As noted in “About 2.5 percent of Boston hospital beds occupied by COVID-19 patients”, it is tough to find out the information that is most relevant to a worried individual, i.e., how full are the hospitals? (and, therefore, will they run out of space/beds before I need one?).
New York is the epicenter of the U.S. epidemic. The “how full” percentage can be teased out of a CNBC article from yesterday:
New York coronavirus cases continue to surge, topping 37,258 on Thursday as the state scrambles to find enough hospital beds and ventilators to handle the coming onslaught of patients, Gov. Andrew Cuomo said.
More than 5,300 residents have already been hospitalized and the state is projecting that will climb to 140,000 over the next two to three weeks, he said. At least 1,517 people have been discharged, he added.
In other words, there are about 3,800 COVID-19 patients in New York hospitals right now. What’s the capacity? A separate web search yields the answer: 57,261. So roughly 6.6 percent of New York’s hospital beds are occupied by COVID-19 patients.
The situation is described in our media as a crisis, e.g., “13 Deaths in a Day: An ‘Apocalyptic’ Coronavirus Surge at an N.Y.C. Hospital”. Maybe that’s not an exaggeration, though. If the system into which we pour 17 percent of GDP (maybe more like 25 percent in 2020!) was already stretched, perhaps the breeze of 6.6 percent additional demand blew it over.
Will the surge of 140,000 show up? If these are mostly in the same week that would certainly be ugly in a state with 57,261 hospital beds (the president that New Yorkers hate is sending one of the Navy’s two hospital ships to NYC, but that will add only 1,000 beds). But why do they have to stay in New York? U.S. case statistics show that Pennsylvania has only 2,218 cases (1/20th as many as New York) and 42,817 beds. Even if coronavirus were to affect all states equally it won’t affect them all at the same time, right? Could this be a case where diversity is our strength? Prepare some ambulance buses to take 10-20 patients at a time to wherever there is significant excess capacity, even if that is across a state line. If Pennsylvania ever does get into a Wuhan-on-the-Hudson scenario, New York’s peak demand will be over at that point and New York hospitals can return the favor by taking Pennsylvania residents in.
Related
- World Bank data on hospital beds per 1,000 people (Japan and Korea at more than 13; Germany at 8.3; France at 6.5; Spain, Italy, and the U.S. around 3)
- As of today, we have no idea what the prevalence of coronavirus infection is in the U.S. Out of every 100,000 people we have tested fewer than 600 (nytimes). This is not a random sample either, but typically people who are hospitalized (or elites with the sniffles!).
This is the bit I find the most frustrating out of all the reporting on this topic. If the healthcare capacity is the reason for all the measures taken, then why aren’t the non-news media players (John’s Hopkins, Bing’s COVID tracker, etc) reporting data on that metric instead of just total cases and deaths.
This site seems to be tracking (or at least trying) the hospitalizations related to COVID, but that’s certainly not a complete data set: https://covidtracking.com/data/
At least in the few news stories not focused on TRUMP, the virus patients are being sent to poor neighborhoods while hospitals in upscale neighborhoods are being spared. There is a shortage of beds that aren’t in rich neighborhoods.
Homie don’t wash his hands.
Then there’s this
https://www.sfchronicle.com/bayarea/article/Coronavirus-patients-filled-nearly-half-the-beds-15157736.php
Isn’t there some deal where hospitals get to vote on whether new hospitals get built in their area? So if there aren’t enough hospital beds, shouldn’t we be upset with them? (Or, we treat stuff like this as something that must be dealt with outside of the normal health care system)
Elmhurst Hospital is the hospital mentioned in the NYT article. I live near there. That part of Queens is full of undocumented foreigners packed four to a room. There are a lot of Chinese wet markets nearby, though the most exotic thing they zell is live turtle. Kew Gardens, home base for JFK airline crews, is a few subway stops away.
I am writing this from a busy Queens public park with social distancing being mostly observed,, except for congregations of drunk itinerant mexicans and sober russian chess players.
A research team at the University of Washington has studied this problem. They expect that extensive social distancing measures will be in place across all states within the next seven days. Their forecast is that 7% more hospital beds will be required nationwide, and 25% more ICU beds. They’re particularly concerned about staffing. http://www.healthdata.org/sites/default/files/files/research_articles/2020/COVID-forecasting-03252020_4.pdf
The British Columbia government has been planning for the surge in hospitalizations. They released their modelling information today, as part of the daily update from the Provincial Health Officer and Health Minister (slides attached): https://globalnews.ca/news/6741258/bc-covid-19-forecast-modelling/
Capitalism. Just in time, just enough capacity(for average conditions). Death panels may be inevitable. It’s awfully ironic that the party who coined the term may be at the helm. No surprise there. To figure out what the Republicans are actually up to, just listen to their accusations.
