[BostonCard]

[tweet]https://twitter.com/COVID19Tracking/status/1334289955376390144?s=20[/tweet]

As of today, 100,000 patients with COVID-19 are in the hospital, which is about 1 in every 9 hospital beds available in the US.  The 2733 people who died from COVID-19 were the second most ever (behind only May 7).  For the first time ever, we've had over 5,000 deaths over the course of two days.  Case counts are also up (195,000 are a record), in part representing some catch-up after Thanksgiving, and in part representing the first infections caught over Thanksgiving, and the test positivity rate (10%) is climbing.  18,000 people are in the ICU (out of a total of about 100,000 ICU beds nationwide).

The worst part is that we have not seen the worst.  The vaccines can't come soon enough.

BC

[BostonCard]

[tweet]https://twitter.com/COVID19Tracking/status/1334289955376390144?s=20[/tweet]

As of today, 100,000 patients with COVID-19 are in the hospital, which is about 1 in every 9 hospital beds available in the US.  The 2733 people who died from COVID-19 were the second most ever (behind only May 7).  For the first time ever, we've had over 5,000 deaths over the course of two days.  Case counts are also up (195,000 are a record), in part representing some catch-up after Thanksgiving, and in part representing the first infections caught over Thanksgiving, and the test positivity rate (10%) is climbing.  18,000 people are in the ICU (out of a total of about 100,000 ICU beds nationwide).

The worst part is that we have not seen the worst.  The vaccines can't come soon enough.

BC

[OutsiderFan]

I just saw CA has a 15% test positivity rate as of today, according to JH.  SCC now up to 3.7%.

It seems inevitable that another SIP is coming unless people start heeding the restrictions in much greater numbers.

[OutsiderFan]

I just saw CA has a 15% test positivity rate as of today, according to JH.  SCC now up to 3.7%.

It seems inevitable that another SIP is coming unless people start heeding the restrictions in much greater numbers.

[dabigv13]

LA county with a SIP order tonight, but some loopholes. Should have done it a while ago.

[dabigv13]

LA county with a SIP order tonight, but some loopholes. Should have done it a while ago.

[OutsiderFan]

Just saw L.A. County is down to 86 ICU beds.

SC County has 44.

L.A. County has 5x the population of SC County and 2x the ICU capacity.  Not ideal.

[OutsiderFan]

Just saw L.A. County is down to 86 ICU beds.

SC County has 44.

L.A. County has 5x the population of SC County and 2x the ICU capacity.  Not ideal.

[fullmetal]

Just saw L.A. County is down to 86 ICU beds.

The population of LA County is over 10 million.  This is...insane.  Don't get sick, don't get into a severe car accident, etc...your odds aren't good if you live in LA County.

[fullmetal]

Just saw L.A. County is down to 86 ICU beds.

The population of LA County is over 10 million.  This is...insane.  Don't get sick, don't get into a severe car accident, etc...your odds aren't good if you live in LA County.

[Farm93]

LA county with a SIP order tonight, but some loopholes. Should have done it a while ago.

SOME loopholes.
This SIP is not Wuhan's or Milan's or even LA's from the spring.

Even with the city certain to blast right through ICU capacity this week, everyone still expects the sacrifices should not impact THEIR life.   It is rather sad, but if these are the problems in LA then I fear what will happen in COVID denier lands.

Health care workers are going to have a very hard 3 months after what has been a very tough 9 months.

[Farm93]

LA county with a SIP order tonight, but some loopholes. Should have done it a while ago.

SOME loopholes.
This SIP is not Wuhan's or Milan's or even LA's from the spring.

Even with the city certain to blast right through ICU capacity this week, everyone still expects the sacrifices should not impact THEIR life.   It is rather sad, but if these are the problems in LA then I fear what will happen in COVID denier lands.

Health care workers are going to have a very hard 3 months after what has been a very tough 9 months.

