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Dec 12 2020 03:33pm
Quote (Black XistenZ @ 12 Dec 2020 22:31)
Fair point, but I'm afraid that there will be de-solidarization either way. All those small business owners whose livelihood was ruined, or the average taxpayer who will be plundered and squeezed in the coming years to pay for all of the lockdowns - do you seriously think they will become more generous and big-hearted because of this experience? And let's not even talk about what happens if we get massive inflation and the saving of the middle class are evaporated. We have historical evidence to know what happens when the masses are impoverished - Stalin and Hitler.




Europe started from a significantly lower level of infections than the US, and look where we're now. Once summer ended, it took about one month before the situation was so dire again that crippling restrictions of public life became necessary. The higher plateau in the US compounds the scope of the problem, but the structural challenges would have been the same either way.


what?!
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Dec 12 2020 03:38pm
Quote (Black XistenZ @ Dec 12 2020 03:31pm)
Fair point, but I'm afraid that there will be de-solidarization either way. All those small business owners whose livelihood was ruined, or the average taxpayer who will be plundered and squeezed in the coming years to pay for all of the lockdowns - do you seriously think they will become more generous and big-hearted because of this experience? And let's not even talk about what happens if we get massive inflation and the savings of the middle class are evaporated. We have historical evidence to know what happens when the masses are impoverished - Stalin and Hitler.




Europe started from a significantly lower level of infections than the US, and look where we're now. Once summer ended, it took about one month before the situation was so dire again that crippling restrictions of public life became necessary. The higher plateau in the US compounds the scope of the problem, but the structural challenges would have been the same either way.



Agree on structural challenges. The issue is the higher plateau is what complicates the problem from being sustainable to unsustainable. In Europe , I would argue you took the mitigations slightly late this fall /winter and with this issue even a couple weeks makes a large difference. Even with that folly you never reached a breaking point however. The situation here is being so dire that we are graduating nurses with minimal clinical training due to how severe the nursing shortage is (was, rather, even prior to covid) and the effects of that are painstakingly clear.

On top of the fact that half the country still thinks corona is fake or inconsequential

This post was edited by Bazi on Dec 12 2020 03:40pm
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Dec 12 2020 03:39pm
Quote (fender @ Dec 12 2020 03:33pm)
what?!


He’s saying your case plateau dropped markedly in summer which is completely accurate. Compared to US where our plateau didn’t really lower to the point that was needed. The problem with being anti shutdown and anti all mitigation. Masks and freedomz derrr jeree

This post was edited by Bazi on Dec 12 2020 03:41pm
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Dec 12 2020 03:43pm
Quote (fender @ 12 Dec 2020 22:33)
what?!


Look up the numbers. The EU (population: 447m) had about 5k daily cases for 2 months, from mid-May until mid-July. The United States (pop: 330m) never got lower than around 20k in the weekly average.

Yes, the "winter wave" hit Europe earlier than the US, but that's not really surprising, considering their lower latitude.
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Dec 12 2020 03:46pm
Quote (Bazi @ 12 Dec 2020 13:12)
“Hard pressed during the flu season are hard pressed” - Err, lol. Hospitals are rarely operating over capacity, no need to muddle the waters with vague terminology. It is rare for an individual hospital to be operating at or over capacity and certainly a novelty for that to become a systemic problem, to the point states are transferring patients to other states for otherwise routine care. Even if it happened to a random hospital, there was always another system that could pick up the slack, within an hour drive. If you aren’t certain this is different than the norm you are: not listening, not capable of understanding, or lying to yourself? I am open to other options here if you feel you are not one of these 3

I know I’m correct about average hospital occupancy. I am part of a hospital admin team actively involved with this. In no year are routine surgical cases systemically canceled/postponed due to “typical stressors, as you eluded to. For the record Flu has been at an all time low, across the country. Whether it’s just a late flu, or mask mitigation efforts preventing our typical flu season, time will tell.

A lot of words but minimal substance in this post tbh. I have already stated it is clear in hindsight that the lockdown was premature. Unfortunately American pocket books and mentality cannot survive another lockdown which is why that will not happen. There are no significant interventions that can change the path we are on anymore. Summer was the time to drop the plateau and the country failed as a whole to accomplish this.



Oh I missed this gem. Again, for about the 20th time at least, when hospital systems are full, care for EVERYONE is decreased. Nursing ratios at 1:8 are not sustainable and you will see excess mortality spike this month and into January likely as a result. Not necessarily directly from corona but via proxy in the form of flooded medical systems


Wait, so now your claim is that hospitals are... over capacity? Again, I'd have to ask where.

