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We're talking about ICU capacity. That's what flattening the curve is all about. Marin and Santa Cruz have LESS Covid patients and are closer to overflowing th

We're talking about ICU capacity. That's what flattening the curve is all about. Marin and Santa Cruz have LESS Covid patients and are closer to overflowing than Escambia. Also covid patients only make up 13% of the ICU? Something is odd with your flattening the curve narrative blaming overflow on Covid patients.

joshuamorton 5y ago
Icus in normal times stay at 70% capacity, so covid adding 20-30 percent capacity fills them up. Doing what CA does, flattening the curve and keeping covid induced capacity at 10-15% allows hospitals to continue functioning normally.
- edmcnulty101 5y ago
  Sounds like maybe whats causing the curve to need flattening is the 80% of non-Covid cases in the ICU?
  - joshuamorton 5y ago
    > Marin and Santa Cruz have LESS Covid patients and are closer to overflowing than Escambia. So I went ahead and checked this, and it's wrong. Escambia's ICU capacity is 87% full, SC's is 90% full (and SC is a bad choice, as they have a total of 21 ICU beds in the county, they use bay area ICU beds for overflow, which are currently sitting at ~80% capacity), and Marin's is....40%. So I'm not sure what data you're looking at, but it seems to just be wrong. Secondly, no, covid capacity really is the problem, because for the last year and a half, hospitals were reducing non-critical care. That means you have tons of people who need hip replacements or brain surgery or tumor removal who haven't been able to get it. Many of them will need to recover in the ICU a bit, so you'd want a higher baseline ICU use post-elective surgery freeze, as that implies that the "clog" is being recovered from. If the hospital is still full due to covid patients, those elective surgeries will never get done, leading people who never caught covid to suffer too. So low covid capacity, but higher overall use temporarily means that we're catching up to all the deferred non-covid care, something we really need to do! The other possibility is that you mean that the 70-80% that ICUs normally run at is somehow problematic (because well like I just said, we did actually "flatten" it by deferring elective ICU recovery for more than a year in many places). The US already has more ICU beds per capita than most nations, even other developed nations, so I'm not sure what your idea here is other than perhaps, "The us population is too unhealthy or is providing too much healthcare", which are both interesting positions to take for sure.
    - edmcnulty101 5y ago
      >Secondly, no, covid capacity really is the problem, because for the last year and a half...<a bunch of non quantitative opinion based unprovable emotional gish gallop stuff I didn't read.> Bullshit. Actual data says that Covid patients in ICU take up between 8% to 20ish% of admissions. COVID is not causing the curve to be need flattening. The medical system is. Maybe they shouldn't fire medical professionals who got immunity through COVID infection instead of the vaccine.
      - joshuamorton 5y ago
        > Actual data says that Covid patients in ICU take up between 8% to 20ish% of admissions. Yes, and actual data says this is a problem, because we don't have the capacity to handle a sustained 15% increase in ICU use. That is simply not a thing we have the capacity to handle. > Maybe they shouldn't fire medical professionals who got immunity through COVID infection instead of the vaccine. The less than 1% of people who fall into this category are probably not the issue. 1% more nurses isn't going to address 15% more patients. > <a bunch of non quantitative opinion based unprovable emotional gish gallop stuff I didn't read.> You really should have, because none of it was "emotional" and most of it was quantitative, so this makes you look rather silly. Like c'mon, you've lied about how full hospitals are in California, when confronted on that you claim I'm "gish galloping" with emotional nonsense that's just true[0] factual content about how we handle and have handled hospital capacity and why your (completely conjectured!) conclusion was wrong. [0]: https://revcycleintelligence.com/news/40-hospitals-in-ny-forced-to-stop-elective-surgery-as-covid-19-surges https://revcycleintelligence.com/news/40-hospitals-in-ny-for...
        edmcnulty101 5y ago
        > we don't have the capacity to handle a sustained 15% increase in ICU use. 100 - 15 is 85. There's 85% left to handle it. Where is this 85% going and why is it less of a concern in flattening the curve? why is no one concerned about this 85% of non-covid ICU patients?? Seems to me covid is a small fraction of ICU cases. Seems to me maybe the ICU should work on handling its caseload.. Seems to me maybe there's systemic problems like the AMA limiting the number of health professionals to keep the salaries up and firing the ones who have natural immunity. Maybe that's why the curve can't get flattened. but one thing that is crystal clear from the data is that covid is not the primary cause of hospital overflow.

