Wow, it’s getting really scary in Texas - and everywhere else!

[brewer12345]

I can recall during even moderately severe flu seasons that lasted over several months time being an absolute nightmare in an acute care hospital. It was not uncommon to queue up patients on gurneys in the E.D. hallways waiting for available beds. Nurse/patient ratios would rise to levels that at times resembled crowd control rather than patient care. It's a "treat 'em and street 'em" scenario.

And to further compound matters, invariably, staff would end up getting sick with the flu.

Add what appears to be an out of control pandemic to an average season of influenza, and E.D. triage will end up looking something like an army field hospital.

Sounds about right. Add in some social unrest and a presidential election at the same time. Do I reach for the bourbon or the rifle?

 

[Montecfo]

Suuurrre.............. There's an entire legion of qualified nurses and other acute care clinicians sitting in the bullpen just itching to get in the game.

Tens of thousands of health care workers volunteered to help in New York during the height of COVID. Some were coming out of retirement, others were able to get off regular jobs, were new grads or were between contracts. Most were not acute care but some were. And many were put to work. In fact the governor created a stir when he said they would be state taxing the pay of the volunteer workers receiving it.

 

[audreyh1]

Suuurrre.............. There's an entire legion of qualified nurses and other acute care clinicians sitting in the bullpen just itching to get in the game.

Having retired after 35 years w*rking in an acute care hospital in the Phoenix area, the news that inpatient/ICU beds are nearing capacity in July is stunning. Typically, inpatient census would average around 60% from mid-May through September. The hospital I retired from has been experiencing daily code purple surge alerts over the past several weeks.

Should this rate of hospitalizations continue into the fall when the annual flu season begins, I can't even begin to imagine what that will look like in a typical acute care hospital.

What is a code purple surge alert?

 

[harllee]

Candrew, flu season is what worries me. If the hospitals are already full with covid patients and the annual flu donkey show starts, it will not be pretty.

I too am very worried about flu season on top of Covid 19. DH and I had really bad flu winter before last even though we both had the vaccine--I was sick for a month and DH still has side effects from the flu (has tinnitus and hearing loss from the flu). I am hoping that if we continue to social distance and wear masks when we have to go out (and of course get the flu vaccine) that may help reduce the cases of flu. This seems to be a never ending nightmare.

 

[gerntz]

Hospitalizations in TX due to COVID-19 have about doubled since Memorial Day. I believe that in the hardest hit counties/municipalities they have gone up even more.* ReWahoo had some pretty impressive statistics for his county. I don't know that there is some fixed ratio. But it's obviously going to be related.
https://www.texastribune.org/2020/06/18/texas-coronavirus-hospitalizations/

*In the Rio Grande Valley, the number of people hospitalized with COVID-19 has more than tripled over the past two weeks, from 253 people on June 22 to 820 on July 4.
https://www.texastribune.org/2020/07/04/texas-coronavirus-rio-grande-valley-hospitals/

Thank you. On Memorial Day there were 529 new cases in TX. Today there were over 9K new cases in TX or about 17x cases today vs. MD. Yet hospitalizations are double. Is that increasing hospitalization correspondingly?

 

[6miths]

Tens of thousands of health care workers volunteered to help in New York during the height of COVID. Some were coming out of retirement, others were able to get off regular jobs, were new grads or were between contracts. Most were not acute care but some were. And many were put to work. In fact the governor created a stir when he said they would be state taxing the pay of the volunteer workers receiving it.

And that's what you want right. People who were retired for a few years or have never done critical care looking after ventilated patients. And just to point out that not all ICUs are equal. That in a top flight university medical center is several levels above those of many smaller hospitals. As Candrew points out, there is no significant excess of MDs, RNs or respiratory techs in the North American health care system, that's just not the way it works. And again, even if there were, they are not trained to deal with what this virus is producing. This is a very specialized skill set that is not quickly acquired or easily maintained.

 

[audreyh1]

Thank you. On Memorial Day there were 529 new cases in TX. Today there were over 9K new cases in TX or about 17x cases today vs. MD. Yet hospitalizations are double. Is that increasing hospitalization correspondingly?

