Corona Virus: It's a Marathon, Not a Sprint

[Max Peck]

Unrelated, but some might remember early on in the pandemic there were some experimental wastewater monitoring stations set up nationwide to see if they could predict the next wave of COVID. Basically monitoring the wastewater for the virus being shed in feces.

Waste water surveillance has been in place here in Ottawa since early on in the pandemic. From what I've seen, it's been working pretty well as an early indicator, although it is still very much a work in progress.



IIRC, that big drop in the waste water indicator in spring, during the beginning of our 3rd/Alpha wave, was due to the impact of spring runoff draining into the sewer system.

[El Guapo]

The latest episode of Malcolm Gladwell's podcast is about use of dogs in medical diagnoses, including COVID. Pretty interesting.

It concludes with a discussion of use of dogs to detect COVID, and how in pandemic planning we should be putting plans into place to have disease sniffing dogs at high schools, stadiums, etc., at least for the next pandemic. Though he's not optimistic that we'll do anything like that, because we suck.

[Victoria Raverna]

Why are their crappy vaccination rates having any kind of impact on the hospital situation in Portland (which sucks right now)?

Lawbeef can probably explain this better, but it has to do with our tiered structure of healthcare. Namely, local/smaller hospitals aren't built or designed to handle "surge" events - they don't have the equipment/space/staff to handle things. Instead, there's an understanding that the more rural health centers are going to send their patients to larger healthcare systems where they have access to more specialized care.

The problem is that the larger healthcare systems are already overburdened with COVID and whatever else they're normally dealing with, so when smaller more rural healthcare centers are trying to send the random 2,3 or 5 people to a larger healthcare center, it adds up. Maybe those centers are typically only sending 1 or 2 people every few months. Now they could be potentially sending them daily.

In short, the system isn't designed to handle what's happening at such a large scale; it never was.

It is almost 2 years since COVID-19 started, why they didn't upgrade the capacity to handle "surge" events with that much time?

[Smoove_B]

It is almost 2 years since COVID-19 started, why they didn't upgrade the capacity to handle "surge" events with that much time?

The American health care system is in no way prepared to deal with a global pandemic that's unfolding in multiple locations simultaneously, nationwide. I'm not sure any health care system is. Even if we could magically create beds and ventilators, who's running them? Who's running them for kids?

[LawBeefaroni]

Why are their crappy vaccination rates having any kind of impact on the hospital situation in Portland (which sucks right now)?

Lawbeef can probably explain this better, but it has to do with our tiered structure of healthcare. Namely, local/smaller hospitals aren't built or designed to handle "surge" events - they don't have the equipment/space/staff to handle things. Instead, there's an understanding that the more rural health centers are going to send their patients to larger healthcare systems where they have access to more specialized care.

The problem is that the larger healthcare systems are already overburdened with COVID and whatever else they're normally dealing with, so when smaller more rural healthcare centers are trying to send the random 2,3 or 5 people to a larger healthcare center, it adds up. Maybe those centers are typically only sending 1 or 2 people every few months. Now they could be potentially sending them daily.

In short, the system isn't designed to handle what's happening at such a large scale; it never was.

It is almost 2 years since COVID-19 started, why they didn't upgrade the capacity to handle "surge" events with that much time?

There is currently a nursing and labor shortage and hospitals are still feeling the financial impact of reduced revenue due to lower utilization (outside of COVID). How and why would they try to expand?

Government money has mitigated a lot of the financial pain but it's not guaranteed in the future.

[gilraen]

It is almost 2 years since COVID-19 started, why they didn't upgrade the capacity to handle "surge" events with that much time?

With what money? Hospitals make the bulk of their profits on elective procedures, which they had to cancel. Many hospitals across the country either closed their doors or were gobbled up by major for-profit healthcare systems that had absolutely no incentive to build them up to handle surge traffic. Hospitals essentially operate on a just-in-time system where they calculate how many beds they should have to handle average expected number of in-patients. Too many empty beds, and it's a financial liability. Which is why no one would consider building a wing or a floor or an ICU "just in case" and risk it being empty.

[Drazzil]

It is almost 2 years since COVID-19 started, why they didn't upgrade the capacity to handle "surge" events with that much time?

With what money? Hospitals make the bulk of their profits on elective procedures, which they had to cancel. Many hospitals across the country either closed their doors or were gobbled up by major for-profit healthcare systems that had absolutely no incentive to build them up to handle surge traffic. Hospitals essentially operate on a just-in-time system where they calculate how many beds they should have to handle average expected number of in-patients. Too many empty beds, and it's a financial liability. Which is why no one would consider building a wing or a floor or an ICU "just in case" and risk it being empty.

Maybe hospitals should start renting their empty rooms. Yaknow, build as a hotel but convert to a hospital in time of need... hahahaha.


Ermmm.... thats not the dumbest idea I've ever come up with, sanitation issues aside.

[Victoria Raverna]

It is almost 2 years since COVID-19 started, why they didn't upgrade the capacity to handle "surge" events with that much time?

