Should we worry about hospitals being overwhelmed with COVID-19 Patients? Libertarian: Nah.
Our friend Donald Boudreaux is at it again, dispensing misleading statistics that just so happen to favor libertarian outcomes.
Two days ago Boudreaux posted some data on hospital capacity that seem to suggest that we do not need to worry about hospitals getting overwhelmed with COVID patients because capacity utilization over time is flat. As Boudreaux puts it:
The bottom line is that, when broken down to the state level – at least for the period November 4th through December 4th – there is no evidence that hospitals in the U.S. are close to running out of beds for patients.
Of course, there are other possibilities that Boudreaux does not flag for his readers. For example, to take a wild possibility at random, it may be that hospitals are not admitting as many sick COVID patients as they fill up.
Ashish Jha in the Washington Post:
What is happening is pretty simple: As hospitals fill up, they are admitting fewer and fewer people. As any doctor or nurse will tell you, as the demand for beds soars, the threshold for admission rises with it. . . .
One theory that some have advanced is that better treatment is leading to fewer hospitalizations or that more testing is identifying milder cases, and that’s why hospitalization rates are dropping. But outpatient treatment of covid has not changed meaningfully in the past month. The most promising potential outpatient treatment, monoclonal antibodies, has yet to see wide usage. Testing has increased, with more than 2 million tests conducted on some recent days, but case numbers and test positive rates have been rising even more steeply, indicating that we are still missing many more cases — especially mild and asymptomatic cases — so there is no evidence that more testing explains the change in rates of hospitalization.
What is happening is that patients who would have been admitted to hospitals earlier in the year are not being admitted now. Indeed, by my best calculation, between a third and half of covid-19 patients who would have been admitted in the beginning of October are now being sent home instead. This is really bad for patients. Some will get much sicker at home. Some may die there.
And from the Grey Lady:
More than a third of Americans live in areas where hospitals are running critically short of intensive care beds, federal data show, revealing a newly detailed picture of the nation’s hospital crisis during the deadliest week of the Covid-19 epidemic.
Hospitals serving more than 100 million Americans reported having fewer than 15 percent of intensive care beds still available as of last week, according to a Times analysis of data reported by hospitals and released by the Department of Health and Human Services. . . .
There is some evidence physicians are already limiting care, Dr. Tsai said. For the last several weeks, the rate at which Covid-19 patients are going to hospitals has started decreasing. “That suggests that there’s some rationing and stricter triage criteria about who gets admitted as hospitals remain full,” he said.
We can debate what is happening and how the government should respond. But Boudreaux just can’t seem to acknowledge that there might, possibly, be a reasonable case for aggressive public health measures to slow the epidemic. Instead, he keeps the anti-government rhetoric dialed up to 11 (“tyranny!”), and continues to stoke outrage with misleading statistics. This is especially perverse given the rise in right wing extremism and the fact that vaccines will soon become widely available.
I had trouble reading the article on my tablet, an IShares advertisement covered half the screen.
It would be really nice if all the reasons for putting people in the hospital spread themselves out to match the available hospital beds. I am sure the SARS-CoV-2 virus will take that into consideration. /s
Lying with statistics is easy and especially egregious when the fact is that statewide averages are meaningless when one considers actual treatment. Covid19 treatment for most of us plebes is what we get in our local community. Your state’s average ICU bed availability might be >1 but YOU are still SOL if your local hospital is full. So yeah, averages only obfuscate the crisis some local communities face. I’m sure Boudreaux would tell me that ICU bed availability at 8% in my county today is no big deal. Even as the number of active cases has quadrupled in the last several weeks and ICU bed availability has plummeted from the mid 20% range. Why worry, right?
I am more worried about healthcare workers being overwhelmed. I stopped worrying about dying myself while a kid in Vietnam after just two weeks in country. Still I don’t want to see my kids (hah, all over 40 YO now) die so young nor do I take any more pleasure in counting the dead now than I did watching the body bags pile up fifty years ago.
Healthcare workers are giving more than most people know. When they come home at the end of a grueling day of battling with the grim reaper then they cannot touch their own loved ones for fear of contagion. Even if healthcare workers are vaccinated, then they cannot relieve their stress with the embrace of their spouse and children unless their entire household is vaccinated, which I have seen no recognition given in the vaccine roll out plans.
IOW, Our friend Donald Boudreaux is a squirrel that can just run up a tree. My cats have better luck catching birds. We need to pay attention to our own ground game rather that being so easily distracted by squirrels.
While I agree entirely, it’s also true that the media has been crying wolf for the last six months about “hospitals at capacity!” and those stories never seem to go anywhere.
Hubris. A flaw in character. Given what’s going on today, Boudreaux is a minor irritant.
Maybe 50 years ago hospitals ran with a fair amount of unused bed space most of the time, so that they would have enough capacity to handle surges. But since then we have become a capitalist paradise, and have worked hard at eliminating all that reserve capacity that ate into profitability while only serving the needs of mere humans — and not humans useful to capital either, but the sick kind of human who is just a drag on capital.
At any rate, these days hospitals are always pretty close to their maximum capacity, so you’re never going to find much of a surge at all in occupancy. Surges have to be dealt with as mentioned above, by ruthless triage, by just not admitting people who would have easily met criteria for admission any other time.
It seems that infections peaked in Wisconsin just prior to Thanksgiving. Not that the virus has gone away, but the trend is unambiguously lower. Hopefully that will take some pressure off hospitals around here.
@Mondo Rock
“…the media has been crying wolf…”
[Is that a wolf in creep clothing or a wolf in cheap clothing? Inquiring minds want to know.
OTOH, six months ago and again now is not the same as “for the last six months.” Some moron came to my door yesterday wanting to buy the land next door wearing no face covering and too stupid to look up the ownership online. Then he broke into conspiracy theories about the outbreak when I told him through my gator that he should not go to people’s door unannounced and without a mask. Would it be inappropriate to consider such people just a useless fuck-wad?]
In defense of useless fuck-wads everywhere then it must be admitted that the media adores sensationalism, so they have gotten worked up into a real frenzy over the global pandemic. For them it is the best thing to happen since Donald Trump. That does not mean though that all these useless fuck-wads will not have become a lot more fearful of communicable diseases by spring, by which time the death toll will be easily an integer multiple (2 to 4 times) what we have had over the entire last year.
So far our measures had done little to abate community spread. With winter air to dry up the mucous linings of bronchi making us more susceptible to respiratory infection then we all will realize what we have accomplished. OTOH, fewer people will refuse vaccination than presently estimated.
So, the fundamental questions are –
What is the cost in time and money to increase the hospital care ward capacity into spillovers in vacant public school buildings by 50%? By 100%?
Then what is the cost in time and money to increase the hospital healthcare staff of doctors and nurses by 50%? By 100%?
So there is a clear difference between a difficult and expensive problem and an impossible problem. It is always best to avoid the problems with the impossible solutions.
All libertarians are assholes, Example #24,889.
https://covidtracking.com/data/charts
The COVID Tracking Project at The Atlantic
The public deserves the most complete data available about COVID-19 in the US. No official source is providing it, so we are.
Testing is also down in Wisconsin.
Strange how that happens, huh?