[M T]

Heard on the radio today: 30,000 new cases in California (15% of the total in the country), about half of them in LA county.  ICU capacity in southern California is down to 8%, limited by staffing. ...  It's worse in the central valley; ICU capacity is <5%.

As the subject heading notes, it's bad out there.

BC

At this point, it is inevitable that the number of "staffed ICU beds" will soon be less than occupied ICU beds for some, and then more, California (and elsewhere) hospitals.  (That's not to say that patients will be in beds without staff, only that the staff have less time per bed.)   That's when care starts falling off dramatically.  The more the shortfall of staff, the worse the outcomes.   (I believe current estimates are for that situation to last through all or most of January in California.)

I expect that some ICU patients need more attention than others.  Specifically, those on ventilators will need more care?  I haven't been tracking ventilator usage but last I looked we still had many available.  But can they be used without specialists to monitor them?

Did we make a lot of progress in full face mask ventilation as an alternative?  I know there was work on that, but I don't know if there are enough such masks and that the results warranted their use.


This is why I wish that the FDA board had recommended to do best effort to get the 2nd doses in 21 days, but to prioritize getting first doses to the people most likely to go to the hospitals if they get COVID.

[M T]

Heard on the radio today: 30,000 new cases in California (15% of the total in the country), about half of them in LA county.  ICU capacity in southern California is down to 8%, limited by staffing. ...  It's worse in the central valley; ICU capacity is <5%.

As the subject heading notes, it's bad out there.

BC

At this point, it is inevitable that the number of "staffed ICU beds" will soon be less than occupied ICU beds for some, and then more, California (and elsewhere) hospitals.  (That's not to say that patients will be in beds without staff, only that the staff have less time per bed.)   That's when care starts falling off dramatically.  The more the shortfall of staff, the worse the outcomes.   (I believe current estimates are for that situation to last through all or most of January in California.)

I expect that some ICU patients need more attention than others.  Specifically, those on ventilators will need more care?  I haven't been tracking ventilator usage but last I looked we still had many available.  But can they be used without specialists to monitor them?

Did we make a lot of progress in full face mask ventilation as an alternative?  I know there was work on that, but I don't know if there are enough such masks and that the results warranted their use.


This is why I wish that the FDA board had recommended to do best effort to get the 2nd doses in 21 days, but to prioritize getting first doses to the people most likely to go to the hospitals if they get COVID.