General Corona Virus Discussion

Uwe · Dec 1, 2020

Bruce said:
I did not see that photo.

Mike pointed out that the picture above was a Texas Aggies game, and the thing you see in the lower right-hand corner is an "ad" for the Seahawks/Eagles game.

-Uwe-

Jack@European_Parts · Dec 5, 2020

The U.S. Has Passed the Hospital Breaking Point

A new statistic shows that health-care workers are running out of space to treat COVID-19 patients.

amp.theatlantic.com

So much for election ending COVID huh?

PetrolDave · Dec 6, 2020

Jack@European_Parts said:
The U.S. Has Passed the Hospital Breaking Point

A new statistic shows that health-care workers are running out of space to treat COVID-19 patients.

amp.theatlantic.com

So much for election ending COVID huh?

The COVID virus doesn't understand elections, maybe changes in human behaviours though :confused:

Uwe · Dec 6, 2020

Jack@European_Parts said:
The U.S. Has Passed the Hospital Breaking Point

A new statistic shows that health-care workers are running out of space to treat COVID-19 patients.

amp.theatlantic.com

Oh no, 100,000 people with the 'ro in hospitals. Sounds terrible. "Faced with a surge of severely ill people, doctors and nurses will have to put beds in hallways"

Of course the article doesn't bother to tell you how many staffed hospital beds there are in the USA.

Anyone wanna take a guess?

Over 900,000.. So about 11% of all hospital beds in the country are occupied by 'rona patients. Context. It matters.

-Uwe-

DV52 · Dec 7, 2020

A new term that's entered the Australian vernacular - "double donut day"; it means a day where the COVID stats declare no new infections AND no deaths. My home state Victoria (which is on the South of the continent) has recorded its 37th straight "double donut day" and based on its present trajectory, Australia could officially eliminate the virus by Christmas (some say here) - great outcome indeed but let's not tempt the fates!!

Don

Uwe · Dec 7, 2020

DV52 said:
A new term that's entered the Australian vernacular - "double donut day"; it means a day where the COVID stats declare no new infections AND no deaths. My home state Victoria (which is on the South of the continent) has recorded its 37th straight "double donut day" and based on its present trajectory, Australia could officially eliminate the virus by Christmas (some say here) - great outcome indeed but let's not tempt the fates!!

Don

Sure, when you (and New Zealand) isolate yourselves from the rest of the world in the manner than you have, you can achieve this "success". I could accomplish the same thing on a smaller scale by never leaving my house, and never interacting with anyone. But how long can anyone, no matter whether it's a house-hold or a sparsely populated island/continent maintain the required level of isolation? And what happens then? Yet another lock-down?

-Uwe-

Andy · Dec 7, 2020

Related to NZ lockdowns, this is a Porsche youtuber I follow who is now locked away in a hotel with armed guards presumably shooting anyone who violates order, in the interest of preventing harm:

Uwe · Dec 7, 2020

Andy said:
now locked away in a hotel

Yep. Possible when your country is an island surrounded by shark-infested waters. But it's kinda pointless when your country has thousands of miles of extremely porous land borders.

Oh and no internet? That's just cruel!

-Uwe-

DV52 · Dec 7, 2020

Uwe said:
Sure, when you (and New Zealand) isolate yourselves from the rest of the world in the manner than you have, you can achieve this "success". I could accomplish the same thing on a smaller scale by never leaving my house, and never interacting with anyone. But how long can anyone, no matter whether it's a house-hold or a sparsely populated island/continent maintain the required level of isolation? And what happens then? Yet another lock-down?

-Uwe-

Uwe- hmm.......... I suspect that perhaps there is a misunderstanding of what "lock-down" means - maybe? "Lock-down" does not equal "Quarantine"!!

Australia has a population of about 25 Million and it has 6 x States and 3 x internal territories. Our population density is 3.2 people per square kilometer - but this is misleading because the vast majority of our land mass (the center of the continent) is desert-like. So the population is more densely located around the coast (mostly on the eastern side).

