COVID-19 Update: Hospital Vitals Still Stable

The picture couldn’t be clearer. By the most reliable metrics available — the number of patients being hospitalized, patients in ICUs, and patients on ventilators — the COVID-19 epidemic has stabilized.

Other metrics gyrate wildly. The number of “confirmed cases” reported to the Virginia Department of Health surged by 732 two days ago and dropped to 596 yesterday. But those numbers reflect cases reported to VDH, often after delays, which in turn reflects the number of tests available and changing protocols for prioritizing those tests. The percentage of positive tests to total tests has swung from a low of 3% to a high of 39.5% over the past month and a half. Meanwhile many COVID-19 cases go unidentified and/or unreported. In sum. the VDH numbers (through no fault of the department) are worthless as a yardstick for tracking the disease.

Even VDH’s “death” count is questionable. Definitions change, as explained by the Virginia Mercury. Moreover, funeral home directors told the Mercury that they have been receiving bodies of patients who were treated for COVID-19 but the cause of death doesn’t appear on their death certificates. The new definitions of a COVID-related death may be more useful in some contexts than the old definition, but evolving criteria makes the comparison of new data with old data problematic.

Why does this matter? Because out of a hyper-abundance of caution, Governor Ralph Northam announced his decision yesterday to extend the ban on elective surgery for a week, despite powerful evidence from the Virginia Hospital and Healthcare Association that hospitals have plenty of capacity to spare. An estimated 15,000 Virginians will have their procedures delays. If past is prologue, Northam’s hyper-cautious approach will govern other decisions whether to extend or roll back his economic lock down. The economic pain stemming from the epidemic may be far harsher and more longer lasting than necessary.

Unfortunately, the issue of when to relax emergency measures has become another litmus test on President Trump and his approach to COVID-19. People are taking sides based on their partisan affinities. Reason flies out the window. Here at Bacon’s Rebellion, however, we will continue to base our evaluation on these issues based on Virginia-specific data.


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21 responses to “COVID-19 Update: Hospital Vitals Still Stable”

  1. LarrytheG Avatar
    LarrytheG

    A one week delay is a “hyper-abundance of caution”? Certainly in the minds of some but what percentage of Virginians think that?

    There ARE issues with elective surgery during a pandemic. It is not “going back to the way it was before”. It’s different now.

    This is the kind of thing that is being made “partisan”… We set up the narrative to blame Northam for something (really silly when it’s one week) , then those that don’t agree are on the “other side”.

    Forget the pandemic.. it’s just another speed bump on the partisan divide!

    😉

  2. djrippert Avatar
    djrippert

    Much of economics is psychological. When people start to feel more confident they start to spend. When businesses feel confident that spending will rise they hire more people. That, in turn, makes people feel more confident. Etc.

    “Reopening” is not a binary decision. There is a lot of gray between “open” and “closed”. Even selective reopening will start the process of restoring confidence in the economy.

    How about opening restaurants in areas of Virginia which are not COVID-19 hotspots with some “social distancing” requirements? Obviously, restaurant owners are under no obligation to open and potential customers are under no obligation to go to these restaurants. However, some will open and some customers will go.

    Will that make a big fiscal difference? Of course not. But it will make a psychological difference. Green shoots and all that.

    1. LarrytheG Avatar
      LarrytheG

      STILL – it seems like a LOT of the “economy” we are talking about is things like sit-down restaurants, bars, entertainment, sports…

      All kinds of work is still going on… and when it comes right down to it – exactly what things can we not do that are actual necessities?

      The problem with the idea you mention – i.e. “local” business where there is not COVID is travel.

      What happens if Farmville “opens up” and has bars, sit-down restaurants and barber shops and NoVa and Richmond do not?

      Got an answer for that?

  3. Based on where the outbreaks are occuring, yes, he’s way off. When his own hospital/fellow doctors are willing to take the financial risks of getting sued to do “elective procedures”, he’s clueless.

