In addition to Idaho activating “crisis standards of care” (read: rationing) for the whole state, every ICU bed in Anchorage is full, so presumably Alaska has de facto crisis standards, declared or not. If you want a real Death Panel, make sure your state has a Republican Governor. None of these fuckers is going to mandate vaccines, lock down or even mandate masks.
Here’s my question: at what point do neighboring states stop taking COVID patients from these red hell holes to preserve their hospital capacity? For example, here’s a local Spokane station’s tour of the ICU in a big hospital there, which is pretty much full of COVID patients. That hospital probably has a good number of Idaho overflow patients. Here’s one from a couple of weeks back in Oregon, which raises still another question: how many country anti-vax yokels should be admitted from rural counties to the Portland hospital? I’m sure there are community hospitals in smaller towns that can put them on oxygen or a bipap and give them their experimental infusions (anything but the vaccine, natch, wouldn’t want to put something unknown in their precious white bodies.) Those hospitals are probably full, too, but there is some justice in having the unvaccinated die due to lack of hospital beds instead of the other folks that are vaccinated but are having heart attacks.
By the way, both of those links are to local TV station specials showing how shit and awful it is to die of COVID in an ICU. They’re both well done and good journalism. I’m assuming they aren’t Sinclair stations.
Jim, Foolish Literalist
Michelle Shocked! (Anchored down in) Anchorage!
I never get these.
@Jim, Foolish Literalist: Too bad she became a fucking facist!
I’m pretty sure the answer is that you have to accept all of them until you have room for no more. That is the moral and probably the legal answer.
Jim, Foolish Literalist
@raven: oy, forgot about that
I don’t think she’s well
Four Seasons Total Landscaping mistermix
@raven: Yeah she lost the plot, sadly.
I love that song so hard and agreed on the too bad about her, now I feel bad about loving the song. Somebody needs to do a cover version of Anchorage and Come A Long Way and The Hard Way so I can enjoy them again.
Lord Fartdaddy (Formerly, Mumphrey, Smedley Darlington Mingobat, et al.)
These assholes have all gotten mumps shots and polio shots and all that shit. I remember when Rick Perry mandated that all the girls in Texas had to get shots for H.P.V., or whatever that’s called, when they reached some specific age. Did people in Texas freak out about that they way they’re doing now? I don’t know what comes about 37 steps beyond “fucked up”, but that’s where we are now.
Four Seasons Total Landscaping mistermix
@Isua: Pescado mojado me encontre
Texas: “We are big. It’s the pictures that have gotten smaller.”
@Lord Fartdaddy (Formerly, Mumphrey, Smedley Darlington Mingobat, et al.):
There was actually a big RW freakout over the HPV vaccine, claiming it “rewarded and encouraged promiscuity.”
For those still wondering about that shit Abortion “law” from Texas, an attorney I follow on YouTube has covered its impact, and history, in some detail: https://www.youtube.com/watch?v=PnO7pL-QWyc
If you prefer a written explainer, I posted https://www.texasmonthly.com/news-politics/texas-abortion-law-explained/ a couple days ago.
Old Man Shadow
@Lord Fartdaddy (Formerly, Mumphrey, Smedley Darlington Mingobat, et al.):
As I recall, there was a lot of Evangelicals freaking out because their daughters would be total slutty sluts if they didn’t have to worry about getting cancer, but they weren’t ready to throw down with their 2nd amendment about it.
I say just triage these unvaccinated puds into open fields. Live by social Darwinism, die by social Darwinism.
Plenty of Spokane patients are from the surrounding Washington hinterlands or even the blood-Red Spokane Valley. Eastern Washington is Trump country.
Bringing forward my comment at the tail end of the dead Canada thread, which is actually more apropos here. I was commenting specifically with respect to ID and MT folks flooding into Spokane hospitals….
James E Powell
I feel like the press/media were all prepared for the recall to succeed and don’t have anything smart or useful to say about it.
LA Times headline: A California in crisis awaits Newsom after landslide win in recall.
Hey assholes, he’s been governor the whole time. He didn’t take time off for the recall. Nobody is “awaiting” him.
Hospital pretty much has to accept a transfer if it has capacity. In practice, there seem to be a lot of hospitals that are not accepting transfers based on, I guess, their expected admissions within a short-term period. ICU care is supposed to be transitional. Covid patients are requiring care for weeks at a time. We aren’t built for that. Nor, really, should we be since this level of trauma is nearly 100% avoidable.
I keep thinking about the young couple with 3 kids under 8 and another on the way, where the wife was just trying to be “careful” by not getting vaccinated while she was pregnant. No idea what the hubbie’s thinking was, but it was more of a “wait and see” kind of thing, not rabid anti-vax sentiment. Both are dead. Their newborn was delivered basically as the mother was dying. All I can say is Goddamnit. How could anyone put their kids at risk like this?
I keep wondering if deaths are counted by where the person lived or where they died? Because a lot of people in the red collar counties around Milwaukee end up going to the dreaded city for care, and if they die there, maybe they get counted there and make it look like an “urban” death?
@Jim, Foolish Literalist:Same. Love that album. Wish her personal crises were less burdensome on her and less public. Mental health crises not easy.ETA:plus what@raven:
<br data-mce-fragment="1" said.
@Barbara: They probably were Trumper’s.
Enhanced Voting Techniques
One would think Washington state tax payers would be outraged that that they are being denied medical services they pay for because the damn fools in Idaho won’t take a vaccine.
@SpongeBobtheBuilder: Supposedly DeSantis was doing or trying to do something like that in FL – trying to assign snowbird COVID deaths to their “home state”.
One of the many post-pandemic tasks is giving the CDC the job of collecting accurate nationwide numbers, and not letting RWNJs play games with them. How, dunno. But we can’t know how a pandemic is going without accurate, near-real-time, numbers.
