has occasionally overreacted both the government and population have mostly followed the Norwegian Public Health Institute (FHI) advice.
- dham 5y ago
  > it's a political question not a medical question. >> Our death rate per unit population is one tenth of the UK and local authorities It's a fat question at the end of the day. Norway doesn't have many fat people.
  - kwhitefoot 5y ago
    It has a lot more now than it did when I arrived here in 1986. Dramatically more so.
KaiserPro 5y ago
given the UK's death rate, I wouldn't use it as a data point for success.

mrfusion 5y ago

If we’re worried about hospital capacity why are we firing healthcare workers?

_3u10 5y ago
Because it helps reduce capacity which increases the political will for mandates.
loeg 5y ago
We have vaccine mandates because infected healthcare workers spreading COVID reduce capacity even more. We haven't actually fired many workers, because the vast majority just get the vaccine (mostly before the mandates).
- LurkingPenguin 5y ago
  1. You need to account for the fact that some percentage (perhaps large) of healthcare workers already survived COVID and have natural immunity. Since the science is demonstrating that natural immunity is as durable and robust as vaccine immunity (if not more durable and robust), one would have to ask what the rationale is for firing workers who have natural immunity (as verified by a past COVID diagnosis or presence of antibodies) and do not want to be vaccinated. 2. The science is clear that vaccinated individuals can contract and spread the virus. While this doesn't mean that the vaccines aren't useful (they absolutely are), we need to be realistic about this in high-risk settings.
  - zdragnar 5y ago
    Healthcare workers have been on the front line, unvaccinated, for going on two years. To mandate it or risk being fired has absolutely pissed off quite a few that I know of... My wife has gotten it, and even she is offended. The hyperbole around this very serious situation just makes all the policies seem even more like theater. To your second point, there was just a new report I saw yesterday that there is no difference in viral load between asymptomatic vaccinated and unvaccinated individuals.

smnrchrds 5y ago

Alberta has 173 normal ICU beds. As of this Monday, there were 312 Albertans in ICUs, 265 of whom for COVID [1]. The extra 139 beds were surge capacity, created by shutting down other services, postponing surgeries, and diverting resources to COVID ICU treatments. Even if the number of COVID patients in ICUs halved, we would have 132 people in the ICU with COVID, or 179 patients in total for all causes. It would still be over capacity and need surge beds, but it would still be much better than the current state. What this tells me is that whether we can skip mandates depends a lot on healthcare capacity in your region. Maybe the US with its higher population-adjusted ICU beds can get back to normal sooner than Canada. [1] https://www.cbc.ca/news/canada/edmonton/alberta-health-care-covid-patients-icu-1.6191057 https://www.cbc.ca/news/canada/edmonton/alberta-health-care-...

shrubble 5y ago
Alberta has 4.4 mln or so people. Colorado, with 5.8 mln people, has over 1700 ICU beds. Alberta's been 'running on fumes' re: ICU beds and they got caught out...
- smnrchrds 5y ago
  I don't think the two jurisdictions count ICU beds the same. Alberta (and Canada in general) have about half as many ICU beds per capita as the US, not 1/10th. If I had to guess, I would say the number for Colorado includes other types of ICU (neonatal, cardiac, etc.) that the Albertan number doesn't. Alberta has 8,513 acute care beds. How many of those would be counted as ICU beds per the Colorado definition, I don't know. https://www.albertahealthservices.ca/about/about.aspx https://www.albertahealthservices.ca/about/about.aspx
- PaulDavisThe1st 5y ago
  Arguably, most of the world's industrial economies have been running on fumes increasingly over the last 30-40 years, as "fat has been trimmed", JIT supply chains have taken over, and "efficiency via merger-then-closure" have been common themes in national economies.

logicalmonster 5y ago

What are normal ICU levels and is this a goalpost that can ever be achieved? Long before Covid, it was well-known that hospital ICUs were designed to run fairly close to 100% capacity because it wasn't profitable to pay for staff that weren't truly needed at any given time. Is there any hospital that is going to pay for far more staff than they need and somehow manufacture many ICU beds out of nowhere? I feel like this is a goalpost intentionally designed to never be achievable. As further evidence, if the situation was actually so dire, would unvaccinated people (many of whom already had Covid) be on the chopping block in so many locations?

easytiger 5y ago
Not to mention standardised admission criteria and ICU eligibility criteria were chucked out the window in many countries when covid became a thing Edit downvotes and no discussion. This place is getting worse
crooked-v 5y ago
> and is this a goalpost that can ever be achieved? It could absolutely be achieved. Literally the only thing keeping things from going back to more-or-less normal conditions right now is that there are many unvaccinated people getting extremely ill from COVID and filling up ICUs.
- logicalmonster 5y ago
  Again, what are normal ICU levels? As far as I'm aware, ICU staffing is modified to achieve close to 100% capacity at all times with minimal spare beds, whether pre-Covid or post-Covid. If this is the case, then there's no scenario possible, regardless of what happens with Covid, where hospitals report anything but "few ICU beds are available".
  - PaulDavisThe1st 5y ago
    The data collected in the US by the Department of Health has routinely shown ICU availability in my county (Santa Fe, NM). That data has generally indicated that roughly half the available ICU beds are filled, with 1 or 2 patients there due to COVID. p.s. according to our local newspaper, this data is incorrect.

KaiserPro 5y ago

remember that in exponential growth, halving the people going to hospital buys you one extra doubling time. (ie, if numbers increase every two weeks, halving the growth buys you two extra weeks.) You need to make sure that the growth has stopped, not just halved.

_3u10 5y ago
Yup, and with an R value for delta between 5 and 8 on a two week infection cycle... well thats about 3 days... even with 100% of people vaccinated it will buy about a month, assuming the vaccine numbers hold and 1/35th of the vaxxed vs unvaxxed get hospitalized.