[Griffins78]

For California I see a 6.3% positivity rate but for LA County it is 10.2%. 

https://covidactnow.org/us/california-ca?s=1388369

[Griffins78]

For California I see a 6.3% positivity rate but for LA County it is 10.2%. 

https://covidactnow.org/us/california-ca?s=1388369

[magnus]

Any word on the military ships that were used to lighten the load on overflowing systems back in the Spring?

---

Any word on the military ships that were used to lighten the load on overflowing systems back in the Spring?

Some of the maritime sites claims the USNS Mercy is in Portland?  That seems like an odd place to be.

[magnus]

Any word on the military ships that were used to lighten the load on overflowing systems back in the Spring?

---

Any word on the military ships that were used to lighten the load on overflowing systems back in the Spring?

Some of the maritime sites claims the USNS Mercy is in Portland?  That seems like an odd place to be.

[BostonCard]

The USNS Comfort is in Norfolk.

https://www.marinetraffic.com/en/ais/det...NS_COMFORT

As mentioned, the USNS Mercy is in Portland (Oregon, not Maine)

https://www.marinetraffic.com/en/ais/det...USNS_MERCY

BC

[BostonCard]

The USNS Comfort is in Norfolk.

https://www.marinetraffic.com/en/ais/det...NS_COMFORT

As mentioned, the USNS Mercy is in Portland (Oregon, not Maine)

https://www.marinetraffic.com/en/ais/det...USNS_MERCY

BC

[BostonCard]

Newsome is about to issue new restrictions, especially for Southern California and the Central Valley, where things are looking pretty bad.

https://www.latimes.com/california/story...r-december

BC

[BostonCard]

Newsome is about to issue new restrictions, especially for Southern California and the Central Valley, where things are looking pretty bad.

https://www.latimes.com/california/story...r-december

BC

[82 Card]

Today's numbers:



Covid Tracking Project shows 210161 new cases (record), 100,667 currently hospitalized (record) and 2,706 deaths: https://twitter.com/COVID19Tracking/stat...0064239616


Worldometers.net shows 218,576 new cases and 2,918 deaths, both new records.

[82 Card]

Today's numbers:



Covid Tracking Project shows 210161 new cases (record), 100,667 currently hospitalized (record) and 2,706 deaths: https://twitter.com/COVID19Tracking/stat...0064239616


Worldometers.net shows 218,576 new cases and 2,918 deaths, both new records.

[fullmetal]

Any word on the military ships that were used to lighten the load on overflowing systems back in the Spring?

AFAIK, the hospital ships weren't used much due to red tape and restrictions on who could be treated (airflow and distancing are/were not possible on board, and it was near impossible to ascertain covid negative status in these patients prior to boarding the ship).

Same thing for those "field hospitals" set up in convention centers, etc.

[fullmetal]

Any word on the military ships that were used to lighten the load on overflowing systems back in the Spring?

AFAIK, the hospital ships weren't used much due to red tape and restrictions on who could be treated (airflow and distancing are/were not possible on board, and it was near impossible to ascertain covid negative status in these patients prior to boarding the ship).

Same thing for those "field hospitals" set up in convention centers, etc.

[magnus]

Any word on the military ships that were used to lighten the load on overflowing systems back in the Spring?

AFAIK, the hospital ships weren't used much due to red tape and restrictions on who could be treated (airflow and distancing are/were not possible on board, and it was near impossible to ascertain covid negative status in these patients prior to boarding the ship).

Same thing for those "field hospitals" set up in convention centers, etc.

I thought their original intent was to handle overflow of non-covid patients. 

But then when they realized that their best laid isolation plans were failing after staff on board were getting infected,  they changed the plan to also treat covid cases (at least in NYC)

[magnus]

Any word on the military ships that were used to lighten the load on overflowing systems back in the Spring?

AFAIK, the hospital ships weren't used much due to red tape and restrictions on who could be treated (airflow and distancing are/were not possible on board, and it was near impossible to ascertain covid negative status in these patients prior to boarding the ship).

Same thing for those "field hospitals" set up in convention centers, etc.

I thought their original intent was to handle overflow of non-covid patients. 