I have a colleague who has been bugnuts on COVID, calling it a “plandemic” and also convinced it is vastly overblown. Now his entire family is sick and his friend is in the ICU on a vent. He was complaining about the course of his infection, how it was up and down daily. He can’t understand why it won’t go away because he’s getting the best possible care – self-medicating with both Hydroxychloroquine and Ivermectin.
I live in Springfield, Oregon and there are 3 good sized hospitals in my area. More than half of the covid patients are from rural Oregon. There are 8 icu beds available. Even the pharmacist who gave me my flu shot today said that they’re overwhelmed. But the good news is that they’re overwhelmed with people getting the vaccine! P
He said people are coming from outside the city to get them.
The video from the hospital in Spokane is devastating. Thank you for the link.
@raven: So true. We were big fans of hers in the 90s, saw her show twice in great, intimate venues. Michell and her band tore the roof off both times, really good.
And there’s far fewer rural hospital options than there used to be, in states that refused all those Medicaid expansion dollars that could have kept them open, kept good jobs in smaller communities…
The thing that bugs me is that these Republican governors are saying: “we don’t need mandates imposed by big government, we can rely on people to do the responsible thing”. But they don’t follow up with: “and we all know that the responsible thing is to wear a mask, to social distance, and” (once they were available) “to get vaccinated”. Only the governor of West Virginia comes close.
Instead, they take a somewhat-defensible argument for relying on the responsibility of free citizens reduce it to a shrug in the face of irresponsible childishness.
@VOR: His own family and friend are in on the con — how betrayed he must feel. Still, reassure him that the low constant sound he keeps hearing is not a symptom of a made-up epidemic. It is giggling.
The Oregon video is from KGW which is NOT Sinclair. Portland’s Sinclair station is KATU.
@LibraryGuy: Most of those hospitals don’t or didn’t have ICUs. Yes, it would be much better if they were there but I don’t know how much they would allow a community to avoid this kind of crisis.
@Barbara: The Covid patients in the ICU for weeks with very poor survival rates is what is killing the system. Our system is set up to keep going until someone is fully dead, but is not good at handling lots of people with a very poor prognosis who are essentially killing multiple people who could have been saved had their bed been available.
It’s strange. I worked in an organ bank, where this sort of decision making and choices were inevitable, so I’m of the mindset that that the current “first come, first served” system is not meeting the current crisis. It is allowing doctors and nurses to keep to the moral code they have been trained for. That is something which must be taken into account. There probably does need to be some sort of x% of ICU beds need to be held open for non-Covid patients. Someone also needs to be munging all of the records of Covid ICU patients so that we have a real, honest look at if these resources are being properly utilized. Are there patients who would be better served by some sort of Covid hospice care? Being on a ventilator in the ICU for weeks is a terrible way to go.
Tell me about it — the stories about kids losing one or both parents to this thing are just horrifying. Imagine growing up and learning that both your parents died and left you alone because they were idiots who refused to get a simple vaccine. I can’t imagine any greater selfishness.
@Stella: I grew up in Eugene. The flip side is that Sacred Heart, the big Eugene/Springfield area hospital has for 50 years been competing with and marketing against the smaller regional rural hospitals in the area. And basically been cherry-picking the most lucrative high-end discretionary and non-emergency procedures as a profit stream. While the small rural hospitals have been left to survive on mostly Medicare and Medicaid stuff and the occasional minor ER stuff.
So we have a medical system that is largely centralized and regionalized for economic and profit reasons. Yes, the rural Covidians have brought this on themselves, but the health care system is regionally centralized largely due to forces outside of their control.
Well there’s his problem. Tell him about the snake venom.
Speaking as a Portland resident, I can assure you we have no hospitals, roads, schools, or any public infrastructure. It all became part of the Jane Antifonda Fondue collective as described in the total destruction of the city on Fox News.
White & Gold Purgatorian
In the short term, I don’t think there is any way out of the overcrowding and sometimes overwhelming of our hospitals by unvaxxed by choice COVID patients. If they show up at the ER, the hospitals will do their best to treat them. They apparently can and do refuse transfers. Our local hospital was refusing transfers for a while last winter because they were full. Haven’t heard, but they are probably not accepting transfers now either since they have done no inpatient elective surgeries in well over a month and as of yesterday were holding over a hundred patients in the ER while waiting for a bed to open up. The hospital head briefly mentioned that patients might spend time “in a hallway” while waiting for treatment or to get a regular bed. So, our red state hospital is full to overflowing but likely isn’t getting even more crowded due to patients getting shipped in from other red areas. Wait times are being stretched out all over and it sounds like care is effectively being rationed by availability of staff. This is an awful situation.
We’ve heard about the man from Cullman, AL who died of a heart attack after they called 43 hospitals to find one that could accept him, in Mississippi, and the veteran in Houston who died of a gallstone after I think 3 days of ER staff trying to find a hospital that could treat him. Also the boy whose appendix burst while waiting at the hospital. Those are wrenching examples of needless death, suffering and expense, but how many more stories are not making it to the evening news? This is seriously scary shit and I’ll bet there are at least 10 untold tragedies for every one that sees the light of day.
Long term, I wonder if COVID only treatment facilities may be in the cards, especially in areas with low vaccination rates. It’s pretty clear this virus is going to be with us a very long time and it may make sense to try and separate the patient streams so non COVID care can be made available to those who need it.
I would have accepted the “no shot so you gotta test weekly” out; no longer. Mandatory shot, motherfuckers (outside of some damn good reason why not). No more asking nicely.
This personal choice thing is such bullshit. I don’t have the freedom to drop my pants and take a dump wherever I choose to do so. It’s a public health issue. Your personal choice has nothing to fucking do with it. I have a condition that puts me at some elevated risk of a hospital need so enough of this choice shit.
Have they asked China if they have bed capacity? We could give them a choice. Parking lot or China.
I still say the expansion tents should be set up in Sinclair Station parking lots.
And fundie churches.
ICU beds are filled in Southern Illinois, a region with high COVID positivity and low vaccination rates. It’s our version of Alabama.
OT: Listening to Jen Psaki’s presser, a reporter is devoting way too much time (2 questions so far) to Niki Minaj. JFC, I hate these people.
