Bacon's Rebellion

Democracy Thrives in Sunlight

COVID-19 Update: Still Lots of Idle Hospital Capacity

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by

James A. Bacon
in

Another day has gone by, Virginia hospitals still have abundant spare capacity to treat COVID-19 patients, and Governor Ralph Northam’s emergency decree against elective surgery continues to drain hospitals of revenue, cost healthcare workers their jobs, and delay many Virginians’ access to healthcare.

The number of COVID-19 patients in hospitals (both confirmed and awaiting tests) crept up by six over the day before to 1,405, according to today’s Virginia Hospital and Healthcare data dashboard. Hospitals still have 5,353 beds to spare.

Meanwhile the number of patients in ICU units declined by 22, and the number of COVID-19 patients on ventilators nudged up only three. The total of ventilators in use by all patients numbers 629, leaving 2,306 ventilators idle.

When Northam announced the one-week extension, the primary justification he gave was to conserve personal protective equipment (PPE) that doctors, nurses and other healthcare workers need to guard against infection by the virus. According to the VHHA dashboard, however, only three of Virginia’s hospitals reported an expectation of experiencing difficulty of replenishing their PPEs over the next three days.

Northam’s blanket decree applies uniformly across the state regardless of the prevalence of the virus or the capacity of hospitals to deal with it. The Roanoke Valley is not Arlington. Here’s the latest data from the Virginia Department of Health website:


A policy that might make sense for Arlington is insanely inappropriate for the Roanoke Valley (City of Roanoke, County of Roanoke, City of Salem), which has approximately the same population. If Northam’s purpose is to bankrupt Roanoke Valley healthcare providers — the Carilion Clinic and the LewisGale Hospital — by cutting off their revenue flow, he is making solid progress. If his goal is reducing deaths from the COVID-19 virus, it is difficult to discern how his elective-procedure edict might improve the situation in any way.

— JAB

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13 responses to “COVID-19 Update: Still Lots of Idle Hospital Capacity”

  1. Nancy_Naive Avatar
    Nancy_Naive

    Send some people to NYC for an all expenses paid vacation. Or, Georgia.

  2. LarrytheG Avatar
    LarrytheG

    Interesting slides:

    https://www.wfxrtv.com/wp-content/uploads/sites/20/2020/04/GOV-COVID-19-Briefing-04.24.2020-FINAL1.pdf

    1. Nancy_Naive Avatar
      Nancy_Naive

      A dry Chlorox martini is the answer.

  3. S. E. Warwick Avatar
    S. E. Warwick

    We still do not know how many of the cumulative daily cases have recovered. It’s been about six weeks, surely someone has some idea how many people who tested positive in the early days have recovered. As the testing increases, so will the cumulative number, but just how useful if that datum for decision making?

    1. cjbova Avatar
      cjbova

      You can track the VHHA hospital discharges since April 6, but VDH says in their COVID-19 FAQ: “Recovery information is not data that the Virginia Department of Health collects. Our data reflect a snapshot in time when the case is reported to us and we are not currently performing subsequent interviews or data collection to see where the person is at another point in the future.”

      Wonder if UVA had suggested tracking recoveries to the Commonwealth. The governor said they’ve been advising the Commonwealth since January. Might have helped their virus model too.

  4. TBill Avatar
    TBill

    As of today, Fairfax Co. is giving more statistics on a new health dept dashboard. The most striking graphic I see so far is the straight line exponential growth of Ffx Co. cases, which has only this week ticked to slightly lower growth rate, suggesting continued increasing growth of cases, but the exponential growth period may have moderated.

    This seems to suggest the exponential growth correlation works well within a specific region.

    To protect patient privacy (gimme a break) Fairfax is not giving us zipcode case loads. We are getting breakdown of huge regions of Fairfax Co., which does not help me know if my town is hot or cold spot.

    http://fairfaxcountygis.maps.arcgis.com/apps/MapJournal/index.html?appid=0027ebc6f73f4ae8bde0bfac8017a958

    1. TBill Avatar
      TBill

      Another striking graphic is the Ffx ethnic data which, if I am correctly reading, shows the hispanic community is the most impacted by far. However keep in mind 25% of cases have unknown ethnicity, so that statistic is a little weaker.

      The website is slow so have to wait a while to see things.

      1. LarrytheG Avatar
        LarrytheG

        Playing regions of the state off against each other during a pandemic doesn’t sound like a wonderful idea.

        We’re literally all in this together – and my understanding is that we still have some parts of the State that do not have assured levels of PPE and how awful would it be to have one hospital lacking PPE while trying to treat COVID19 patients while other hospitals are using PPE to do elective surgery?

        If Roanoke and SW Va needed help, I’m quite sure NoVa would help them and, in fact, I would expect most folks in Virginia to support this idea.

  5. cjbova Avatar
    cjbova

    There’s no question hospital beds are available, and no good reason not to allow a hospital with adequate PPE and enough healthy staff to resume doing elective procedures.

    There’s also no reason not to allow any business to reopen if they use phone or internet orders with parking lot or curbside delivery to car trunks or truck beds, or who have minimal direct contact with customers.

    But there are questions that need answers before relaxing social distancing overall.
    One group we have no information on is the number of patients discharged from hospitals who still need more care than they can receive at home. How many beds are available in supportive settings like rehab or nursing homes? And even more importantly, how many of those facilities are safe for recovering patients to enter?

    If the situation is stabilizing, why is the number of hospital discharges not steadily increasing and the number of hospitalizations is still rising above previous weeks?

    Today, VHHA shows discharges are down to 45, so there’s only a net of 56 new hospitalized tested and another 5 fewer waiting results. But the number hospitalized (tested and presumptive) is still higher than in previous weeks:
    April 6……..1194 (first VHHA report)
    April 10……1238
    April 17……1308
    April 25……1405

    And why is there a steep increase in reported cases in young children, ages 0-9?
    March 28….7
    April 4…….19
    April 10…..26 (do not have April 11 number, the 12th was 33)
    April 18…..65
    April 25…150
    Does it reflect the new testing of newborns of diagnosed mothers?
    Or is it because so many children have been going to grocery stores with a parent? Remember, food stamp recipients cannot use internet orders and must show their EBT cards at the register.

  6. Dick Hall-Sizemore Avatar
    Dick Hall-Sizemore

    After testing every inmate and staff member in several affected facilities, the number of inmates with a positive test in DOC facilities has risen only by 2, to 224, over the last report. The number of hospitalizations is unchanged at 8.

    1. cjbova Avatar
      cjbova

      That’s a good sign if all the test results are back!

    2. LarrytheG Avatar
      LarrytheG

      That’s good news! But to also point out – a day or a week from now – you won’t know a status unless you test again.

      That’s the hard issue. One test is not going to do it.

      How much should we test?

      So a couple of extreme examples.

      1. – if you are sheltering in place and and not mixing with others, perhaps having your groceries delivered – you probably don’t need testing.

      2. – If you are mixing with dozens of people every day and some of them are covid-19 positive – like first responders – you probably need to be tested every day.

      In a prison – if you are in a cell most of the day and do not mix with other prisoners – that’s different than someone who is in a dorm with dozens of others.

      So testing is not one-size-fits-all for everyone… it will vary – but the idea that we would limit testing arbitrarily no matter the circumstance is not going to work either.

      The same with contact tracing. Contact tracing in a prison dorm makes little sense. But contact tracing a grocery worker that tests positive is essential if you want to not have your entire workforce infected.

    3. LarrytheG Avatar
      LarrytheG

      Dick – do you know where they are getting their tests? Is it VDH or a private sector provider, etc?

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