Yes we can shift a lot of resources around. But you have to realize it means nothing else is getting done. All elective surgeries are cancelled until further notice. All of our anesthesia residents have been temporarily assigned to ICUs, along with every other qualified fellow (cardiology etc) in the institution. Currently about 310 of our 900 total beds are occupied by covid patients, and we are increasing by 15-20 covid patients per day. The peak in April was 160. Not looking good. Some hospitals in the state are something like 80-90% covid patients, e.g. El Centro.
The limit on hospital beds is more often a staffing limit than a physical limit. It isnt like there is a huge pool of RNs out there available to hire to staff an extra 20 beds every day. This is particularly true of ICU nurses. Most nurses dont work in ICUs. Respiratory therapists are also in high demand. Overtime is very expensive. If you come into the ER for any non-covid reason, your care will be impacted, including the ambulance taking you to a distant facility because the ER where you would like to be taken is closed. At any rate we will do what we have to do. Most of the fear mongering is media driven - not hospitals or providers. Our hospital is normally full. Giving up over 300 beds is a big deal. But no one is in the parking lot - yet. Hospitals are only "businesses" in the sense that they are not publically supported, so they run as nonprofits typically. They have to watch the bottom line or they can run out of cash quickly. If they were not run as businesses, we would have to pay for them with tax money. Daily new cases seem to have peaked here now, but hospitalizations tend to lag the new cases by a week or two. So we could easily be over 400 patients in hospital before this wave subsides. We also have no idea why we are even in a wave, as we remain mostly locked down, but there are lots of people in high density housing working essential jobs who are likely contributing, and apparently that is enough to cause a spike. In other news, some details of the botched CDC testing fiasco. What a cluster this turned out to be when they could have simply bought some tests from Thailand or Korea. A real "perfect is the enemy of good" scenario: https://www.washingtonpost.com/investigations/cdc-covid/2020/12/25/c2b418ae-4206-11eb-8db8-395dedaaa036_story.html?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_most&carta-url=https%3A%2F%2Fs2.washingtonpost.com%2Fcar-ln-tr%2F2de0633%2F5fe766a79d2fda0efb94a093%2F5e2922849bbc0f632602b279%2F8%2F68%2F5fe766a79d2fda0efb94a093 On Mon, Dec 21, 2020, 11:41 AM Meade Dillon via Mercedes < mercedes@okiebenz.com> wrote: > My understanding of the hospital bed "shortage" is that hospitals are > businesses, and having an empty bed "just because" is a money losing > proposition. Thus the number of available beds is set based on demand and > forecasted demand. Chicken Little crying about the sky is falling because > hospital beds are nearly full / nearly at capacity is deceptive > fear-mongering. When the demand exists, hospitals will meet it. Back at > the start of this panic, the US. Navy hospital ships were mobilized, one to > each coast, and they were not used to treat Wuhan Red Death patients. That > would be a money losing proposition for the hospitals, so no one should be > surprised. > ------------- > Max > Charleston SC > > > On Mon, Dec 21, 2020 at 11:12 AM Curt Raymond via Mercedes < > mercedes@okiebenz.com> wrote: > > > You do bring up a good point about hospitals being hit with shortages > > again. You'd have thought that having the summer off they'd have stocked > up > > on PPE. I've certainly stocked us up on cleaners, TP and paper towels. > I've > > got meat and frozen veg laid in assuming we're going to be locked down > > starting at the first of the year. > > Apparently hospital administrators don't think ahead. Angie has laid in a > > year's worth (!) of masks, rubber gloves and cleaner for her practice > > although I expect her to be closed down after the holidays. > > -Curt > > > > On Sunday, December 20, 2020, 6:11:39 PM EST, Clay Monroe via > Mercedes > > <mercedes@okiebenz.com> wrote: > > > > Short term success in this plague is no measure of long term > > effectiveness. > > > > There are small victories that have not withstood the test of time. > > Kauai, HI shut itself off for seven months and now is being hard hit by > > infections. AK also thought it had a handle, but that early control was > > shown to be immune to the reality of disease spread. New Zealand also > > though they had mastered it, but keeps getting hit while being sealed off > > from the world. And the list of places that followed the narrative of > > plague control are now hotbeds. > > > > The West Coast is full of sheeple who would willingly follow mandates and > > narrative. Yet that willingness to isolate and mask has not translated > > into a reduction. Medical centers are filled to the gills. Maybe the > > agenda would have been more effective had historical data been used to > plan > > for