@White & Gold Purgatorian: Bring back the plague hospitals!. Honestly, I know this is wrong, but if someone wanted to open a Covid only, all the quack cures you can handle facility, I’d be all for it.
News from upstate NY
White & Gold Purgatorian
Also, has he heard about gargling with betadyne?
@James E Powell: “A California crisis awaits Newsome…” What would the headline be if Elder had won? My guess: “Elder ready for the challenge!”
Enhanced Voting Techniques
@James E Powell: One article read like they had used the Windows Office search and replace function to change the word Edlers to Newsom the way it was going about how Newsom needed to learn how to the job of governor.
@Bill K: @Kent: @LibraryGuy: @Barbara: @Feathers: Concur w Kent: high-end medical-care facilities are regional, not community- or state-based, and there are sound reasons for this. The alternative is basically substantial overcapacity — sizing for maximum demand community-by-community rather than region-by-region — which means substantially higher-than-necessary costs. (It’s actually one of the reasons our hospital costs are out of line with other countries.)
BUT, care still can be — and is — rationed by criteria other than the address on your ID. And that’s really where the rub comes. As some doc mentioned a few weeks ago — no idea of the source — a LOT of COVID patients on ventilators are so unlikely to survive that they shouldn’t be on vents at all. I’m willing to bet the same is true, though perhaps to a lesser degree, of ICU beds in general. The question then is, can standards of care be developed that avoid this kind of misallocation of resources, perhaps giving more weight to expected outcome than to severity of symptoms, even when families demand “everything that can be done”?
It’s a difficult problem, which would require taking account of the larger context in deciding how to treat a patient, which might seem too complex and even unethical. But it seems to me that, by NOT taking the larger context into account, doctors and hospitals are effectively making such a decision anyway: if you treat everyone solely on the basis of symptoms and first-come-first-served, some patients are going to have worse outcomes — including dying — because they don’t get the kind of treatment from which they could benefit. IOW, the larger context is inevitably involved, whether you consider it explicitly or not.
Any medical ethicists in the house?
White & Gold Purgatorian
@Feathers: Such a facility would have plenty of customers, eager for the latest snake oil. Would it really be morally wrong to give these people what they want, what they are in fact demanding in many cases? I’m probably a bad person.
@White & Gold Purgatorian: Don’t forget the zinc. If people just ate a roofing nail every day, we’d have fewer
put them on oxygen or a bipap and give them their experimental infusions (anything but the vaccine, natch
By the time they get to the hospital, the vaccine will not help them.
Some of them beg for it before they die.
@Tim C: The crazy thing is, as the hospitals and gas stations are being blown up by Antifa, house prices keep going up and up. Must be that fat Soros loot propping everything up.
This Vox article provides some useful observations about healthcare rationing in the U.S., e.g., from a health economist: “We’re so used to rationing by ability-to-pay in this country that classic capacity rationing feels a bit foreign.” What I thought was most insightful was an underlying message that when we talk about “the U.S. health system” it’s different from talking about “the U.S. military” or “the U.S. government” or other relatively well-defined organizations. It’s closer to K-12 public education in the U.S., with dozens if not hundreds of different organizations with similar goals but few universal rules or constraints, limited mechanisms for cooperation, and no overarching authority.
I currently live in Spokane. FWIW, the local paper (Spokesman Review) very recently claimed that the majority of patients in our local hospitals are Washington residents – although there are also some from Idaho (29 according to the report).
I can believe that most are locals: despite the rapid rise in new cases, virtually no one was masking in the (few) indoor places I visited until Gov. Inslee’s indoor mask mandate dropped late last month. And while compliance with that mandate has since been pretty good in the stores I shop at, it’s been extremely low at the Interstate Fair (at least as of the 12th, when the linked article was published). I will be utterly unsurprised if it turns into a superspreader event (like several other recent outdoor events have).
@Ken: Some of these Folks going for the really whacked out alternative cures (gargle with Betadine?!) need an involuntary psych hold.
@VeniceRiley: Put them in the fucking churches, let them depend on prayer. More convenient for funerals, too.
@Ken: There’s something perfectly Dante-esque about the image of anti-vaxxers sprawled out on tarps in a Walmart parking lot while attendants in Hazmat gear wander among them dispensing roofing nails and rattlesnakes.
Another Young Immortal story about COVID-19, from the UK’s football world.
38-year-old team manager, ex-Army, tested positive for COVID-19 at the end of last year but had no problems then. He caught it again in July this year, was hospitalised and spent over a week on oxygen watching other COVID-19 sufferers in his ward die. He went from bench-pressing 110kg at the gym to collapsing on the toilet floor because he wasn’t strong enough to stand upright.
Enhanced Voting Techniques
@Robert Sneddon: Well that’s refreshingly honest.
I’ve been hammering on this point for years. It’s wrong to talk about the US having a healthcare system; there’s no system to it. We have a gigantic mishmash, with public and private insurance and public and private providers. Within the private side, there are for profit and non-profit, with many of the non-profit providers being religious. The whole thing is massively inefficient, and it’s incredibly difficult for anyone to navigate. Everyone knows it’s awful, but we can’t seem to change it because there are too many people making too much money who will fight tooth and nail to keep their good thing going.
The Pale Scot
Go with the Honky Tonk Freeway tactic
I still have nightmares about Licky the Carnivorous Horse
They should be forced to send them to other Red States.
James E Powell
@Enhanced Voting Techniques:
The tweets from FTFNYT reporters on Tuesday were a study in anticipation & disappointment. They all turned from “this could be big trouble for Biden & Democrats” to “this means nothing good for Democrats.”
James E Powell
Republicans depend upon the fact that, notwithstanding our rants, Democrats are not cruel people.
Who is paying for all this care? Certainly many of the patients are uninsured.
The Pale Scot
“no shot so you gotta test
It has to be this way for testing to have any affect.
And they pay for every test, no insurance coverage
Fire him, and let’s get his job listed.