But then when they realized that their best laid isolation plans were failing after staff on board were getting infected,  they changed the plan to also treat covid cases (at least in NYC)

[magnus]

With 210k new cases, Trevor Bedford predicts we'll hit 3500 deaths in about 3 weeks. 

Very sad. 

[Tweet]https://twitter.com/trvrb/status/1334684101836566528?s=20[/tweet]

[magnus]

With 210k new cases, Trevor Bedford predicts we'll hit 3500 deaths in about 3 weeks. 

Very sad. 

[Tweet]https://twitter.com/trvrb/status/1334684101836566528?s=20[/tweet]

[OutsiderFan]

There were 217,000 new infections reported in U.S. yesterday, including a gobsmacking 21,000 in CA. And even at 7am PST, already over 4,000 new ones in CA just today. This is gonna be as bad or worse here than France and Belgium last month.

The question I have is how much will the - what has been typical - 1.7% CFR increase as hospitals are overwhelmed and ICU capacity evaporates. Also am curious to know how much greater the over expected death rate grows for all people, even those who die with non-Covid maladies, as hospitals are overwhelmed.

The IHME projections show close to 500,000 dead by March, but this is from Covid. We really should be looking at the total lives lost above expected to get an accurate count of deaths caused by pandemic.

I'm also very much curious about long-term Covid is having on survivors and numbers around that.  We have a clear idea what the known CFR is, and can use the 1.7% number, but what is the corresponding one for lives that suck now as a result of having Covid? I assume greater than 1.7%, but I have seen zero data on it. My suspicion is it is gonna be like 5% at least, but there is also a long-term reality we can't possibly know yet. Those with lung scarring who were on vents, might never heal, or it will take a longer time to know. But there are other known complications and unknown ones too.  Would be nice to have some insight into the post infection complication rate.

[OutsiderFan]

There were 217,000 new infections reported in U.S. yesterday, including a gobsmacking 21,000 in CA. And even at 7am PST, already over 4,000 new ones in CA just today. This is gonna be as bad or worse here than France and Belgium last month.

The question I have is how much will the - what has been typical - 1.7% CFR increase as hospitals are overwhelmed and ICU capacity evaporates. Also am curious to know how much greater the over expected death rate grows for all people, even those who die with non-Covid maladies, as hospitals are overwhelmed.

The IHME projections show close to 500,000 dead by March, but this is from Covid. We really should be looking at the total lives lost above expected to get an accurate count of deaths caused by pandemic.

I'm also very much curious about long-term Covid is having on survivors and numbers around that.  We have a clear idea what the known CFR is, and can use the 1.7% number, but what is the corresponding one for lives that suck now as a result of having Covid? I assume greater than 1.7%, but I have seen zero data on it. My suspicion is it is gonna be like 5% at least, but there is also a long-term reality we can't possibly know yet. Those with lung scarring who were on vents, might never heal, or it will take a longer time to know. But there are other known complications and unknown ones too.  Would be nice to have some insight into the post infection complication rate.

[fullmetal]

The rundown on USNS Comfort's role in the NYC crisis
https://www.nytimes.com/2020/04/02/nyreg...mfort.html

Article on both hospital ships:
https://news.usni.org/2020/05/25/beyond-...ine-at-sea

Unfortunate, but there seems to have been a mismatch between mission requirements and capabilities/protocols.

[fullmetal]

The rundown on USNS Comfort's role in the NYC crisis
https://www.nytimes.com/2020/04/02/nyreg...mfort.html

Article on both hospital ships:
https://news.usni.org/2020/05/25/beyond-...ine-at-sea

Unfortunate, but there seems to have been a mismatch between mission requirements and capabilities/protocols.

[Nan3cy]

There were 217,000 new infections reported in U.S. yesterday, including a gobsmacking 21,000 in CA. And even at 7am PST, already over 4,000 new ones in CA just today. This is gonna be as bad or worse here than France and Belgium last month.

Why is it gobsmacking that California had 10% of new cases, given that it has about 12% of the US population? Unless you think that 21K is unusually low, but I don’t think that’s what you meant.