  4. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    The COVID-19 situation in DOC is fairly stable, with the number of positive cases inching up in most facilities. According to Frank Green of the Richmond-Times Dispatch, all of the offenders housed at Deerfield and Haynesville prisons have been tested, even those not showing symptoms.
    https://www.richmond.com/news/virginia/covid-19-cases-rise-in-virginia-prisons-along-with-increased-testing/article_436f351d-0ce3-5f27-86a1-6921be01c041.html
    Here is the summary:
    222 total active positive, with 8 of those in the hospital (Yesterday’s report showed a total of 204, with 8 hospitalizations.

    The most worrisome aspect of today’s report is the appearance of positive cases in a facility not heretofore on the report: Dillwyn Correctional Center in Buckingham County. It is a medium security, dormitory facility for male offenders. There were 3 offenders testing positive.

    1. LarrytheG Avatar
      LarrytheG

      Dick – dumb question time again. How do NEW infections happen at prison facilities that had none before?

      how does that happen?

      1. Reed Fawell 3rd Avatar
        Reed Fawell 3rd

        People outside go inside.

        1. Dick Hall-Sizemore Avatar
          Dick Hall-Sizemore

          Reed is correct. Staff come and go in shifts. There are also outside contractors making deliveries, food, for example. DOC probably should be testing all staff, even those not showing symptoms, at all facilities. But any testing would be just a snapshot. It probably would be impractical to test all staff at every facility repetitively, even weekly. This is an example of community spread in a rural area.

          1. LarrytheG Avatar
            LarrytheG

            This sounds like what is going on at meat-packing plants also.

            Any facility that has people congregated in close quarters, urban or rural is at risk.

            Prisons, nursing homes, churches, schools, restaurants, etc

            urban and rural…………

            If prisons in rural areas – with their significant facility perimeters, cannot keep the coronavirus out, that oughta tell us something.

          2. LarrytheG Avatar
            LarrytheG

            re: testing – how much, how often, etc

            Think of any facility with a workforce – a prison, a meat-packing plant – a grocery store.

            Think of what happens if someone on the inside gets COVID19 and is not detected fairly quickly, what will happen?

            What happened on the Roosevelt or the Tyson/Smithfield meat packing plants?

            If you do not test frequently – you risk a high percentage of the workforce getting Covid19.

            I’m amazed that the grocery stores – with a large number of customers and lots of vendors has not run into the problem the meatpackers or the Roosevelt had…

            Without some continuous level of testing.. we’re flying blind.

            In a given community – you need to scrupulously track down contacts of those who got infected and get those contacts that are positive isolated… over and over… once will not do it, you’re just never going to get all of them on any one cut.. even if the contact tracing was flawless and the tests were flawless.

  5. Steve Haner Avatar
    Steve Haner

    Was just out and about in the Short Pump area on this lovely Friday afternoon. Wegman’s crowded…tried to get into a nearby garden shop and the line was out the door (probably a limit of folks inside the store.) Masks? Some. What shutdown? Lots of people are just done with this…..getting on with it. The businesses following the rules must be fuming. Came back to turn on the tube and hear His Excellency dancing around May 8….

    1. Reed Fawell 3rd Avatar
      Reed Fawell 3rd

      Great reporting, Steve. The emperor has no clothes.

  6. LarrytheG Avatar
    LarrytheG

    Walmart up here, as well as Wegmans, Lowes and Home Depot are limting the number in the store and in the garden shop.

    There are lines outside of Wegmans waiting to get in.

    I see a lot of folks wearing masks…

    A LOT of places are open – grocery, home improvement, pharmacies, Dollar General, Weis, COSTCO, BJs, Total Beverage, tire companies, post office, gasoline, parks, trails, and yes… a lot of folks are out

    but the polls say they support the restrictions … 80% of them do.