@bbleh: That’s what I meant by somebody needs to do a study. Look at the huge number of medical records of the people hospitalized with Covid and, from that, look to see who did and didn’t survive, what care they received, and what their health was like before they got Covid. Build guidelines from that.
As I said above, I did work for a while for an organ bank. Learning how the border between life and death isn’t so clear cut, especially when mechanical life support is involved, changed how I view a lot of this.
We are learning more about the after effects of Covid and a significant drop in kidney function, at least in the short term, is part of it. We will be needing to make decisions about how all the Covid patients who will be needing kidney (and other) transplants. I am very curious about how the doctors running the priority lists will be handling this. Will anti-vaxxers be pushed off the list for presumptive non-compliance with the post transplant medication regimen? One could make a strong case for it.
If there are no beds in Alaska, where can they send patients?
Here in Texas overflow was first going to the bigger cities and then to the neighboring states. In some of the more remote parts of west Texas they were going straight to New Mexico.
Luckily my area still has ICU beds available but for a while it was really close. I’ve got an elderly dad so I keep an eye on that just in case.
I know we’re all sick of TFG, but Cauvin continues to amaze.
@rikyrah: A lot of Alaska ER and specialty cases get life-flighted to Harborview or Swedish hospitals in Seattle. I don’t know if they are doing that with Covid patients though.
@pat: Lots and lots of GoFundMe accounts.
It seems the unvaccinated are also the completely uninsured.
Luckily our county did not dismantle the surge beds or send off ventilators to Belize or somewhere. We hit a third peak in Covid patients at the beginning of the month and it’s showing a downslope with about a hundred available ICU beds. Occupied ICU beds total 447 of which 340 are Covid patients.
Because it’s a regional medical center some of those patients are from adjacent counties. Possible we’re getting some from the Reno area but I’m not aware they’re out of space.
Oregon is about on par with CA at about 60% vaccination rate, while Nevada and Arizona are just above 50%.
ETA the county reports 30 breakthrough case deaths from over 7,200 total cases.
Can’t find the link now, but there was a video on twitter yesterday from Tennessee with 3 holy rollers bitching that the hospital wouldn’t let them into the covid ward. The woman couldn’t visit her husband. Why take him to a hospital then? aaaarrrrrrgggghhhh
@RSA: That Vox piece was good.
Another critically important point that I keep making and is very pertinent to all of these discussions: hospitals and health systems are like grocery stores. Some services, like surgery and imaging, make the hospital a lot of money. Some stuff breaks even or even loses money (emergency, trauma, behavioral health). So, for the hospital to stay operational, they have to have the profitable service lines active to cover the ones that lose money. Covid has been really hard on hospitals because they are having to pause surgeries and slow down imaging, in order to devote more treatment to inpatient care, which is reimbursed at a much lower rate.
Now I’ve got Firesign Theatre’s “Waiting for the Electrician” going through my head.
Newscaster: “Ed, it’s an amazing scene here. Like lemmings, the crowds are waiting on the shore, torches blazing, as the long line of shrouded funeral rafts drift lazily into view, great black candles flickering at helm and stern. The excitement is contagious, and so are the Black Cross volunteers, as they pass from family to family, pausing now and again to touch a child’s head.”
@lowtechcyclist: Ultimately, of course, we’re talking about a hell that they chose for themselves (in order to piss off people like us).
The Pale Scot
I understand the Polar Bears are starving. One problem solves the other problem
@SpaceUnit: If only they’d have the decency to crawl off and die alone, or go to their pastor to pray them well, rather than depriving other people of non-Covid-related medical care. Then they’d be welcome to piss me off all they wanted.
@Suzanne: We had a small hospital chain here in the Dallas area that only took private insurance (no Medicare or Medicaid). They eventually went bankrupt. I think it took about 10-12 years.
@BeautifulPlumage: Maybe if the wife tried that ivermectin-hydroxychloroquine-betadyne-snake venom cocktail, she’d end up in an ICU bed next to her husband?
I’m good with that part. The real question is, what do you do when the next patient in need of an ICU bed comes in? IMHO, if it’s a non-Covid patient, at that point you kick out the unvaccinated Covid patient with the least likelihood of survival.
By which I mean, you call in the family, explain that the choice is between pulling the patient off the vent and transferring them to hospice care (if they can live long enough without the vent to get there), or moving them to another hospital that has beds available, however far away that might be – again with the possibility that the patient might die enroute, or even while the front office is calling around.
@lee: There are some big, prestigious hospitals that are very successful that won’t take Medicare/Medicaid, too. Of course, they do the high-dollar stuff.
The dream patient for a hospital gets some expensive images before an expensive surgery and then recovers at home. Inpatient stays, especially ICU, are not moneymakers. This is part of why rural hospitals can’t make it financially. They aren’t good at the expensive stuff (major medical centers do all of that better), and the patients who depend on them for access are mostly rural poor and working-class people.
At this point, my only concern is the risk that the plague rats are causing everyone else, and the strain they’re putting on the hospital system.
If not for those, I wouldn’t give two shits if the fascist right wanted to have a voluntary extinction event.
I would say they could bring back putting them on an ice floe and shoving it out to sea, but climate change is cutting down the amount of sea ice.
@Cacti: Got notified yesterday that there is a positive Covid case at Spawn the Younger’s school. I called the school nurse, and it’s not in her grade. This stress is making me crazy.
I remember when I thought that Americans cared about children and helping create the conditions for them to thrive. A very smart woman once pointed out that that was a common project. It takes a village, or something.
@rikyrah: Ice floes.
I really miss “Come a Long Way.” Great song, and a pretty good video, too. Both erased from YouTube harder than that guy standing next to Stalin in the photo. I used to have that album (Arkansas Traveler), but no more, alas.
@Barbara: This article was from before the husbands death, but what makes it worse, if that’s possible is that she was an RN (labor and delivery). So she was working, unvaccinated, with patients.Nurse with 5 children dies of COVID
Davy Macias, a mother of five and registered nurse who had been caring for patients since the beginning of the pandemic, died Thursday after being hospitalized with COVID-19.