Hospitalizations must lag new case detection somewhat. But otherwise, I have no idea if that would be a ratio that could be used to predict increases in hospitalizations.

Also, it must vary considerably by region. Note that the Rio Grande Valley saw a tripling of CV-19 hospitalizations in 2 weeks! I don’t know how much new cases surged over those same two weeks.

 

[brewer12345]

And that's what you want right. People who were retired for a few years or have never done critical care looking after ventilated patients. And just to point out that not all ICUs are equal. That in a top flight university medical center is several levels above those of many smaller hospitals. As Candrew points out, there is no significant excess of MDs, RNs or respiratory techs in the North American health care system, that's just not the way it works. And again, even if there were, they are not trained to deal with what this virus is producing. This is a very specialized skill set that is not quickly acquired or easily maintained.

Ah, C'mon, you stick the ventilator in them, they suck on the tube for a while, and they get better after a while. How hard can it be?

 

[REWahoo]

Thank you. On Memorial Day there were 529 new cases in TX. Today there were over 9K new cases in TX or about 17x cases today vs. MD. Yet hospitalizations are double. Is that increasing hospitalization correspondingly?

Not sure where you got those numbers.

This State of TX website says on Memorial Day there were 623 new CV19 cases and today (7/6) there were 5,318 new cases, 8.5 times as many.

This State of TX website says on Memorial Day there were 1,511 CV19 patients hospitalized. Today there were 8,698 hospitalized, 5.8 times as many.

Looks correspondingly close to me, especially when you account for the lag time audrey1 pointed out.

 

[MRG]

And that's what you want right. People who were retired for a few years or have never done critical care looking after ventilated patients. And just to point out that not all ICUs are equal. That in a top flight university medical center is several levels above those of many smaller hospitals. As Candrew points out, there is no significant excess of MDs, RNs or respiratory techs in the North American health care system, that's just not the way it works. And again, even if there were, they are not trained to deal with what this virus is producing. This is a very specialized skill set that is not quickly acquired or easily maintained.

A plan based on a hail Mary to retired staff? What could possibly go wrong with that?

 

[6miths]

A plan based on a hail Mary to retired staff? What could possibly go wrong with that?

Certainly nothing that I can think of.

 

[Montecfo]

And that's what you want right. People who were retired for a few years or have never done critical care looking after ventilated patients. And just to point out that not all ICUs are equal. That in a top flight university medical center is several levels above those of many smaller hospitals. As Candrew points out, there is no significant excess of MDs, RNs or respiratory techs in the North American health care system, that's just not the way it works. And again, even if there were, they are not trained to deal with what this virus is producing. This is a very specialized skill set that is not quickly acquired or easily maintained.

What I want is neither here nor there. What we have is what we work with.

Whether there are excess health professionals or not, at least 90k volunteered to work in NYC.

A lot of US hospitals are not as busy as Houston it turns out.

 

[JoeWras]

^
Always irks me to see "the beach" as any risk when not qualified - as other activities are - as "with others" or something.

I can go to the beach, park, walk and plonk myself down, swim in the ocean, etc., and even on a busy florida beach do all that staying easily 15-20 feet away from anyone. Vs. the grocery store where I come within 6 feet of a dozen people who can't figure out that aisles are one-way despite markers being down for 2 months...

Same for "public pool." Lane distanced set-aside lap swimming time is clearly different than bouncing around in the pool and yelling "marco-polo."

Testing bottleneck again - commercial testing labs say they are swamped and it’s starting to take days to get results in many cases.

DW finally got hers back yesterday. It took NINE days. The test was useless. After day 5, based on her lack of symptoms and how she felt, she knew it was a negative and the symptoms she briefly had were simply due to nerves and overheating in the sun one day. She still distanced herself from everyone, including me, during the 9 days. She never got beyond the boundaries of our property.

BTW, the reason she thought she was exposed was due to a dental visit. Her brief symptoms of fever were 4 days after her visit. It all seemed very plausible for those few hours.

 

[Golden sunsets]

Good point. My priorities are obviously all out of whack...

[emoji3516]

 

[candrew]

Tens of thousands of health care workers volunteered to help in New York during the height of COVID. Some were coming out of retirement, others were able to get off regular jobs, were new grads or were between contracts. Most were not acute care but some were. And many were put to work. In fact the governor created a stir when he said they would be state taxing the pay of the volunteer workers receiving it.