[Nan3cy]

There were 217,000 new infections reported in U.S. yesterday, including a gobsmacking 21,000 in CA. And even at 7am PST, already over 4,000 new ones in CA just today. This is gonna be as bad or worse here than France and Belgium last month.

Why is it gobsmacking that California had 10% of new cases, given that it has about 12% of the US population? Unless you think that 21K is unusually low, but I don’t think that’s what you meant.

[BostonCard]

Another sign that things are reaching a breaking point:

https://www.theatlantic.com/health/archi...ed/617301/

The ratio of new hospitalizations to new diagnoses is going down.  That would be a good thing if the diagnoses are being made earlier or of patients with milder symptoms (because of increased testing), but as the article makes plain, that's not what is going on (as one can tell by observing that the case fatality rate is actually going up).  What is happening is that people who might have previously been admitted to the hospital are being turned away (or are deciding not to go to the hospital).

But ominous no longer fits what we’re observing in the data, because calamity is no longer imminent; it is here. The bulk of evidence now suggests that one of the worst fears of the pandemic—that hospitals would become overwhelmed, leading to needless deaths—is happening now. Americans are dying of COVID-19 who, had they gotten sick a month earlier, would have lived. This is such a searingly ugly idea that it is worth repeating: Americans are likely dying of COVID-19 now who would have survived had they gotten September’s level of medical care.

BC

[BostonCard]

Another sign that things are reaching a breaking point:

https://www.theatlantic.com/health/archi...ed/617301/

The ratio of new hospitalizations to new diagnoses is going down.  That would be a good thing if the diagnoses are being made earlier or of patients with milder symptoms (because of increased testing), but as the article makes plain, that's not what is going on (as one can tell by observing that the case fatality rate is actually going up).  What is happening is that people who might have previously been admitted to the hospital are being turned away (or are deciding not to go to the hospital).

But ominous no longer fits what we’re observing in the data, because calamity is no longer imminent; it is here. The bulk of evidence now suggests that one of the worst fears of the pandemic—that hospitals would become overwhelmed, leading to needless deaths—is happening now. Americans are dying of COVID-19 who, had they gotten sick a month earlier, would have lived. This is such a searingly ugly idea that it is worth repeating: Americans are likely dying of COVID-19 now who would have survived had they gotten September’s level of medical care.

BC

[teejers1]

Another sign that things are reaching a breaking point:

https://www.theatlantic.com/health/archi...ed/617301/

The ratio of new hospitalizations to new diagnoses is going down.  That would be a good thing if the diagnoses are being made earlier or of patients with milder symptoms (because of increased testing), but as the article makes plain, that's not what is going on (as one can tell by observing that the case fatality rate is actually going up).  What is happening is that people who might have previously been admitted to the hospital are being turned away (or are deciding not to go to the hospital).

But ominous no longer fits what we’re observing in the data, because calamity is no longer imminent; it is here. The bulk of evidence now suggests that one of the worst fears of the pandemic—that hospitals would become overwhelmed, leading to needless deaths—is happening now. Americans are dying of COVID-19 who, had they gotten sick a month earlier, would have lived. This is such a searingly ugly idea that it is worth repeating: Americans are likely dying of COVID-19 now who would have survived had they gotten September’s level of medical care.

BC

I understand the urge to paint as bleak a picture as possible - and it is correct that regulators are clamping down.  

But it is worth noting that the article you highlight uses words like "suggests," and "likely."  Also, your point assumes that the only reason people are deciding not to go to the hospital is because  . . . what?  There are too many cases there?  In other words, what makes you think that hypothetical set of people would have gone to the hospital in September?

I'm most focused on SCC.  The situation is certainly deteriorating - it's also true than non-Covid patients (1700) outpace Covid patients (325) by substantial amount.  I suspect there can be some interim relief there with non-emergency admits.  Separately, the bed numbers were re-set (as were ventilators) to remove surge beds or make number more aligned with staffing availability (IIUTC - but defer to MT on that).  I'm good with that as capacity numbers should be realistic, but it's also possible there is upside there.