Anyhow, for the purposes of COVID, we operate at State/Territory level with federal government oversight - so effectively 9 x separate COVID cells. COVID restrictions here escalated with the infection levels within the community. Certainly, no one was happy about the restrictions, but there was a general acceptance in the community of the State government impositions (yes, we also had our share of complaints from some folk).

Stage 4 = "lock-down". It's certainly true that lock-down meant restrictions on both commerce and community - but it's a tad incorrect to define this as "never leaving my house, and never interacting with anyone". We were able to do both albeit with limitations.

I really do understand your point - and I suspect that stuff could have been done differently down here. But we are now out of the second wave of COVID and our health care system has survived the onslaught (notwithstanding the tragedy of those individuals that didn't survive).

Could we have done a better job (as distinct from a different job)? No doubt, the answer is a resounding "Yes" and of course there are lessons to be learned from our approach.

However, I would more prefer Australia being at a point of double-donut days and asking how we might relax the past lock-down restrictions in a possible third wave - rather than the alternative of watching infection rates and deaths rise in the community because certain civil liberties are considered sacrosanct amongst the inevitable community sacrifices needed to fight a war (i.e. a pandemic).

Ultimately, these are questions of fine balance in which hindsight is never an available facility at the time of making decisions !!! :facepalm:

Don

Uwe · Dec 7, 2020

DV52 said:
I would more prefer Australia being at a point of double-donut days and asking how we might relax the past lock-down restrictions in a possible third wave - rather than the alternative of watching infection rates and deaths rise in the community because certain civil liberties are considered sacrosanct

Meanwhile I am shocked and dismayed by the large number of people who are willing to give up liberties that are supposed to be sacrosanct in exchange for small and temporary increase in safety.

-Uwe-

DV52 · Dec 8, 2020

Uwe said:
Meanwhile I am shocked and dismayed by the large number of people who are willing to give up liberties that are supposed to be sacrosanct in exchange for small and temporary increase in safety.

-Uwe-

Uwe: Don't be shocked and please don't be dismayed- Australians/Victorians/Melbournites are as passionate about their liberties as any one else and rest assured that I'll be the first to knock on your door (gun in hand but no knowledge about its use) to join the revolution if ever there is a real threat to citizen rights.

Your position regarding lock-down is theoretical - my position regarding lock-down is based on actual experience!! I really think that your use of the term "Give-up" might also be a tad over-the-top!! From my experience - "temporarily suspend" is a better description of what happened down here under lock-down. Or better said, "temporary suspension" with a very, very high degree of certainty that whatever civil liberties we discontinued would be returned when the statistics abated. And guess what -our liberties were returned when the numbers abated.

So the fears of the few who preached gloom-and doom down here before our Stage 4 restrictions were unequivocally and demonstratively WRONG! The lock down wasn't a Government subterfuge to rest control from the people. Nor was the lock-down a clandestine attempt by our ruling political party to enslave the populous under a dictatorship like rule; ALL the conspiracy theories were WRONG!.

In fact, quite the opposite; the Government lock-down was shown to be motivated by exactly the same objectives that the rank-and-file had in agreeing to temporarily suspend their civil liberties- they both wanted to create an environment where a virulent infection in our community would have the least impact! And isn't this exactly what is expected (what is demanded) in a healthy democracy; communities that work hand-in-hand with their elected Governments for the common good and in a pandemic, for the good of those that might otherwise fall ill and die. And yes - like all things in life that are worth pursuing, there are sacrifices that we must all make in the process - but what's the alternative? Should we all hunker-down in our private silos and staunchly defend our civil liberties while the pandemic rages in ever increasing record numbers in our neighborhoods?

