[M T]

An anecdote, fwliw:  a relative is on Board of Trustees at big Houston hospital and he mentioned that the reporting on capacity - to extent it states or implies - that Covid cases are causing the burst at seams, was misleading (at least respecting the hospital he has info on).  I presume his opinion was based on the same factors outlined above.

I believe I've posted on this.  Texas Medical Center ("TMC", a collection of the hospitals in Houston) has quite thorough and transparent data.  I have family that are on the staff there and live there, so it is of interest to me.  They have a very flexible way of accounting for their ICU numbers.  Basically, they can expand their ICU capacity from 1300 beds to 2100 beds.  They seem to try to keep it close to the normal "max" capacity of around 1300, but they have two stages beyond 1300.   When I looked in late June, they had something like 950 non-COVID patients in ICU.  The charts for expected usage in two weeks kept that 950 and added expected COVID patients, leading to a "We'll run out of room" situation.  What got into the news was that the ICU was about to hit 100% of (normal) capacity.

It got in the newss & people were worried about an immediate NYC or Italy scenario.  Personally, I wasn't worried yet as I was pretty sure that 950 could be reduced, at least temporarily.  And they have, when I looked 3 days ago, it was down to about 775 non-COVID ICU beds, but the projection still was "We'll run out of room" in 2 weeks if the non-COVID stays the same and the COVID grows as expected.

Whether this projection helped or not, the governor & (I think) the city tightened controls so as to limit how quickly COVID spread.  I think I saw the curves were bending from less exponential. 

But, as BC said, if R0 > 1, it may take longer, but the growth will still happen.  [Btw, I think of R0 as a measure of what happened, not as a predictor.  Kinda like saying if you won a game, then you must have scored more points. That's a backwards way of looking at it.  If you scored more points, then you won.  If you have exponential increases, then R0 > 1.  So, i actually see BC's statement as a tautology.]

I will also note that we usually think of almost all medical procedures as being necessary.  Some are more urgent than others.  If we recognize that the current state of affairs may go on for 5 years are more, most of those 950 (or more) ICU patients in that perhaps typical (or perhaps artificially reduced) snapshot will eventually need the procedures, then Houston is getting a logjam of procedures that are waiting for a break in COVID that may not come for 5 years or more.  In the meantime, those necessary procedures may become more critical & more urgent, so the flexibility in scheduling them gets lost.

I'm glad that particular medical center had the flexibility (so far), and I'm glad the government there found a different balance of liberty and life.
Not all (probably not many) medical centers have that flexibility.

[M T]

An anecdote, fwliw:  a relative is on Board of Trustees at big Houston hospital and he mentioned that the reporting on capacity - to extent it states or implies - that Covid cases are causing the burst at seams, was misleading (at least respecting the hospital he has info on).  I presume his opinion was based on the same factors outlined above.

I believe I've posted on this.  Texas Medical Center ("TMC", a collection of the hospitals in Houston) has quite thorough and transparent data.  I have family that are on the staff there and live there, so it is of interest to me.  They have a very flexible way of accounting for their ICU numbers.  Basically, they can expand their ICU capacity from 1300 beds to 2100 beds.  They seem to try to keep it close to the normal "max" capacity of around 1300, but they have two stages beyond 1300.   When I looked in late June, they had something like 950 non-COVID patients in ICU.  The charts for expected usage in two weeks kept that 950 and added expected COVID patients, leading to a "We'll run out of room" situation.  What got into the news was that the ICU was about to hit 100% of (normal) capacity.

It got in the newss & people were worried about an immediate NYC or Italy scenario.  Personally, I wasn't worried yet as I was pretty sure that 950 could be reduced, at least temporarily.  And they have, when I looked 3 days ago, it was down to about 775 non-COVID ICU beds, but the projection still was "We'll run out of room" in 2 weeks if the non-COVID stays the same and the COVID grows as expected.

Whether this projection helped or not, the governor & (I think) the city tightened controls so as to limit how quickly COVID spread.  I think I saw the curves were bending from less exponential. 

But, as BC said, if R0 > 1, it may take longer, but the growth will still happen.  [Btw, I think of R0 as a measure of what happened, not as a predictor.  Kinda like saying if you won a game, then you must have scored more points. That's a backwards way of looking at it.  If you scored more points, then you won.  If you have exponential increases, then R0 > 1.  So, i actually see BC's statement as a tautology.]

I will also note that we usually think of almost all medical procedures as being necessary.  Some are more urgent than others.  If we recognize that the current state of affairs may go on for 5 years are more, most of those 950 (or more) ICU patients in that perhaps typical (or perhaps artificially reduced) snapshot will eventually need the procedures, then Houston is getting a logjam of procedures that are waiting for a break in COVID that may not come for 5 years or more.  In the meantime, those necessary procedures may become more critical & more urgent, so the flexibility in scheduling them gets lost.

I'm glad that particular medical center had the flexibility (so far), and I'm glad the government there found a different balance of liberty and life.
Not all (probably not many) medical centers have that flexibility.