That was at a time when N.Y. was the nation's only COVID hotspot. Health systems that are struggling under inpatient surge conditions is not the ideal training environment for new grad nurses and bringing retirees up to speed.

What is a code purple surge alert?

In our system, Code Purple is called when the E.D. is full and there are not enough available inpatient beds.

 

[6miths]

What I want is neither here nor there. What we have is what we work with.

Whether there are excess health professionals or not, at least 90k volunteered to work in NYC.

A lot of US hospitals are not as busy as Houston it turns out.

I won't get into the discussion but that is one of the issues with the US healthcare system - it's the only country in the world where the goal is to have the hospitals be 'busy'.

As pointed out, the limiting factor is not beds but healthy and qualified (and heaven forbid it come to that but willing) staff. Also bear in mind that when hospital ERs and ICUs get even close to 'overwhelmed' that people start to die of treatable causes unrelated to COVID as there are no resources to manage them and that the more COVID cases there are in an area the more reluctant people are to even present to for care.

 

[gerntz]

Not sure where you got those numbers.

This State of TX website says on Memorial Day there were 623 new CV19 cases and today (7/6) there were 5,318 new cases, 8.5 times as many.

This State of TX website says on Memorial Day there were 1,511 CV19 patients hospitalized. Today there were 8,698 hospitalized, 5.8 times as many.

Looks correspondingly close to me, especially when you account for the lag time audrey1 pointed out.

Here under new cases per day:

https://www.worldometers.info/coronavirus/usa/texas/

 

[REWahoo]

Here under new cases per day:

https://www.worldometers.info/coronavirus/usa/texas/

Looks like their information isn't up-to-date with the numbers the state is reporting on the two web sites I linked.

 

[The Cosmic Avenger]

Here under new cases per day:

https://www.worldometers.info/coronavirus/usa/texas/

Their cumulative data has been pretty good, but their "last 24 hours" numbers are often missing; I noticed this because I kept checking for Florida's record-breaking numbers and I never saw them listed on Worldometers. Right now, only two states have new cases, and only three list new deaths.

 

[audreyh1]

Their cumulative data has been pretty good, but their "last 24 hours" numbers are often missing; I noticed this because I kept checking for Florida's record-breaking numbers and I never saw them listed on Worldometers. Right now, only two states have new cases, and only three list new deaths.

There is a small window to see some of the US states numbers before the new cases column resets at midnight GMT which is 7pm eastern time, 6pm central time - just two hours after TX publishes its new case count for the day.

 

[Aerides]

Their cumulative data has been pretty good, but their "last 24 hours" numbers are often missing; I noticed this because I kept checking for Florida's record-breaking numbers and I never saw them listed on Worldometers. Right now, only two states have new cases, and only three list new deaths.

Florida usually updates their daily tally right around Noon EDT each day. You can see all of their 10k plus and other days on the graphs half way down the florida specific page.

 

[audreyh1]

Florida usually updates their daily tally right around Noon each day. You can see all of their 10k plus and other days on the graphs half way down the florida specific page.

I’ve been seeing the numbers. They show up on worldometers shortly thereafter, but will disappear after 7pm eastern time.

 

[The Cosmic Avenger]

Florida usually updates their daily tally right around Noon EDT each day. You can see all of their 10k plus and other days on the graphs half way down the florida specific page.

Right, I've been looking at the graphs, but I wish the columns stayed populated, that way I could sort states by new cases or new deaths, as that's a better trend indicator. Instead, for that kind of directional measure that can be compared across states I've been checking the Rt for states here: https://rt.live/

 

[gerntz]

There is a small window to see some of the US states numbers before the new cases column resets at midnight GMT which is 7pm eastern time, 6pm central time - just two hours after TX publishes its new case count for the day.

You can see cases & deaths by each day for each state if you click on the state & go down.

 

[gerntz]

Looks like their information isn't up-to-date with the numbers the state is reporting on the two web sites I linked.

Well if the day totals don't match over time or at least they don't match by week, one or both aren't very believable.