Can someone who is knowledgeable please answer the following.
In Italy, and it seems other countries, anyone who tests positive for the Virus, and then dies, is recorded as having been killed by the Virus. There is no autopsy done, as death figures are released within 24 hours. Doesn’t an autopsy need to be done before one can determine the cause of death? Simply having tested positive for the virus does not mean it *caused* death. It seems to me there are at least 4 possibilities:
a) The virus was the sole cause of death
b) The virus was one of the causes of death.
c) The virus was not a cause of death, but helped “trigger” the actual cause of death to strike earlier than it should have done.
d) The virus played no part in causing death.
Surely only a detailed autopsy in each case can determine which of the above is actually what happened in each case?
But currently as long as the virus is detected as existing, it is immediately recorded as the cause of death.
Thanks.
I imagine if they can see someone’s lungs have turned into a slushie on an x-ray, that would explain most of the cases without ambiguity. You seem to be imagining a situation like “House, M.D.” where you need a forensic genius to figure out what killed someone who was on a ventilator for a week.
The reality is, even autopsy and massive lab work are not sufficient to pin this or that pathogen as the cause of death. And sick people usually have collections of them.
For example, check how long did it take the medical profession to figure out what was causing most common ulcers.
I know someone who was diagnosed with cancer 8 years ago and given 1 to 2 years to live. She is a fighter having survived this long but her immune system is shot. If she gets Coronavirus and dies, she will be listed as a Coronavirus death. By-the-way, whatever happened to the vaping health scare and all the folks coming down with “popcorn lung” and such? Are vaping deaths now classified as Coronavirus deaths?
There is a very simple solution to the US hospital bed shortage. If you are over 70 years old you are to stay at home, no matter what, there is no need to come to a hospital since their will be a “do not resuscitate order”. Amazon should make home delivery of ventilators available to anybody over the age of 70. Your survival at home with a ventilator will be higher than in a hospital. If the hospitals are still filling up, next smokers, vapers and people with high blood pressures will not be admitted. If you are stupid enough to smoke, vape or eat like a pig, too bad, you are a drain on the economy and should die.
Hospitals should be only for people under the age of 70 who do not smoke, vape and are not overweight. This would eliminate the hospital bed shortage and make it much easier on the doctors, who are more than happy to help out patients that take care of themselves, live healthy but unfortunately got the corona virus.
The corona virus may actually save the hospital system and the US government money in the long run, by killing off the people which would be very costly to the medical system in the first place. The US government just has to make sure they die at home and not in the hospital system.
It’s simple, they are talking not just about any beds, but about ICUs. The article does mention that as a reason:
> All of the more than 1,800 intensive care beds in the city are expected to be full by Friday
> Like other hospitals, Elmhurst has come perilously close to running out of ventilators several times; other hospitals have replenished its supply.
And indeed there is a newer article – https://thecity.nyc/2020/03/new-york-hospital-icus-nearing-limit-as-covid-19-surges.html – that says that only 15% beds out of 2,011 are left as of Saturday 03/28. Presumably this means that those 1800 beds available earlier were filled and 300 new were constructed.
According to https://www.nytimes.com/aponline/2020/03/26/health/ap-us-med-virus-outbreak-hospital-beds.html the spare ICU capacity in the U.S. in normal times is something like 25000 beds:
> U.S. hospitals reported operating 74,000 ICU beds in 2018, with 64% filled by patients on a typical day.
Transporting a patient in a serious condition is something that will indeed need to be done, but the logistics here is not that easy. E.g. Germany currently has spare ICU capacity but apparently only takes patients from Italy in batches of 6 – this is how much you fit on a medical plane (https://www.dw.com/en/flying-hospital-ready-in-an-emergency/a-335072).
The last link I sent was quite old, but this one from yesterday confirms they fly 6 patients at a time: https://metro.co.uk/2020/03/28/military-flies-italian-french-patients-germany-treatment-12471328/
Thanks for the link. I was thinking that a state being overwhelmed would transfer patients just at the stage where they were showing up at the ED, not after they’d already crashed. So the transport by bus wouldn’t take much longer than the typical wait to be seen at a U.S. ED on a normal day. The ones who need an ICU would stay where they are.