joshuamorton 5y ago

Icus in normal times stay at 70% capacity, so covid adding 20-30 percent capacity fills them up. Doing what CA does, flattening the curve and keeping covid induced capacity at 10-15% allows hospitals to continue functioning normally.

edmcnulty101 5y ago
Sounds like maybe whats causing the curve to need flattening is the 80% of non-Covid cases in the ICU?
- joshuamorton 5y ago
  > Marin and Santa Cruz have LESS Covid patients and are closer to overflowing than Escambia. So I went ahead and checked this, and it's wrong. Escambia's ICU capacity is 87% full, SC's is 90% full (and SC is a bad choice, as they have a total of 21 ICU beds in the county, they use bay area ICU beds for overflow, which are currently sitting at ~80% capacity), and Marin's is....40%. So I'm not sure what data you're looking at, but it seems to just be wrong. Secondly, no, covid capacity really is the problem, because for the last year and a half, hospitals were reducing non-critical care. That means you have tons of people who need hip replacements or brain surgery or tumor removal who haven't been able to get it. Many of them will need to recover in the ICU a bit, so you'd want a higher baseline ICU use post-elective surgery freeze, as that implies that the "clog" is being recovered from. If the hospital is still full due to covid patients, those elective surgeries will never get done, leading people who never caught covid to suffer too. So low covid capacity, but higher overall use temporarily means that we're catching up to all the deferred non-covid care, something we really need to do! The other possibility is that you mean that the 70-80% that ICUs normally run at is somehow problematic (because well like I just said, we did actually "flatten" it by deferring elective ICU recovery for more than a year in many places). The US already has more ICU beds per capita than most nations, even other developed nations, so I'm not sure what your idea here is other than perhaps, "The us population is too unhealthy or is providing too much healthcare", which are both interesting positions to take for sure.
  - edmcnulty101 5y ago
    >Secondly, no, covid capacity really is the problem, because for the last year and a half...<a bunch of non quantitative opinion based unprovable emotional gish gallop stuff I didn't read.> Bullshit. Actual data says that Covid patients in ICU take up between 8% to 20ish% of admissions. COVID is not causing the curve to be need flattening. The medical system is. Maybe they shouldn't fire medical professionals who got immunity through COVID infection instead of the vaccine.
    - joshuamorton 5y ago
      > Actual data says that Covid patients in ICU take up between 8% to 20ish% of admissions. Yes, and actual data says this is a problem, because we don't have the capacity to handle a sustained 15% increase in ICU use. That is simply not a thing we have the capacity to handle. > Maybe they shouldn't fire medical professionals who got immunity through COVID infection instead of the vaccine. The less than 1% of people who fall into this category are probably not the issue. 1% more nurses isn't going to address 15% more patients. > <a bunch of non quantitative opinion based unprovable emotional gish gallop stuff I didn't read.> You really should have, because none of it was "emotional" and most of it was quantitative, so this makes you look rather silly. Like c'mon, you've lied about how full hospitals are in California, when confronted on that you claim I'm "gish galloping" with emotional nonsense that's just true[0] factual content about how we handle and have handled hospital capacity and why your (completely conjectured!) conclusion was wrong. [0]: https://revcycleintelligence.com/news/40-hospitals-in-ny-forced-to-stop-elective-surgery-as-covid-19-surges https://revcycleintelligence.com/news/40-hospitals-in-ny-for...
      - edmcnulty101 5y ago
        > we don't have the capacity to handle a sustained 15% increase in ICU use. 100 - 15 is 85. There's 85% left to handle it. Where is this 85% going and why is it less of a concern in flattening the curve? why is no one concerned about this 85% of non-covid ICU patients?? Seems to me covid is a small fraction of ICU cases. Seems to me maybe the ICU should work on handling its caseload.. Seems to me maybe there's systemic problems like the AMA limiting the number of health professionals to keep the salaries up and firing the ones who have natural immunity. Maybe that's why the curve can't get flattened. but one thing that is crystal clear from the data is that covid is not the primary cause of hospital overflow.