{"id":30910,"date":"2021-01-17T23:05:41","date_gmt":"2021-01-18T04:05:41","guid":{"rendered":"https:\/\/philip.greenspun.com\/blog\/?p=30910"},"modified":"2021-01-18T13:21:33","modified_gmt":"2021-01-18T18:21:33","slug":"our-heros-hospital-is-full-but-not-with-patients-who-should-be-there","status":"publish","type":"post","link":"https:\/\/philip.greenspun.com\/blog\/2021\/01\/17\/our-heros-hospital-is-full-but-not-with-patients-who-should-be-there\/","title":{"rendered":"Our hero&#8217;s hospital is full (but not with patients who should be there)"},"content":{"rendered":"\n<p>From May 2020, <a href=\"https:\/\/philip.greenspun.com\/blog\/2020\/05\/18\/a-typical-american-hospital-during-coronapanic\/\" data-type=\"post\" data-id=\"27048\">A typical American hospital during coronapanic<\/a>:<\/p>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\"><p>The author of <a href=\"http:\/\/fifthchance.com\/MedicalSchool2020\"><em>Medical School 2020<\/em><\/a> gave me an update on his training hospital. They have roughly <strong>1,100<\/strong> beds. They have admitted <strong>24 <\/strong>Covid-19 patients since the plague began. There are currently <strong>7 <\/strong>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. &#8220;We&#8217;re allowed to do elective surgeries as of this week,&#8221; he said, &#8220;and I thought there would be a huge backlog, but there isn&#8217;t. We&#8217;re still not busy.&#8221;<\/p><\/blockquote>\n\n\n\n<p>How about now? &#8220;Every bed is full. The ICU is full. The ED has 55 patients waiting for rooms [in the rest of the hospital].&#8221; Is COVID-19 that prevalent? &#8220;No,&#8221; he responded, &#8220;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&#8217;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&#8217;t do better at placing discharged patients.&#8221;<\/p>\n\n\n\n<p>What about the COVID-19 patients per se? &#8220;Most of them are on 1 liter of oxygen [per minute], which is nothing,&#8221; he said. &#8220;They might not notice if it were stopped. People can be at home on 5 liters.&#8221; 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&#8217;t need to be in the hospital, but who could be sent back into nursing homes for fear that they would infect others (enter <a href=\"https:\/\/khn.org\/morning-breakout\/gov-cuomos-order-to-house-covid-patients-in-nursing-homes-scrutinized\/\">the hero Governor Cuomo<\/a>!).<\/p>\n\n\n\n<p>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&#8217;t get organized to turn empty hotels into Covid-19 halfway houses.<\/p>\n\n\n\n<p>Department of Nobody Listens to Me&#8230; from April 2, 2020&#8230; <a href=\"https:\/\/philip.greenspun.com\/blog\/2020\/04\/02\/if-we-could-build-renal-dialysis-capacity-why-not-covid-19-treatment-centers\/\" data-type=\"post\" data-id=\"26429\">If we could build renal dialysis capacity, why not COVID-19 treatment centers?<\/a>: treat COVID-19 patients in strip malls.<\/p>\n\n\n\n<p>Update: A medical school professor who read the above&#8230; &#8220;It&#8217;s all true. But one big additional reason is that discharging all those patients would be a loss of $$$$$.&#8221; (I&#8217;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&#8217;s perspective.)<\/p>\n\n\n\n<p>Related:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><a href=\"https:\/\/philip.greenspun.com\/blog\/2020\/12\/06\/health-care-workers-plead-with-you-to-stay-home-and-avoid-travel\/\" data-type=\"post\" data-id=\"29447\">Health care workers in Aruba plead with you to stay home and avoid travel<\/a>, in which a med school prof and our hero answer the question of whether Covid patients should be in the hospital: &#8220;Many things could be done from home cheaper and safer but we don\u2019t have the infrastructure or culture. Home model kills the rationale for the hospital cash cow.&#8221;<\/li><\/ul>\n","protected":false},"excerpt":{"rendered":"<p>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. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[61],"tags":[],"class_list":["post-30910","post","type-post","status-publish","format-standard","hentry","category-coronapanic"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Our hero&#039;s hospital is full (but not with patients who should be there) - Philip Greenspun\u2019s Weblog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/philip.greenspun.com\/blog\/2021\/01\/17\/our-heros-hospital-is-full-but-not-with-patients-who-should-be-there\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Our hero&#039;s hospital is full (but not with patients who should be there) - Philip Greenspun\u2019s Weblog\" \/>\n<meta property=\"og:description\" content=\"From May 2020, A typical American hospital during coronapanic: The author of Medical School 2020 gave me an update on his training hospital. 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