“She touched everybody’s life. When she’s there, she’s an advocate for all of her patients. It’s always for the benefit of the patient and the babies. She’s a great and amazing woman,” her sister added.
In other news, … GovExec:
Presumably we’ll know substantially more about this worrying problem in a year or two (as research results start rolling in).
Thank you for the Spokane tv clip. Images & voices from the front lines of this war are invaluable. It’s possible that a couple of anti-vaxers will listen to our folks who are on the front lines. The fact that the nurses & techs are still on the front lines gives me a bit of hope.
This amazes me. I was able to get my shots in Jan/Feb because I’m a medium old, but that’s been more than a couple months ago, and grown ass adults are still getting shots? I understand ignorance and even understand the politics, but if it wasn’t for autonomic breathing and heart beating, at least a third of the human race would never have made it past their first day. Maybe close to half of all the humans, if you count all conservatives. They stopped doing those mass drive in, sit in your car for your shots, shooting galleries, we had at least 3 in socal that I know of and know people that went to them. Hundreds of people per hour getting shots.
@pat: You are paying for all this care one way or the other. Through taxes, higher insurance rates, and higher future hospitalization costs.
@SpaceUnit: Heh, the “roofing nails and rattlesnakes” bit brought a song to mind.
Have not looked at comments here, but this is one anecdata about current burdens on large Oregon medical systems overrun by Covidiots denying care to folks with treatable conditions, ending badly for some.
Fuck’em. Let them rot at home if they think vaccines are at all an imposition.
Ella in New Mexico
I’m on a 13 minute lunch break so forgive me for not deep-diving into the details but I’d like to know how many of these “full to capacity” hospitals are still accepting non-emergent, convenience or elective procedure admissions?
Because that’s what has been happening here in NM: were super busy with COVID patients, of course but we haven’t gone back to limiting hospital admissions to only the most necessary diagnoses, unlike we did last year which enabled us to focus on staffing for the neediest patients. Yes, it was still tough as hell for providers and care-giving staff, but when the hospitals in NM were ordered to halt all non-urgent in- and outpatient care it meant we were able to devote our resources where they were needed.
Nurses “float” all the time to take care of patients outside their specialty units. If they weren’t still working on Med-surge giving IV antibiotics to someone who could get them as an outpatient or caring for “Bob the Avid 6-Day a Week Golfer Who Must Have his Knee Replacement TODAY”, they could be utilized, at the very least, to staff sub-acute units or for some who have gotten appropriate training, ICU units.
Yes, I’m sure you all are shocked–SHOCKED–that hospitals admit people who could be cared for at home as an outpatient or who could wait to get that knee replacement until after the fucking pandemic is over, but it does pay the bills, so unless they’re made to do cut back, I’m guessing many of these “Bed Shortages” will continue.
Also, too, to answer MM’s question above: given all kinds of ethical and contractual problems with just randomly refusing someone from a red state, I don’t think you’ll see that happen until that state is also “Filled to Capacity”.
@Barbara: In that case it was probably fear of medical complications caused by the vax.
That is the defense I am hearing from antivax family now. They totally would get the vax, you see, but they know someone who did and got sick so now they’re gonna wait and see.
Mostly at that point I just start ripping on the idiots sucking down horse paste and hope that dissuades them from making actively worse choices.
@VOR: Tell him that the horse wormer is killing the intestinal flora that help produce his body’s natural defenses. Whatever beneficial effect it may be having <cough>, it is offset by the damage inflicted. Like amputating an arm to get rid of a gangrenous finger.
I have had some small luck with that tack. Not much, but you take what you can get these days.
Meanwhile, in Iowa.
The article goes on to note the public comments at the school board meeting were all in favor of masking.
Here’s the interesting part, Storm Lake is (now retired) Rep. Steve King’s home town. He doesn’t seem to reflect the “local values.”
@Ella in New Mexico:
Probably most of them, as they need to make money.
Until we make up their budget shortfalls, I find it difficult to criticize them for this. Hospitals aren’t as resilient as they should be…. financially, physically, socially.
Same problem has occurred periodically in California. Local jackass governments in Imperial and Tulare and Kings Counties let covid run wild among poor agricultural and other essential workers, and poorly run for-profit old folks homes. So, they killed off the ‘surplus population’ a la Scrooge (for more $$$$$ in their pockets aka blood money), and caused acute and ICU bed crisis in more responsible places like SF Bay and Sacramento.
@Ella in New Mexico: All understood.
It’s still infuriating that there’s even any one of several problems because meatheads buy into the myth that prevention — mask and vaccine — is infringier/riskier than infection.
@Ella in New Mexico: All understood.
It’s still infuriating that there’s even any one of several problems because meatheads buy into the myth that prevention — mask and vaccine — is infringier/riskier than infection.
@germy: Maybe his natural immune system will help him file unemployment…
@Jim Appleton: Adequate ventilation indoors will give you a chill an you’ll catch cold. Sounds pretty dangerous to me.
/snark, if a tag is needed
Edit: now, squeezing a tube of cow ivermectin paste over your salad for a savory dressing, that is sheer genius.
Second largest high school in Oregon is going back to remote learning after too many Covid cases
@Mo MacArbie: Thanks, that was very haunting. Not what I was expecting.
@SpaceUnit: Vipers, not rattlesnakes. (And Brazilian to boot.)
Rattlesnakes are fine for stopping Covid. They have a similar “success” rate as being dropped from height or strangulation, poisoning, gunfire, etc.
“There was that district in, where was it, Florida? Mississippi? Texas? where five teachers and a few kids died in the first two weeks. I want to see if that’s what happens here. If so, well, those are tolerable numbers, from what the governors tell me. But if it’s much more than that, I might consider doing something.
“P.S. I am not a sociopath.”
@jl: tastes like chicken. Yum. Does nothing for my potentially fatal infection, but, boy, does the outgoing burn feel good while watching OAN.