Looking at the dashboard, there are only a couple states where Covid and/or flu patients are using even 25% of beds. Most states, it's 1 in 8 (12.5%). So, if there are hospitals that are "over capacity" that means they're still conducting routine "non-emergency" business. So I'm not doubting that there may be some hospitals, most especially in urban areas, and potentially in "rural" towns with a high percentage of elderly patients. But you're behaving as though this is a common problem impacting everyone. I'm just not seeing it. Not only not seeing it from the anecdotal level, I can't find any evidence of it from the healthcare reporting systems. Perhaps you can provide some sourcing, or...?

And yeah, as far as all time low flu numbers, big shock. Apparently coronary disease is down as well. Which brings us back around to overreporting regarding covid, underreporting elsewhere.

To put a fine point on it, you seem to be exaggerating the shit out of the "covid hospital crisis". There's no reporting on it, there's no official complaints over it, and there's absolutely the ability to go and build temporary hospitals again, like back in April. So some evidence of your claims would be good.

Also note: Death-wise, there were roughly 138K deaths reported between April 1st and July 11th. That was after things were already heating up. Going into the cold season, from September 1st through December 11th, there's been roughly 113k deaths. Same amount of time, far fewer deaths. So if hospitals are being overwhelmed in your area, I believe it may be necessary to ask some basic questions regarding policies followed with patients, severity, are you turning away asymptomatic cases, etc.

Effectively, April-July, stardard policy changed in hospitals to, "If it's not an emergency, don't show up at the hospital." Due to that policy, a ton of hospitals saw capacity drop to record lows. It appears that you're indicating that no such policy has been adopted for the new flu/covid season. Is that correct? If so, why? If covid influx is as terrible as you say, non-emergency shit should be pushed off, yes?
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Dec 12 2020 03:56pm
Quote (InsaneBobb @ Dec 12 2020 03:46pm)
Wait, so now your claim is that hospitals are... over capacity? Again, I'd have to ask where.

Looking at the dashboard, there are only a couple states where Covid and/or flu patients are using even 25% of beds. Most states, it's 1 in 8 (12.5%). So, if there are hospitals that are "over capacity" that means they're still conducting routine "non-emergency" business. So I'm not doubting that there may be some hospitals, most especially in urban areas, and potentially in "rural" towns with a high percentage of elderly patients. But you're behaving as though this is a common problem impacting everyone. I'm just not seeing it. Not only not seeing it from the anecdotal level, I can't find any evidence of it from the healthcare reporting systems. Perhaps you can provide some sourcing, or...?

And yeah, as far as all time low flu numbers, big shock. Apparently coronary disease is down as well. Which brings us back around to overreporting regarding covid, underreporting elsewhere.

To put a fine point on it, you seem to be exaggerating the shit out of the "covid hospital crisis". There's no reporting on it, there's no official complaints over it, and there's absolutely the ability to go and build temporary hospitals again, like back in April. So some evidence of your claims would be good.

Also note: Death-wise, there were roughly 138K deaths reported between April 1st and July 11th. That was after things were already heating up. Going into the cold season, from September 1st through December 11th, there's been roughly 113k deaths. Same amount of time, far fewer deaths. So if hospitals are being overwhelmed in your area, I believe it may be necessary to ask some basic questions regarding policies followed with patients, severity, are you turning away asymptomatic cases, etc.

Effectively, April-July, stardard policy changed in hospitals to, "If it's not an emergency, don't show up at the hospital." Due to that policy, a ton of hospitals saw capacity drop to record lows. It appears that you're indicating that no such policy has been adopted for the new flu/covid season. Is that correct? If so, why? If covid influx is as terrible as you say, non-emergency shit should be pushed off, yes?


I have to attend weekly town halls for our covid status. I work at a medical school associated with a hospital system. We've cancelled all elective procedures and have the pediatricians, some of which haven't treated an adult in over 5 years, taking ER shifts for Covid patients. My boss is an oncologist who has never worked ER and he may get pulled in the next week to cover emergency shifts.

You can't just look at state wide beds and assume capacity isn't an issue. It doesn't do any good for my city or hospital system if there's open beds in a rural clinic 200 miles away.

Bazi is an internal medicine physician in a major city. He is literally on the ground floor treating Covid patients. You're barking up the wrong tree if you think you're going to convince anybody with your "I looked at a dashboard" approach. Some of us have personal experience in these systems and actually know what's going on.

This post was edited by Thor123422 on Dec 12 2020 03:57pm
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Dec 12 2020 04:27pm
Quote (Thor123422 @ 12 Dec 2020 13:56)
I have to attend weekly town halls for our covid status. I work at a medical school associated with a hospital system. We've cancelled all elective procedures and have the pediatricians, some of which haven't treated an adult in over 5 years, taking ER shifts for Covid patients. My boss is an oncologist who has never worked ER and he may get pulled in the next week to cover emergency shifts.