I'm not sure if our double donut days coming so soon after the lock-down was a fluke - maybe? But I'm glad (and somewhat proud) that we have achieved this meaningful, albeit perhaps temporary milestone. And I am willing to credit both our Government and my fellow citizens for the success. American communities might have a different view of the intentions of their elected Governments - I don't know. But if such feelings are rife in your communities - it may speak volumes about the health of your democracy!!

Don

jyoung8607 · Dec 8, 2020

Uwe said:
Oh no, 100,000 people with the 'ro in hospitals. Sounds terrible. "Faced with a surge of severely ill people, doctors and nurses will have to put beds in hallways"

Of course the article doesn't bother to tell you how many staffed hospital beds there are in the USA.

Anyone wanna take a guess?

Over 900,000.. So about 11% of all hospital beds in the country are occupied by 'rona patients. Context. It matters.

-Uwe-

If a COVID patient can't recover at home and is actually admitted past the ER, they're close to or actually in-need of intensive care with the associated equipment (ventilation, etc) and staff skill/ratio needs. As you can see in your own link, ICU beds are a tiny fraction of the total.

December utilization for Florida hospital ICU beds is above 80%: healthdata.gov. Click the date collected header to sort by date, or click the Filters button to change the FL state filter to something else as you like. Bed utilization doesn't necessarily reflect quarantine measures needed to separate COVID cases from other ICU patient needs, etc.

ICU beds and staffing are no joke. I visited my youngest son briefly in one, when he was coming out of surgery for adenoid removal when he was 2 or 3 years old. He was intubated during surgery and had been weaned off it, but had a very brief backslide into respiratory depression due to remnants of anesthesia. Have you ever watched one of your kids turn blue while you're holding them? Blue enough to make an experienced ICU nurse yank the CODE cord? I don't wish it on my worst enemy. To be clear, he was 100% fine in the end, the whole thing was over in less than 60 seconds. But ten seconds into it, I couldn't breathe myself. Some of that was panic, but a lot of it was the room instantly becoming mosh-pit dense with medical professionals. I really could have done without that life experience, but in a weird sort of way, I'm also oddly comforted for having seen the "TELEPORT 30 DOCTORS AND NURSES TO THIS LOCATION IMMEDIATELY" button at work. Kudos to Cincinnati Children's for that.

I don't tell you that as part of a commie-lib plot to tug on your heartstrings, but to make sure you understand not all hospital beds are alike. The bed you're in for having a broken arm set, or to convalesce from uncomplicated vaginal birth, or to recover from an appendectomy... those are very much NOT equipped and staffed ICU beds used by patients with respiratory distress or other COVID complications.

Uwe · Dec 8, 2020

jyoung8607 said:
December utilization for Florida hospital ICU beds is above 80%

I believe that. But again, context matters. What was the utilization in December of 2019, before Covid?

-Uwe-

jyoung8607 · Dec 8, 2020

Uwe said:
I believe that. But again, context matters. What was the utilization in December of 2019, before Covid?

My response to that would be threefold:

1, your literal answer: I can't immediately find good data for 2019, because of all the search engine hits on COVID-(20)19. I did find data for 2018 putting it around 68% for Florida. See pages 3 and 6 in the PDF below. Rural and urban capacity sum roughly aligns with upthread 2019/2020 capacity data.

https://www.ruralhealthresearch.org/mirror/13/1302/surge-capacity.pdf

2, your context answer: it doesn't matter if it was 20% or 68% or 90% before. What matters is whether we have hospital capacity (beds, staff, equipment, medication, consumables) to accept new COVID patients in a way that meets reasonable standards of care, or not.

3, your meta-context answer: some thoughts co-authored with my buddy Jack Daniels and then deleted as counterproductive.

PetrolDave · Dec 9, 2020

jyoung8607 said:
2, your context answer: it doesn't matter if it was 20% or 68% or 90% before.

I have to disagree there - we need to understand the scale of the extra strain on medical and funeral resources so that we can decide whether to believe the hype, and whether COVID-19 is something of a minor irritation (2018, 2018 & 2020 ICU occupancy substantially similar) or something to be really concerned about and that we all have a responsibility to take action (2020 ICU occupancy significantly higher than 2018/2019).