@Suzanne: The American Rescue Plan has money to make up for lost revenue. Enough? Is it going out? Dunno.
The Provider Relief Fund is – https://www.hrsa.gov/provider-relief
There’s a lot of money being spent on this stuff, in principle… Money shouldn’t be the limiting factor in care during the pandemic.
@Dan B: Nitpicking. Give em rattlesnakes. You think I’m gonna drive a truck to Brazil and back for these knobs?
@VOR: “He can’t understand why it won’t go away because he’s getting the best possible care – self-medicating with both Hydroxychloroquine and Ivermectin. ‘
As long as the fake cures have been mentioned, I’ll admit that I am very curious why some of become cult fads while others have not. Hundreds of cheap existing medications have been screened for some usefulness in treating or preventing covid. As was expected, over 99 percent didn’t work. You just need a few home runs for that project to pay off.
But some big successes, for example, cheap steroids in handling inflammation after immune system is revved up to fight the viral infection.
Clinicians I talk with said that hydroxy and ivermectin were good bets way at the beginning based on some plausible causal theories (that eventually didn’t pan out), but OK a year ago when needed to try anything that might work. But, they do nothing, or so little that it’s not worth the side effects.
But there are dozens and dozens of drugs like those two. But why those two? I think for hydroxy, one of Trump’s buddies blew a wad of cash buying up a stockpile figuring to make some bank off it, so Trump flacked it. But that is just my guess based on my general causal theory of why Trump does a lot of his weird crap.
Anyway, I’m curious why some of these drugs that didn’t pan out take off into cult fetish fame, and others don’t.
Anyone have a clue?
Yea, they could call them QAspitals. Staffed by respected veterinarians. That way, patients wouldn’t have to bring their own horse medicine.
Hunkered down in north-central Idaho. We are fully vaccinated and very careful about Covid. We are trying to not do anything stupid right now. I am prone to trip over things or get knocked around by goats or the horse so I am trying to be very careful and not get a broken bone, laceration, or concussion. We are also minimizing driving as well. Our hospital in our little town has a total of 23 beds, I think they might have one they consider to be an ICU bed, but they always have in the past shipped their critical patients. Wish us luck, there are some of us trying to live here amongst the nutjobs.
@Another Scott: Many of the bed shortages are in urban (and suburban) hospitals, because lots of rural hospitals don’t have ICU care. Urban hospitals are also getting lots of patients from their regions. So that aid to rural hospitals doesn’t help them.
IIRC, that was the shell game Cuomo was playing to make it seem like the nursing home death rate was lower. “but grandma died in the hospital!”
Centralized healthcare is a good thing in general. The economies of scale of centralized resources balance against the lack of access of distance. There are much better ways to optimize care then a blanket keep rural hospitals open policy.
Sorry about the case with your child’s school.
I worry everyday about getting a notice from Peanut’s school. I bother her everyday with..
” did you wear your mask all day?”
I don’t know what else to do. She’s vaccinated, but, I’m still worried.
I love those songs, too, but I bet anyone who covered them now would get beaten up on social media and even be accused to harboring those same beliefs.
We often have discussions on the SFF side about enjoying the works of authors who turn out to be varying degrees of odious. Some folks fall on the ‘hate the sinner, love the sinner’s books’ side but others can’t or prefer to not separate art from the artist.
@jl: I think your theory about the hydroxychloroquine generalizes. Someone (not necessarily TFG or one of his friends) is making money pushing the useless drugs. That needn’t be from selling the drugs — there are services that will hook you up with a doctor who, for a “consulting fee”, will write you a prescription for your quack remedy of choice.
@bbleh: Withdrawing futile care is a lot less ethically problematic than you think. Doctors refuse to do it. Their preferred option is to pressure the family into saying ok.
@The Dangerman: Time to stop firing people’s asses if they don’t get vaccinated. Period. As for the “self-employed” (plumbers, electricians, etc.) — time for consumers to start demanding proof of vaccination or these assholes won’t get the fucking job — with consumers spreading the word about which tradesmen to avoid like (literally) the plague. I learned recently that two young relatives (young men who are an electrician and a plumber respectively) are loudly and proudly anti-covid-vaccine. Until a few days ago I had had the impression that they had common sense and common decency. At this point I’m above the opinion that they’ve declared themselves to be pariahs, and should be shunned as such.
I want to say that I can’t believe how little caring some of these governors, school administrators, all the fucking Republicans have for children but years of acceptance of school shootings gives us plenty of evidence of what sociopaths they are.
Just going through the tragedy at my son’s school the past few weeks and seeing how devastated the students, staff, faculty and community are today makes me absolutely livid about what the Republicans are putting so many schools through. When your kid calls from school crying and tells you all their friends are crying – I would do anything to have prevented this if I could have. We are all just so unbelievably sad.
I don’t want anything to do with the Republicans, Qs, anti vax and anti mask assholes. I don’t see how it’s possible to ever get along with them.
@Ken: I did not know that consulting rackets were part of it. Thanks.
So, maybe you need several elements: cheap generic, and easy to purchase and stockpile, so you long expiration date and cheap storability (for example, at room temp), and no Rx needed. And some truly depraved swindlers backing the scheme.
Wait, that’s a conspiracy theory?
I’m disappointed in Biden.
@Ruckus: my county was at 75% vaccinated in July. But the eastern part of the state is much lower so the state overall is at about 59%. I went to the big drive through clinic at the football stadium in April. The pharmacy has been crowded for days now with people still needing to be vaccinated.
Ella in New Mexico
@Suzanne: Actually, once Congress passed the COVID relief bill(s) which required insurance and Medicare reimburse at significantly higher rates for COVID-19 many hospitals were doing BETTER than they were in the past. The University of NM system did so well we all got across the board raises and bonuses. All hourly and salaried employees now make at least $15 dollars an hour (many made 10 or so) and pay was adjusted accordingly. It’s not that hospitals can’t make money with the pandemic.