You can't just look at state wide beds and assume capacity isn't an issue. It doesn't do any good for my city or hospital system if there's open beds in a rural clinic 200 miles away.

Bazi is an internal medicine physician in a major city. He is literally on the ground floor treating Covid patients. You're barking up the wrong tree if you think you're going to convince anybody with your "I looked at a dashboard" approach. Some of us have personal experience in these systems and actually know what's going on.


I am not attempting to minimize, but it's still quite anecdotal. I've already given that some hospitals may be being pushed. The issue I take with what Bazi's saying is that it's somehow this massive widespread problem.

There's no problem here. But all non-essential care was redirected to urgent care clinics. But the point still stands, how are the 50 million people in the US aged 65+ going to benefit from the 300 million who don't fall within the at risk group having their businesses shut down, their schools shut down, and being locked in their homes, with supply chains fractured? How does this help hospitals, or the elderly, or anyone? It's a serious question, because even with the harshest lockdowns across the world, new flu season covid has hit absolutely brutally. So is the answer what... Shut the world down for a couple years, whoever doesn't starve is good to go, or...?
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Dec 12 2020 04:40pm
Quote (InsaneBobb @ Dec 12 2020 03:46pm)
Wait, so now your claim is that hospitals are... over capacity? Again, I'd have to ask where.

Looking at the dashboard, there are only a couple states where Covid and/or flu patients are using even 25% of beds. Most states, it's 1 in 8 (12.5%). So, if there are hospitals that are "over capacity" that means they're still conducting routine "non-emergency" business. So I'm not doubting that there may be some hospitals, most especially in urban areas, and potentially in "rural" towns with a high percentage of elderly patients. But you're behaving as though this is a common problem impacting everyone. I'm just not seeing it. Not only not seeing it from the anecdotal level, I can't find any evidence of it from the healthcare reporting systems. Perhaps you can provide some sourcing, or...?

And yeah, as far as all time low flu numbers, big shock. Apparently coronary disease is down as well. Which brings us back around to overreporting regarding covid, underreporting elsewhere.

To put a fine point on it, you seem to be exaggerating the shit out of the "covid hospital crisis". There's no reporting on it, there's no official complaints over it, and there's absolutely the ability to go and build temporary hospitals again, like back in April. So some evidence of your claims would be good.

Also note: Death-wise, there were roughly 138K deaths reported between April 1st and July 11th. That was after things were already heating up. Going into the cold season, from September 1st through December 11th, there's been roughly 113k deaths. Same amount of time, far fewer deaths. So if hospitals are being overwhelmed in your area, I believe it may be necessary to ask some basic questions regarding policies followed with patients, severity, are you turning away asymptomatic cases, etc.

Effectively, April-July, stardard policy changed in hospitals to, "If it's not an emergency, don't show up at the hospital." Due to that policy, a ton of hospitals saw capacity drop to record lows. It appears that you're indicating that no such policy has been adopted for the new flu/covid season. Is that correct? If so, why? If covid influx is as terrible as you say, non-emergency shit should be pushed off, yes?


Hospitals across the Midwest over the last 3-4 weeks have been increasing beds beyond staffing to accommodate the increased volume and still falling short, the definition of over capacity. Everyday there are tens of patients in any given ER waiting for a hospital bed with flooded waiting rooms. As I said earlier, this last week has been a bit better than where it has the 3 weeks prior, but likely temporary. You are asking where, the question has already been answered. All across the Midwest hundreds of beds have been added by turning single patient rooms into make shift doubles. This strategic maneuver has lessened the load but it is a matter of time (week) before the efficacy of that strategy is maxed as well. Do you really think asymptomatic patients are admitted to hospitals? May I ask what you do for a living that would allow you to make such an erroneous assumption?

Just because YOUR news outlets are not mentioning how overwhelmed hospital systems are, does not mean it isn’t reality. Most local news stations across the Midwest indeed are reporting on it. I would not expect it to be the subject of routine National news, it was a couple weeks ago but people get bored of hearing about it. You can google any hospital system in the Midwest and most have social media in regards to bed situations. I am not exaggerating anything. If you aren’t lazy you can just google xyz city in the Midwest and type hospital capacity after it. For example Des Moines:

https://www.google.com/amp/s/www.kcci.com/amp/article/unitypoint-des-moines-health-reports-all-hospitals-at-capacity/34622200

-30 days later no change
-can be utilized for any city in the post prior and basically any city in the Midwest

Re : Flu - again, lol. There is no “under reporting of flu”, the cases simply are not present. When someone comes to the hospital the same covid screen tests for about 15 other viruses as well. There have been historic lows with flu, likely from mitigation efforts, not “under reporting.” There isn’t a conspiracy to hide flu.