We may end up in the calamity/Hospital Armageddon many here have . . . predicted.  Hopefully people will behave more responsibly and bring the numbers down and that can be avoided.

As an aside, given what I see in day-to-day life in Palo Alto (i.e., universal mask compliance; not a lot of group socializing outside - and if so, pretty responsible at parks), I really wonder what's driving these numbers.  One thing that remains alarming:  LTCF.  In last half of November, 75 cases (and the first half of November was much worse - 145).  Wonder how many of those folks end up in SCC hospitals?  [And we just got notice that at my mom's facility a staffer tested positive, so the whole place is set for a couple rounds of testing there].

[teejers1]

Another sign that things are reaching a breaking point:

https://www.theatlantic.com/health/archi...ed/617301/

The ratio of new hospitalizations to new diagnoses is going down.  That would be a good thing if the diagnoses are being made earlier or of patients with milder symptoms (because of increased testing), but as the article makes plain, that's not what is going on (as one can tell by observing that the case fatality rate is actually going up).  What is happening is that people who might have previously been admitted to the hospital are being turned away (or are deciding not to go to the hospital).

But ominous no longer fits what we’re observing in the data, because calamity is no longer imminent; it is here. The bulk of evidence now suggests that one of the worst fears of the pandemic—that hospitals would become overwhelmed, leading to needless deaths—is happening now. Americans are dying of COVID-19 who, had they gotten sick a month earlier, would have lived. This is such a searingly ugly idea that it is worth repeating: Americans are likely dying of COVID-19 now who would have survived had they gotten September’s level of medical care.

BC

I understand the urge to paint as bleak a picture as possible - and it is correct that regulators are clamping down.  

But it is worth noting that the article you highlight uses words like "suggests," and "likely."  Also, your point assumes that the only reason people are deciding not to go to the hospital is because  . . . what?  There are too many cases there?  In other words, what makes you think that hypothetical set of people would have gone to the hospital in September?

I'm most focused on SCC.  The situation is certainly deteriorating - it's also true than non-Covid patients (1700) outpace Covid patients (325) by substantial amount.  I suspect there can be some interim relief there with non-emergency admits.  Separately, the bed numbers were re-set (as were ventilators) to remove surge beds or make number more aligned with staffing availability (IIUTC - but defer to MT on that).  I'm good with that as capacity numbers should be realistic, but it's also possible there is upside there.

We may end up in the calamity/Hospital Armageddon many here have . . . predicted.  Hopefully people will behave more responsibly and bring the numbers down and that can be avoided.

As an aside, given what I see in day-to-day life in Palo Alto (i.e., universal mask compliance; not a lot of group socializing outside - and if so, pretty responsible at parks), I really wonder what's driving these numbers.  One thing that remains alarming:  LTCF.  In last half of November, 75 cases (and the first half of November was much worse - 145).  Wonder how many of those folks end up in SCC hospitals?  [And we just got notice that at my mom's facility a staffer tested positive, so the whole place is set for a couple rounds of testing there].

[winflop]

I'm curious as to why we haven't heard about governors calling up FEMA to deploy their mobile hospitals to provide additional capacity?

Also, both hospital and ICU capacity is not a fixed number. Many hospitals have rooms or entire wards that have been taken offline/out of service that in a pinch could be re-activated with additional equipment. Regular hospital rooms can also be converted to ICU rooms within 24 hours with additional equipment.

This isn't meant to imply that the situation isn't serious. Only to explain that capacity numbers are somewhat flexible both with federal support via FEMA and with additional equipment and onlining/converting idle capacity.

[winflop]

I'm curious as to why we haven't heard about governors calling up FEMA to deploy their mobile hospitals to provide additional capacity?

Also, both hospital and ICU capacity is not a fixed number. Many hospitals have rooms or entire wards that have been taken offline/out of service that in a pinch could be re-activated with additional equipment. Regular hospital rooms can also be converted to ICU rooms within 24 hours with additional equipment.

This isn't meant to imply that the situation isn't serious. Only to explain that capacity numbers are somewhat flexible both with federal support via FEMA and with additional equipment and onlining/converting idle capacity.