Uwe · Dec 9, 2020

jyoung8607 said:
it doesn't matter if it was 20% or 68% or 90% before.

Of course it matters. I guarantee you that normal ICU utilization is not 20% because nobody would build and staff them without the expectation that they will be used so rarely.

But let's phrase the question differently. If ICUs are 80% full, what fraction of the patients in them are there due to CV? Because that's what tells us: Will 20% more CV cases that need ICU care fill them, or is it 100% more?

-Uwe-

jyoung8607 · Dec 9, 2020

PetrolDave said:
I have to disagree there - we need to understand the scale of the extra strain on medical and funeral resources so that we can decide whether to believe the hype, and whether COVID-19 is something of a minor irritation (2018, 2018 & 2020 ICU occupancy substantially similar) or something to be really concerned about and that we all have a responsibility to take action (2020 ICU occupancy significantly higher than 2018/2019).

Uwe said:
Of course it matters. I guarantee you that normal ICU utilization is not 20% because nobody would build and staff them without the expectation that they will be used so rarely.

But let's phrase the question differently. If ICUs are 80% full, what fraction of the patients in them are there due to CV? Because that's what tells us: Will 20% more CV cases that need ICU care fill them, or is it 100% more?

To be brutally frank, we know those things. We have that understanding. Your questions are asked and answered on a daily basis by incredibly smart, qualified subject matter experts in positions of responsibility, along with many thousands of other professionals on the front lines, busting their asses and putting themselves at risk to save lives.

The problem is how to counter the perceptions of people who believe they're lying.

We could go through a whole tiresome argument about which word you'd use instead of lying: perhaps "over-dramatizing", or "fearmongering" if you like, or "just asking questions" in the dishonest style of Glenn Beck. Whatever term you want to use, if it's something that effectively conveys an accusation of making false statements, while granting you freedom from the burden of proof and absolution from the consequences of putting it out there, then let's just skip it. Have the sack and the integrity to man up and call them liars, or don't. That statement is the essence of my meta-context point 3 from my post last night, the one I deleted before posting, because my co-author was a much bigger asshole about it.

Here's an open raw dataset with some commentary:

GitHub - CareSet/COVID_Hospital_PUF: The community created FAQ about the hospital-level COVID capacity data.

The community created FAQ about the hospital-level COVID capacity data. - GitHub - CareSet/COVID_Hospital_PUF: The community created FAQ about the hospital-level COVID capacity data.

github.com

Here are some excellent visualizations along with current hotspots; note how screwed NM/SD/ND are at this particular moment:

‘There’s No Place for Them to Go’: I.C.U. Beds Near Capacity Across U.S. (Published 2020)

More than a third of Americans live in areas where hospitals are running critically short of intensive care beds.

www.nytimes.com

Coronavirus in the U.S.: Latest Map and Case Count

A detailed county map shows the extent of the coronavirus outbreak, with tables of the number of cases by county.

www.nytimes.com

I believe that our hospital ICUs are dangerously full, because credible experts say so, and there's a mountain of evidence to back them up: video, audio, personal testimony, graphs and projections, availability of detailed underlying raw data, the concurrence of hundreds of other subject matter experts, and there isn't any real evidence I'm aware of to say it's false. Why don't you share this understanding? Who told you you're being lied to? If you believe you're being lied to, what standard of evidence will convince you otherwise? Does such a standard exist?

If you really want to discuss the headroom/margins and how fast the space could fill up, then let's discuss. But instead let's start from a place of "I don't yet understand, how does this fit in" rather than "here's a tangentially related datapoint about hospital capacity HAHA FAUCI BUSTED CHECKMATE."

dieseldub · Dec 9, 2020

The California state government last week divvied up the state into "regions" and made a plan that enacts the most restrictions (stay at home orders) should available ICU beds fall below 15%. Actually sounded like a pretty reasonable plan considering my region at least seemed to average closer to 25-30% availability throughout most of the pandemic.