the inevitable secondary and tertiary waves that would truly tax and > be > > greater yet than initial contagion. The public was shown those trends as > > they were trotted out by talking heads and officials as a means to > convince > > the populace that such as thing as “flatten the curve”. Which really > just > > meant to prolong the disease until an effective response could be > > mustered. > > > > Today we are witnessing just what a sham the flat curve was. Nobody > seems > > to have bulked up a response to better handle the coming surge. Where > are > > the bigger treatment centers and beds? Who has all the N95 masking, > > gloves, gowns that the current wave requires? How many of the laid off > > medical staff are being repurposed to care for both the infected as well > as > > those requiring normal care? The disease has been kept at a simmer… low > > and slow. That seems to point to an effort to keep it a crisis, not to > > effectuate a reliable treatment or cure. > > > > Now the discussion is how to triage. Since the pooch was screwed, we > will > > now be looking at providing treatment for those who can be saved instead > of > > the heroics for all methods used over the last ten months. Today, > doctors > > and administrators really are deciding whose Granny gets to live and who > > they will be sending to the morgue. An acceptance of the reality of > > lacking required resources, proper treatments, true dimensions of the > > transmission, and hubris those in charge are guilty of. May have been > more > > realistic to have allowed the thing to burn out and achieve herd immunity > > naturally. That is what happens in Africa with Ebola, no matter how much > > prancing around WHO/UN/MSF and the Gates Foundation did. > > > > It will be decades before there is enough verifiable data to show what > > really was effective and what was tissue paper dreams. Just like medical > > proclamation of the magic of radiation treatments has turned out to have > > been a lethal dose of false narratives. From Marie Curie on, and that is > > just one example of modern doctors and medical professionals getting > things > > oh, so, very wrong. Diet pills, pain pills, early government endorsed > > treatments for HIV/AIDS turned out to be damaging, ineffective, or > outright > > toxic and became public health embarrassments. All that Oxy pushed by > > doctors could well be the root cause of the homeless crisis. FDA and CDC > > endorsed the use. Look how right they got this crisis. Or, lets ban and > > not allow research into THC, which is very effective in treatment of many > > health issues. Helps with side effects of chemo, ophthalmic issues, and > > might even assist in breaking fatal outcomes in opioids laces with > > fentanyl. (Currently being investigated in BC Canada) > > > > There are no simple or easy solutions. There are no political personages > > who were not chasing their own tails on this. Because those supposed to > be > > “enlightened” and medically trained or establishment endorsed speaking > > heads could not provide a reliable or consistent message from the start, > > and kept on vacillating if not daily then on a weekly basis. Hard to > hit a > > target spun out of control by the people you are supposed to trust on the > > issue. > > > > Clay > > > > > > inter urinas et faeces nascimur > > > > > On Dec 19, 2020, at 7:34 PM, Karl Wittnebel via Mercedes < > > mercedes@okiebenz.com> wrote: > > > > > > That is a reasonable question. I tend to think that had they been > allowed > > > to do what they wanted to do, based upon their expertise in this area, > > > rather than being micromanaged at every turn by people with no formal > > > training in medicine, public health, or any other form of scientific > > > endeavor, that things would have been very different in terms of the > > course > > > of this epidemic and its magnitude. We have lots of examples of > countries > > > that had a strong centralized government response, and did far better > > than > > > we have in terms of deaths per 100k. > > > > > > _______________________________________ > > http://www.okiebenz.com > > > > To search list archives http://www.okiebenz.com/archive/ > > > > To Unsubscribe or change delivery options go to: > > http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > > > > > > _______________________________________ > > http://www.okiebenz.com > > > > To search list archives http://www.okiebenz.com/archive/ > > > > To Unsubscribe or change delivery options go to: > > http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > > > > > _______________________________________ > http://www.okiebenz.com > > To search list archives http://www.okiebenz.com/archive/ > > To Unsubscribe or change delivery options go to: > http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com > > _______________________________________ http://www.okiebenz.com To search list archives http://www.okiebenz.com/archive/ To Unsubscribe or change delivery options go to: http://mail.okiebenz.com/mailman/listinfo/mercedes_okiebenz.com