Now, if they are for-profit hospitals, that money most likely is going to the home office, and mostly to upper level management and shareholders. All while their affiliated hospitals are starving their employees and cutting their budgets to meet Corporate “algorithms”.
I’ll never EVER work for a for-profit healthcare entity ever again because of that.
@Barbara: Yeah, but … Logically “at capacity” should mean that x% of the ICU beds are empty, to allow for “typical expected peaks in demand” (from heart attacks, gunshots, etc.) — however “x” is calculated. That’s how it works in half-baked computer system capacity planning, anyway.
@Baud: But Sun Tzu would approve.
Planting a conspiracy theory works and is so much cheaper.
Edit: but the Baud XXXX! standard plan for everything, free stale beer, is acceptable too, everyone too buzzed to bother finding their way to the protest.
Ella in New Mexico
@Jim Appleton: couldn’t agree more.
@rikyrah: They will annoy the hell out of Canada.
Funny. I recently passed along this excerpt elsewhere, in a discussion of military pushback against the COVID-19 vaccination:
“18? That’s the jab that breaks the camel’s back!”
Dorothy A. Winsor
@trollhattan: Some tiny newspaper in Storm Lake won a Pulitzer not too long ago. There was a documentary about it.
Right now, there’s significant evidence that rural hospital closures create higher rates of bad outcomes in those communities. There are definitely benefits to specialization, which will realistically only happen in communities of size, but the evidence is clear that right now, today, in the world we live in and not the world we wish we lived in, rural hospitals are a lifeline for their communities. Their closures are more problematic for the poor and less mobile parts of their communities, not the middle-class and rich who can easily go to a big city hospital.
This harkens back to the thinking during the 60s, when we would close all those shitty, inhumane “insane asylums” and replace them with community mental health clinics and have patients live with their families! Except we only opened about 20% of the clinics we needed, many of their families were not able or willing to support them, and we closed the asylums anyway. The asylums sucked and deserved to be closed, but we didn’t do a good job filling that gap. The results still follow us today.
The number of schol boards in red states willing to defy their pro-covid governors on masks gives me some hope that not all the people there are wiling to let their kids die to pwn the libs, and also that the school boards are listening to parents and not the loons throwing tantrums at their meetings. On the other hand, my sister in rural WI tells me their board had a visit from the loons, and not only did they decide not to require masks, they shortened the required quarantine time, and took school nurses out of the contact tracing loop. No need for those nurses to be bothered by information about who might be infected in their schools.
That’s a good one. I find that they hit better if I just listen and not watch.
@joel hanes: After 19 months of this being in the news, they are still too fucking stupid to understand how a vaccine works.
@Ella in New Mexico: My two biggest clients right now were doing really badly financially until about October of last year, when the money started rolling out more effectively. A lot of my healthcare friends got furloughed but got brought back. I don’t have any for-profit clients right now, which is nice.
@rikyrah: I am so fucking stressed. Spawn the Elder is not in school — again — this year, because there’s no mask mandate there.
@James E Powell:
You can look at those sorts of headlines two ways:
Take your pick. I lean toward #1 for no better reason than IMHO anyone who isn’t paranoid in this day & age isn’t paying attention…but I’ll concede that it might be something free of malice aforethought like #2.
The sarcastic @Ragnarok Lobster hasn’t hasn’t said much today, but he did retweet a series of tweets by @Sherrilynn Ifill about initiatives the Justice Department has taken this week, including an announcement by Assistant AG Kristen Clarke that the department is launching a civil rights investigation of Georgia prisons. Said Ifill, “This is huge. The humanitarian crisis in Southern prisons is a critical issue.”
Steve in the ATL
We lost our beloved dog recently and having been wondering what to do with his leftover medicine. My wife did not appreciate my suggestion that we post on Facebook that Apoquel and Rimadyl are the secret COVID cures that Biden, Gates, and Soros don’t want you to know about! I was hoping to retire early with the fortune we could make!
@Suzanne: Obliquely related – I’ve seen bits and pieces of histories of horror novels and such on TV recently. One said that “mental hospitals” were basically filled with people who had syphilis.
General paresis of the insane at Wikipedia:
It took a long, long time to figure out the cause and effective treatments. In the meantime, people kept being sent there until the 1960s-1970s because society didn’t want to deal with them other ways.
It’s a sign of progress that those huge, obsolete, often damaging facilities were actually closed. But I completely agree with you that not enough was done to help the people who actually needed help…
@The Pale Scot:
I was thinking ice floes, but this is even better!
@Kelly: Just FTR, you misspelled StinkLair, not once, but twice…
“Yes, but it’s not as important as my pet issue <Y>, so why is the DOJ wasting precious resources on it?”
— far too many people, I expect
@EmbraceYourInnerCrone: To be fair, she was concerned about the effects of the vax on her unborn child. The jury was still out on that one.
@Subsole: Why bother? I want as many of these idiots to self-destruct as possible. Get them off the voter lists and out of the gene pool. Yes, I am a big meenie, but like many of us, I’ve had enough of this BS.
I think it’s really hard, probably impossible, to work out an explicit policy that doesn’t produce outcomes in some cases that most people would call unethical.
I am a pragmatist, by nature. I have to be, to do my job, I suppose. I am used to limits, regulations, budgets, feasibility studies, constraints from a million different places. So I get frustrated with a lot of discussions, even on our political “side” that conclude that “the system sucks and we have to start over and do something better” — even if this is absolutely correct — because in the interim time, it will be really bad and a genuinely thoughtful solution would be transparent about that.
The first of two debates between Virginia Governor candidates Terry McAuliffe and Glenn Youngkin begins in less than an hour, at 7pm. McAuliffe needs to aggressively break down Youngkin’s thematic messaging and sly concealment of his hard right positions on firearms regulation and women’s rights. I had a couple of issues about McAuliffe’s first go-round as Governor, but I was happy to vote for him in the primary. I think he has the elements of a street fighter. I hope his attitude tonight is, “”Below the belt? What belt !?”