Southern California has been in trouble in the last month with a massive spike in cases and starting to stress hospital capacity, but here around the Bay Area it's largely been OK with the exception of Santa Clara county (San Jose and surrounding cities).

Where my shop is, Marin county, is one of the lesser populated and more spread out counties of the state, has had a relatively low case load in comparison to these areas, 25% ICU bed availability, they still decide to issue stay at home orders anyway.

That was a wild swing for me in the span of a day. Went from going "Hey, finally a reasonable metric I can understand the logic to increase restrictions--and our area has been doing OK so I'm not too worried about being issued a stay at home order again."

Next day, the county issues their stay at home order anyway despite having good numbers. Just... FU.

Apparently this county just hates local businesses. Went to my favorite breakfast spot the day before the stay at home orders took effect, since even outdoor dining won't be allowed, and left them what extra I could for a tip.

As beautiful as this area is, how many of my customers have been great, I'm over it. Time to go where I can actually afford property rather than being rent poor.

jyoung8607 · Dec 9, 2020

dieseldub said:
Where my shop is, Marin county, is one of the lesser populated and more spread out counties of the state, has had a relatively low case load in comparison to these areas, 25% ICU bed availability, they still decide to issue stay at home orders anyway.

That was a wild swing for me in the span of a day. Went from going "Hey, finally a reasonable metric I can understand the logic to increase restrictions--and our area has been doing OK so I'm not too worried about being issued a stay at home order again."

Next day, the county issues their stay at home order anyway despite having good numbers. Just... FU.

So far as questioning public health orders has gone in this thread, this is a pretty good one.

I spent a few minutes puzzling out why Marin County says it's implementing the State's Regional Stay Home Order, but according to the State's data, it isn't subject to the RSHO and has 20.9% ICU availability. It turns out, they are in fact not subject to a regional order at this time, but are choosing to implement something identical.

I can see a number of real rationalizations for why they'd pull the trigger early. Directly connected to a sicker county full of commuters by the world's most iconic bridge, Thanksgiving hangover and upcoming Christmas surges, trendline headed in the wrong direction fast: 20.9% availability today is down from 24.1% three days ago, with one county already below the 15% limit and the whole region projected to hit the threshold by mid-December. But... that's not what's on Marin County's website.

IDK what they're saying in the media, but on their website, they just refer back to the State order. I don't know for sure what the motive is there. If I had to guess, I think with all the maliciously stupid hoax-flu-nobigdeal-democrat-CHYYNNA-conspiracy floating around, they want to do the right thing but it's very tempting to shield themselves with a narrative that it's out of their hands, the State is making them do it, let the political blowback roll uphill. But in this case, it's not quite true, and it conflicts with the State's message and takes away some of that ability for you to track and understand and plan on your own based on the available data. Worse yet, it nourishes that big government control conspiracy narrative when we need to be starving it.

So yeah, I get that this sucks, and it was confusing. I'm not a big fan of the way they're rolling it out. If it makes you feel any better about it, you were getting this order in a week or two even if Marin County took no action.

Uwe · Dec 10, 2020

The stories regarding hospital capacity have a strangely familiar ring to them. Just a few examples; there are many more:

USA:

Hospitals Overwhelmed by Flu Patients Are Treating Them in Tents

Across the country, medical centers are taking extraordinary measures.

time.com

Hospitals overwhelmed by mass influx of flu patients - UPI.com

Hospitals and medical centers across the United States are scrambling to treat a mass influx of flu patients.

www.upi.com

California hospitals face a 'war zone' of flu patients — and are setting up tents to treat them

California hospitals have had to scramble for more space and staff to keep up with the high numbers of patients showing up in the ER sick with a deadly strain of the flu.

www.latimes.com