    The 20%? not so much …

    Perhaps if not a whole lot die in Georgia, folks will become even braver?

  7. Reed Fawell 3rd Avatar
    Reed Fawell 3rd

    Md Gov. Larry Hogan just finished a highly informative press conference on Maryland’s testing, tactics, and coved-17 status plus its just issued economic recovery plan going forward.

    The comprehensive and plan is found here:
    https://governor.maryland.gov/wp-content/uploads/2020/04/MD_Strong.pdf

    1. Reed Fawell 3rd Avatar
      Reed Fawell 3rd

      The Maryland Governor’s just finished today’s press conference can be found at:

      https://www.youtube.com/watch?v=ozGhhPMJBsQ

  8. LarrytheG Avatar
    LarrytheG

    and crickets on the Virginia Plan presented hours ago…. 😉

    Hopefully, we’ll get a post or two outlining each state’s plans….

  9. JB, I’m coming around on this question of elective surgery. It seemed to me that if you’re going to shut down businesses, you should shut down businesses — including hospital business, to the extent it’s optional, or “elective.” And there’s the argument that if the surge still looms, you’d better keep the rooms available until you know the demand.

    But now, in spite of Kerry’s histrionics, I think you make the case for Virginia’s hospital capacity remaining sufficient for long enough into the future that we should allow them to use their capability — they can, after all, judge for themselves whether they need to suspend again the elective surgery influx — if, for now, the surge in COVID cases has flattened out. “Essential” big box businesses like Walmart and Home Depot already seem to be operating in all departments on an “shop with caution” basis; what is a hospital but one more “essential” big box?

    The problem is not the stores, but the people going to them. “Elective” surgery is surgery nonetheless; having a knee replaced may be “elective” but it’s not a trivial walk in the park. Shopping for groceries is something we have to do. But shopping without a mask for spring annuals and bags of mulch at a crowded Home Depot? At some point we make a mockery of “stay at home” directives — which I support, for the very selfish reason that I am at high risk from this disease, as well as the public policy imperative of saving lives. If we are going to be inconsistent, let’s be consistently inconsistent.

    1. Acbar, you touched upon a critical point here: Hospitals “can, after all, judge for themselves whether they need to suspend again the elective surgery influx.”

      Exactly, if hospital capacity to treat COVID-19 ever comes close to being fully utilized, hospitals always have the option of dialing back their elective surgeries. I can’t begin to understand the mentality that says they should not be trusted to do so.

      1. LarrytheG Avatar
        LarrytheG

        Wasn’t the issue originally that it was not a matter of trust but a concern about existing supplies of things like PPE?

        This is another example of how the “free market” has it’s own interests and they may actually conflict with other societal needs.

        And all of a sudden, all the rhetoric against “overly profitable” hospitals has evaporated and now it’s about those “poor” hospitals who cannot do elective surgeries! lordy!

        Aren’t these the same folks that the anti- COPN people want to allow other facilities to compete against ? I wonder what Jim S thinks about this?

      2. Reed Fawell 3rd Avatar
        Reed Fawell 3rd

        “I can’t begin to understand the mentality that says they should not be trusted to do so.”

        The exquisite pleasure some people feel in gratuitously exercising power over large numbers of other people. Power’s exercise justifies all. Lenin refined this. Stalin mastered its exercise. Thus it makes no rational sense. That is the point of it all.

        Hence gun criminals go free. Law abiding citizens go jail for gun possession they need to defend themselves against freed gun criminals. The less logic there is behind act, the greater the pleasure of power.

        1. Reed Fawell 3rd Avatar
          Reed Fawell 3rd

          This is also why in a democratic society, politicians operating in that arena, far more often than we realize, invent false problems to solve that more often than not, do more harm than good, while, at the same time, they ignore the real problems that fester under the obvious problems on the surface of issues they claim to address.

          Public education, it’s chronic never ending stream of failures and false cures, is a poster child to this kink in human political psychology.

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