As we discussed earlier this week, COVID hospitalizations significantly lag new infections. Today’s new hospitalizations were likely Halloween’s new infections. The US is currently in a massive upswing of infections at this time.
Wisconsin is reporting that their hospital systems are nearing capacity:
More than 7,000 people in Wisconsin tested positive again on Wednesday — the third time in the last five days — and 62 more people died. Hospitalizations are at a record high, too, with just 8% of the total number of ICU beds in the state available.
Infections for the week before Halloween was averaging about 5,000 new cases per day. Cases have skyrocketed in the state.
This matters a lot. Symptomatic case fatality rate when there is sufficient hospital capacity is about 1.7%. This will vary by a function of individual characteristics, treatment technology availability, learning and luck. Older, heavier and male patients have worse outcomes than younger, lighter and female patients. HOWEVER if there is insufficient hospital capacity available, fatality rates increase significantly and quickly. A lot of people who would be saveable won’t live through a hospitalization.
In the April and July surges, the hospital demand peaks were localized. National reserves and resources could be deployed. There were jets full of nurses and doctors flying into metro New York for three and four week tours to supplement and relieve local trained staff. Flights headed down to Florida, Texas and Arizona from the Northeast over the summer to do the same. The first two surges were accompanied by regions of the country with significant slack. There was flex in the system.
I am not sure if we are able to mobilize locally slack resources to surge to states. This is not a political judgement. It is a judgement that almost the entire country is red with rapidly rising daily case counts. There are no big states with low case counts and large medical complexes that are underutilized.
If regions have their hospitals overrun, fatality rates will quickly spike. Reserves and deployable resources that added skilled, trained staff to extend surge capacity in the first two waves may not be readily available.
Mask-up and stay distant as much as you can.
satby
Hey David, not to be a pest, but can you do the covid image on this one too? I shared it an it looks like a big white cat is talking about hospital utilization.
David Anderson
Updated
PenAndKey
This one hits close to home for me. My ex and I are still in contact on social media and her father contracted COVID in his nursing home. The hospitals in the La Crosse area are at capacity already and there weren’t any beds to send him to so they had to try and set up a COVID field ward in the home instead. The last I heard he had taken a turn for the worse two days ago and I honestly will be surprised if he survives. The worst part, besides the death of a great man? She is a nurse at one of the local hospitals herself and hasn’t been able to see her dad in months. The last visit she had was, literally, her climbing on top of a three story ladder to talk to him through his room window because he is too frail to be transported to the ground level.
And yet we still claim to be the “greatest country on earth”? This isn’t the sort of thing citizens of a major world power should ever have to deal with, yet here we are.
Sab
@PenAndKey: This is it. I have dental appointments next month. Cancelling. Not going to risk it when neither I nor my spouse would meet the triage criterion to be treated in a hospital.
bluefoot
My sister is a doctor in Wisconsin in one of the major hospitals. They have insufficient PPE, staff can’t get tested for the virus regularly (only if you have symptoms, not even if you’re a close contact of someone who has COVID), healthcare workers are already burnt out. They never really stood down from the emergency staffing they were doing – where people with any kind of training in COVID-related areas were pulled off their regular responsibilities to take care of COVID patients. That means a lot of people aren’t getting their regular care because there aren’t enough doctors, nurses, etc. It’s a mess and will be turning into an actual horror show.
satby
@bluefoot: that fact that hospitals STILL face a PPE shortage is a crime that I hope someone (cough, Jared) is held accountable for.
bluefoot
@satby: Yeah, and it’s not just Wisconsin. Someone I know who works at one of the major hospitals in Boston say the same about insufficient PPE. We are 10 months into this and we still can’t get PPE for healthcare and essential workers. It makes me want to punch things.
Tangentially, one of the things that has surprised me about myself in the last four years, especially the last 10 months, is how much I hate these sociopaths. The sheer depth and breadth of human suffering these people caused makes me want all of these sociopaths to have all that suffering and death visited upon them.
I’m normally a peaceful person, but I truly want them to die, if only to stop them from hurting more people. And I don’t think they will stop until they die.
Edmund Dantes
We are the Titanic and the coronavirus is the iceberg ripping a hole alongside alongside our hull.
PenAndKey
I’m not as nice as you are. The only reason I don’t voice the true depths of what I actually think on a near daily basis is that I’d prefer to avoid getting put on watch lists.
tarragon
I’ve just been ignoring my Dentist’s office attempts to get me to come in. No thank you.
I cancelled a long standing appointment for a medical test. The earliest possible reschedule was Aug, 2021 so I signed up for that and will reschedule again if needed.
tybee
ditto
Eunicecycle
@PenAndKey: Me too. I got put into Twitter jail for saying I wanted someone to take a long walk off a short pier. And that was very mild considering what I was really thinking.
NeenerNeener
I’ve got an eye test, an MRI, a mammogram and NYS car inspection all scheduled before year end. The only one I can’t put off is the car inspection. I really need the MRI so they can figure out why I never got all the feeling back in my right hand after a bout of rotator cuff tendinitis last spring, but I can’t spend 90 minutes to 2 hours in an MRI machine wearing a mask, even with valium.
marklar
I was in a meeting yesterday with a bunch of pre-med academic advisors yesterday, and the exponential spread came up. I mused that we’re currently watching an “inaction potential”. We are sitting on the axon hillock, and the graded potentials (i.e., small, individual inputs) are adding up. We’re heading for a pretty scary action potential (the term for when a neuron “fires”, which occurs once the graded potential reach a tipping point). This will be pretty much fine, until the voltage gates open, and then we’re screwed.
JPL
@PenAndKey: SAME
BC in Illinois
Headline in St Louis Post-Dispatch
In the meantime, St Louis City and St Louis County are tightening restrictions, while the worthless (recently elected to a full term) Governor is loosening restrictions because that’s more popular in the rural areas, whose hospitals are closing because the worthless Republican legislature refuses to expand Medicaid. The Missouri Republican approach to health is to kick people, including thousands of children, off Medicaid, sue to eliminate the ACA (Hawley), and resist any Covid-mitigating steps, for Freedom’s sake.
Salus Populi Suprema Lex Esto
“Let the health / well-being of the people be the highest law”
Misery State Motto
louc
I just read this Atlantic piece, which says there are no staffed hospital beds left in the entire state of Iowa and that hospital workers across the country have reached their breaking point.
Bill Arnold
[Thank you for these analytical-style posts. They tighten up my (our) thinking.]
A woman from anywhere (formerly Mohagan)
I heard on MSNBC last night that there are no available ICU beds in Utah. At all. Period.
moops
Welp, we stumbled our way into widespread triage. Doctors are now going to have to ration care and start picking victims and survivors. After a week of that kind of medical work they will start to develop more mental problems. On top of the higher direct death toll. I recommend not having a cardiac event for the next two months.
Humanities Prof
This is HP’s wife, a physician (OB/GYN). My rural hospital is full (except the L&D ward). Our tertiary hospitals are not accepting transports because they’re full. It is a fucking shit show. I’m fucking terrified of WHEN (not if) we get a really sick maternity patient.
Aaron
#FIFY
Bob Hertz
@Aaron: American hospitals have so many lives over the years, that we are worried and depressed when we realize that some Covid patients will die.
We are being perfectionists. And that is not wrong, but we are not monsters if we lose some lives.
Losing an 85 year old Covid patient would not concern us in all of prior human history.