From May 2020, A typical American hospital during coronapanic:
The author of Medical School 2020 gave me an update on his training hospital. They have roughly 1,100 beds. They have admitted 24 Covid-19 patients since the plague began. There are currently 7 Covid-19 patients in the hospital. Residents have been working week-on/week-off due to the shortage of cases from which they might learn. “We’re allowed to do elective surgeries as of this week,” he said, “and I thought there would be a huge backlog, but there isn’t. We’re still not busy.”
How about now? “Every bed is full. The ICU is full. The ED has 55 patients waiting for rooms [in the rest of the hospital].” Is COVID-19 that prevalent? “No,” he responded, “but we have to test every patient before discharge even if we have no reason to suspect Covid. If someone tests positive, he or she can’t go back to the nursing home for three weeks. People who would have been in the hospital for 4 days in 2019 are staying 6 weeks. We will have to shut down elective surgeries soon if we can’t do better at placing discharged patients.”
What about the COVID-19 patients per se? “Most of them are on 1 liter of oxygen [per minute], which is nothing,” he said. “They might not notice if it were stopped. People can be at home on 5 liters.” In his opinion, the ones who were on ventilators had to be in the hospital because they needed to be managed by nurses, but none of the other Covid-19 or Covid-19-positive patients had any medical need to be in the hospital. They were there because no infrastructure had been built to accommodate patients who didn’t need to be in the hospital, but who could be sent back into nursing homes for fear that they would infect others (enter the hero Governor Cuomo!).
Essentially, the hospital is packed because, even with nearly a year to prepare, state and local health departments that regulate hospitals and track hospital capacity couldn’t get organized to turn empty hotels into Covid-19 halfway houses.
Department of Nobody Listens to Me… from April 2, 2020… If we could build renal dialysis capacity, why not COVID-19 treatment centers?: treat COVID-19 patients in strip malls.
Update: A medical school professor who read the above… “It’s all true. But one big additional reason is that discharging all those patients would be a loss of $$$$$.” (I’m disappointed in myself for not immediately realizing that a 100-percent full hospital, and a ready excuse in the form of hysterical headlines for why it is 100-percent full, is not the end of the world from the hospital CEO’s perspective.)
Related:
- Health care workers in Aruba plead with you to stay home and avoid travel, in which a med school prof and our hero answer the question of whether Covid patients should be in the hospital: “Many things could be done from home cheaper and safer but we don’t have the infrastructure or culture. Home model kills the rationale for the hospital cash cow.”
Probably half of the patients we admit for COVID just need oxygen, but Medicare won’t allow us to send patients home from the ER with oxygen (i.e. they won’t pay for it because ER doctors aren’t qualified to certify that patients need home oxygen). The private insurers follow suit.
They could save money (and lives, indirectly, by freeing up hospital resources) if we could arrange for home O2.
Let us look at this from a different view point.
If we have similar standardize test (which we do but ignore) for our education system as such every single student must get a passing grade at their grade level (which they don’t) to move on and we hold them back (which we don’t), I think in about a year we would have a national crises. Schools would fall apart (no room to keep those who cannot move on) parents would riot (my kid will not graduate to go to collage?) and the US economy would collapse turning us into a 3rd world country (other countries would see the true color of our nation).
I guess the priority of the US (and the world) is misplaced. One death person from covidsandal is one too many, but 100’s of students graduating with almost no math or reading skill is OK.
> Department of Nobody Listens to Me
Heh. At least you have some doctors and others who read your posts and will answer your questions, validate or invalidate your theories, etc. A week ago I asked one of my ER physician friends from a big hospital in a rather large northeastern state about the pace of vaccine rollout. He hasn’t responded to me, even though I know he read the message – and I told him I would anonymize or not repeat anything he said, if he wanted. I’m sure he’s busy, and maybe that’s why, but I get the impression that he does not want to discuss it publicly. This is a man I’ve known since we were five years old.
I too was grateful to read Dr. Sam’s actual boots-on-the-ground comment (above). FUBAR insurance carrier/hospital admin/govt intervention (Medicare) system always mucks things up. (Third-hand from my husband who was listening to a podcast) — Dr. Drew Pinsky, the Fox News consultant, is just now recovering from COVID, which he suspects his teenager(s) brought into his household. He spoke about steroids and possibly another drug, and implied that there’s a shortage of those, but that he was able to order them for himself (he does hold an MD, and not an Ed.D. like First Lady-elect Jill Biden). Dr. Drew was sick enough to worry about whether he would pull through. He’s considerably older than Emmanuel Macron, for instance, who managed without medical intervention, probably. They both present as lean & fit, so in theory don’t have co-morbidities. Husband’s takeaway after hearing Dr. Drew’s podcast — due to very high incidence of COVID at the moment, stay very tightly locked-down if you are able.
Just pulled up this account closer to the source:-)