Oooh. Team Popehat is gonna bring the righteous smackdown!!1
Thread. From today. MCI still seems to be in business. Today.
I’m reminded of what happened at Walter Reed. Ancient facilities that were going to be closed. Little spent on maintenance because it was going to be closed. But things like renovating giant hospitals or merging hospitals take longer and cost more than expected, and in the meantime the old facilities get worse. And then the press finds out about wounded people sitting in hospital rooms with black mold, etc., etc.
“Show me your budget and I’ll tell you your values.”
Doing things properly is never cheap, but doing things cheaply is always much more expensive…
@Ken: I hear a lot of 4chan chud-buds buy up a little stock, get a couple botnets to hype the company, then sell high.
Just a scam, all the way down.
Kinda like the gamestop stock short ftom, what, 1000 years ago?
” I’m assuming they aren’t Sinclair stations.” Nice touch.
Gin & Tonic
@Another Scott: MCI, aka Worldcom, aka MCI/Worldcom has not been in business for about 20 years. The name and the customer base were bought by Verizon, but MCI sleeps with the fishes. As does their CEO, Bernie Ebbers (he died a month after being released from prison for accounting shenanigans leading to the bankruptcy.)
Through work, I knew several MCI/Worldcom employees back then. They were *very strongly* encouraged to invest their 401(k)’s in MCI/Worldcom stock, so when the company went bust, they not only had no job and no pension, but no savings. There is a valuable lesson here.
Maybe if we start with a simpler case. Let’s say that there’s a trolley….
(And as XKCD obliquely notes, it’s only difficult for non-sociopaths.)
@Gin & Tonic: Yup, I remember. That’s why I found Popehat’s thread so surprising.
Their business model made no sense to me even as a youngster… “We’re a gigantic company because we sell long-distance cheaper than anyone even though we don’t own the wires or the switchgear or … and we spend a fortune on TV advertizing…” ??!
I hope Popehat’s partner takes Verizon to the cleaners. I’ve disliked them from the days of $5 for the privilege of putting a single ringtone on your phone…
@Steve in the ATL: I bet if you donated whatever you got to animal shelters she would get on board.
@Ken: Hah! I hadn’t thought of that connection. The trolley scenario does have the same in-the-middle-of-things flavor that I was thinking about. (I think there’s a Latin legal phrase for that, but I don’t remember it.)
Now we just need to convince them that the FBI is waiting to round up every Republican who shows up at their local polling place…
It’s even more aggravating when people talk about how we have to let the system collapse so we can build something better to replace it. As if the people who they claim to want to help by building a better system won’t be hurt the most by letting the system collapse. They just don’t want to do the hard work of convincing people of the need for a better system and figuring out how to make it happen, so they blow off the enormous damage of letting the old system fail. And, of course, they casually assume they’ll be the ones designing the replacement.
@RSA: You may be thinking of in media res. It usually refers to narratives that start in the middle of some action, and only later show how the situation arose.
agree x 1000. My mother got cancer when I was 12. I don’t know all the details because I was a kid at the time, but her doctor was able to get her into a trial of an experimental cancer drug — the cancer was well advanced when it was found and the standard therapies available then were not helping.
it did not work. But it always helped me to know that she had done everything she could do to survive the cancer. I cannot even imagine how these kids whose parents chose not to be faxed will feel.
Oops, at comment 170 I meant to type “vaxxed.”
My thought whenever I hear the trolley problem is first to feel sorry for the poor soul who’s stuck with the problem of whether to pull the lever and second to blame the executives at the trolley company. I mean seriously, I can think of at least 4 safety failures in 3 categories (2 sets of people on the tracks, runaway trolley, no alarm system to let people know a trolley is coming) that have to have happened for the whole thing to have happened. That’s a sign the trolley company lacks a proper safety culture, and that is something that comes from the top.
@Jess: I’m calling BS. First, the jury is not out on the fact that being pregnant raises the likelihood of a worse than average case of Covid. The guidance in most countries is that pregnant women in particular should get vaccinated.
Nearly 30 years ago I had an emergency premature delivery because my baby stopped growing. Never found out why, but doctor said it was most likely the result of a viral infection. It turns out that viral infections just generally speaking can cause problems for a fetus — and of course, we know that for many: cytomegalovirus, toxoplasmosis, and most recently Zika. There is zero reason to think that Covid doesn’t present at least as great a risk as the vaccine, particularly when it is an omnipresent threat that takes effort to avoid (unlike, say toxoplasmosis). The grandmother thinks that they most likely picked up the infection when they took their kids to an indoor commercial playground.
J R in WV
Oh, I don’t disagree. But (a) fuck ’em, and (b) maybe if the Covidiots realize there’s even a chance they (rather than some other poor souls) might get less-than-optimal treatment for Covid, it might scare them into getting vaxxed.
They are betraying this country by their refusal to consider the safety of their fellow citizens in the middle of a pandemic, and they really deserve a traitor’s end. I’m willing to settle for moving them to a distant hospital to make room for people with normal medical emergencies. If that’s unethical, I’m past the point of being bothered by it.
Yes! Thank you. All I could think of was mens rea, which isn’t right and led me in the direction of legal terms.
@lowtechcyclist: As speculative fiction, count me in. :-) I’d buy it.
Ella in New Mexico
@Suzanne: You make a great point—I shouldn’t paint all hospitals with the same brush. And it’s true that the COVID money took a while to roll in. Many of our state’s small, rural hospitals who stabilized and then ended up transferring most of their COVID patients to bigger facilities with higher levels of care certainly struggled financially much more than those in the metro areas until the state started targeting them with other COVID funding.
@Roger Moore: + eleventy billion.
It reminds me of the “if the election were held today, who would you vote for?” questions months before the election. I know what they’re asking, but the counter-factual isn’t meaningful. The circumstances just before an election are vastly different than they are months before…
Of course, these days the general election choices are much easier for non-RWNJ-voters. But as a general rule in normal times, no.
Polls can be valuable if done well. I’m not sure how valuable they are too far out though…