“Most states at 12.5% covid “ - do you not understand how high this number is? When hospitals approach 100% capacity during winter times, do you think it is easy to increase personal/beds/equipment with a snap of the finger , across every hospital in a region? You don’t recognize the significance of your own statistic. Non emergent procedures/surgeries have been canceled for the last 30 days in counting, you don’t think that would be the first modification to make?

Quote
Also note: Death-wise, there were roughly 138K deaths reported between April 1st and July 11th. That was after things were already heating up. Going into the cold season, from September 1st through December 11th, there's been roughly 113k deaths. Same amount of time, far fewer deaths.


Deaths always will lag cases, and new cases still have not reached peaked, but regardless you selected erroneous timeframes. Did I say anything about capacity in September or October? Quite clearly September and the majority of October were fairly calm times in terms of cases so why would you expect to see deaths there? It is easy to cherry pick timeframes, but any 3rd grader can tell you when the peak deaths (up to this point) are occurring. If you’re trying to, honestly, compare peaks you will compare the summer peak to the winter peak which last until January. Maybe you can come back and tell me in February how different the peaks were.

This post was edited by Bazi on Dec 12 2020 04:44pm
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Dec 12 2020 04:48pm
Quote (Bazi @ Dec 12 2020 04:40pm)
Hospitals across the Midwest over the last 3-4 weeks have been increasing beds beyond staffing to accommodate the increased volume and still falling short, the definition of over capacity. Everyday there are tens of patients in any given ER waiting for a hospital bed with flooded waiting rooms. As I said earlier, this last week has been a bit better than where it has the 3 weeks prior, but likely temporary. You are asking where, the question has already been answered. All across the Midwest hundreds of beds have been added by turning single patient rooms into make shift doubles. This strategic maneuver has lessened the load but it is a matter of time (week) before the efficacy of that strategy is maxed as well. Do you really think asymptomatic patients are admitted to hospitals? May I ask what you do for a living that would allow you to make such an erroneous assumption?

Just because YOUR news outlets are not mentioning how overwhelmed hospital systems are, does not mean it isn’t reality. Most local news stations across the Midwest indeed are reporting on it. I would not expect it to be the subject of routine National news, it was a couple weeks ago but people get bored of hearing about it. You can google any hospital system in the Midwest and most have social media in regards to bed situations. I am not exaggerating anything. If you aren’t lazy you can just google xyz city in the Midwest and type hospital capacity after it. For example Des Moines:

https://www.google.com/amp/s/www.kcci.com/amp/article/unitypoint-des-moines-health-reports-all-hospitals-at-capacity/34622200

-30 days later no change
-can be utilized for any city in the post prior and basically any city in the Midwest

Re : Flu - again, lol. There is no “under reporting of flu”, the cases simply are not present. When someone comes to the hospital the same covid screen tests for about 15 other viruses as well. There have been historic lows with flu, likely from mitigation efforts, not “under reporting.”

“Most states at 12.5% covid “ - do you not understand how high this number is? When hospitals approach 100% capacity during winter times, do you think it is easy to increase personal/beds/equipment with a snap of the finger , across every hospital in a region? You don’t recognize the significance of your own statistic. Non emergent procedures/surgeries have been canceled for the last 30 days in counting, you don’t think that would be the first modification to make?



Deaths always will lag cases, and new cases still have not reached peaked, but regardless you selected erroneous timeframes. Did I say anything about capacity in September or October? Quite clearly September and the majority of October were fairly calm times in terms of cases so why would you expect to see deaths there? It is easy to cherry pick timeframes, but any 3rd grader can tell you when the peak deaths (up to this point) are occurring. If you’re trying to, honestly, compare peaks you will compare the summer peak to the winter peak which last until January. Maybe you can come back and tell me in February how different the peaks were.


Yeah, here are stats from the Minnesota Department of Health regarding beds in MN. https://mn.gov/covid19/data/response-prep/response-capacity.jsp

Even here though, capacity varies between Twin Cities metro and outstate. Metro ICU beds have 6.3% availability, and non-ICU is 2.0% available. West-central MN, OTOH has 35.0% and 46.8% available, respectively.
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Dec 12 2020 04:57pm
Quote (Surfpunk @ Dec 12 2020 04:48pm)
Yeah, here are stats from the Minnesota Department of Health regarding beds in MN. https://mn.gov/covid19/data/response-prep/response-capacity.jsp

Even here though, capacity varies between Twin Cities metro and outstate. Metro ICU beds have 6.3% availability, and non-ICU is 2.0% available. West-central MN, OTOH has 35.0% and 46.8% available, respectively.



Right and keep in mind with that % that these hospital systems are doing everything they can to increase their # of beds too. For example fairview in Minneapolis (or St. Paul I can never remember) has recently added 20 additional icu beds and who knows how many med surg beds

This post was edited by Bazi on Dec 12 2020 04:59pm
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