With what money? Hospitals make the bulk of their profits on elective procedures, which they had to cancel. Many hospitals across the country either closed their doors or were gobbled up by major for-profit healthcare systems that had absolutely no incentive to build them up to handle surge traffic. Hospitals essentially operate on a just-in-time system where they calculate how many beds they should have to handle average expected number of in-patients. Too many empty beds, and it's a financial liability. Which is why no one would consider building a wing or a floor or an ICU "just in case" and risk it being empty.

Maybe hospitals should start renting their empty rooms. Yaknow, build as a hotel but convert to a hospital in time of need... hahahaha.


Ermmm.... thats not the dumbest idea I've ever come up with, sanitation issues aside.

That is kinda what they do in some countries. Turn hotel into hospital.

[Isgrimnur]

Ain’t for-profit medicine grand?

[malchior]

Ain’t for-profit medicine grand?

I mean who would have guessed that exposing families to unaffordable market forces without choice or transparency for an essential service wouldn't work out? <Checks notes> Oh...almost the entirety of the rest of the advanced economies and many if not most emerging economies.

[noxiousdog]

Ain’t for-profit medicine grand?

Hospitals are mostly not for profit.

[malchior]

Ain’t for-profit medicine grand?

Hospitals are mostly not for profit.

True but also not really all that relevant. One that is an artifact of the many small hospitals across the country and second many providers inside that hospital will be for profit and will bill you separately. Your in-network nonprofit hospital will often have out of network providers provide care for the most expensive services. It's one the dumbest, least transparent markets in the world.

[noxiousdog]

Ain’t for-profit medicine grand?

Hospitals are mostly not for profit.

It's one the dumbest, least transparent markets in the world.

Absolutely, but it's not hospital profit that's driving it.

[LawBeefaroni]

Ain’t for-profit medicine grand?

Hospitals are mostly not for profit.

True but also not really all that relevant. One that is an artifact of the many small hospitals across the country and second many providers inside that hospital will be for profit and will bill you separately. Your in-network nonprofit hospital will often have out of network providers provide care for the most expensive services. It's one the dumbest, least transparent markets in the world.

Those are the horror stories and while shockingly awful, they aren't the norm. It is also becoming increasingly regulated by states along with the federal "no surprises" bill becoming effective 1/1/2022.

[malchior]

Ain’t for-profit medicine grand?

Hospitals are mostly not for profit.

True but also not really all that relevant. One that is an artifact of the many small hospitals across the country and second many providers inside that hospital will be for profit and will bill you separately. Your in-network nonprofit hospital will often have out of network providers provide care for the most expensive services. It's one the dumbest, least transparent markets in the world.

Those are the horror stories and while shockingly awful, they aren't the norm. It is also becoming increasingly regulated by states along with the federal "no surprises" bill becoming effective 1/1/2022.

Fair enough we are seeing incremental "reforms" but several of us happen to be in one of the states that still has surprise bills - sorta. We have an arbitration system where the providers tend to win. I am looking forward to having that arbitrary and ridiculous artifact go away even if it'll partially just distribute across the premiums.

[Smoove_B]

Hey parents, whatever you feel - it's ok.

https://twitter.com/RobinCogan/status/1 ... 0015561732

An Iowa school district is now leaving it up to parents to decide if they will quarantine their child who was exposed to COVID. They can choose to send their exposed child to school to potentially expose other people's children unless they have symptoms.

[Blackhawk]

And less than one day after being forced into requiring masks for '4-6 weeks', the school sent me an email this morning about their fundraiser. Select bits:

The Band, Choir and Art programs are teaming up for the school’s 2nd Annual Mattress Fundraiser and we need to spread the word! [snip] ...in the gym and our only job is to get as many people through the doors as possible. There will be 25+ mattresses for folks to try out!

So, next week they're going to stuff as many people into the gym as possible and have them take turns lying on the same demo mattresses.

[Smoove_B]

~280K reported cases of COVID-19 yesterday for America. We're closing in on the January 8th peak of ~308K cases - the highest it ever went.

This is beyond mind-boggling. Why the F isn't there a national mask mandate recommendation at this point???

[Zaxxon]

This is beyond mind-boggling. Why the F isn't there a national mask mandate recommendation at this point???

Freedumb.

[Smoove_B]

I understand that not everyone is a public health expert (well, excluding Nate Silver, of course), but I would hope that just by looking at the numbers people could see that the vaccination only strategy we adopted in May isn't working.

I also understand that how people feel about that is going to vary, but can we at least agree that the path we're on is resulting in just as many cases as we'd seen back before the vaccine was rolling out? Should I get the white board out and help everyone connect the dots?

I know I'm ranting and it's certainly not at anyone here, but JFC already. We tried the honor system. We're now looking at ~300K cases again and I'm guessing it's going to get worse. Can we at least talk about all the other options?

I have that beginning of a disaster movie feeling again where I'm pointing at the numbers and everyone else is just shrugging their shoulders.

Suddenly...raptors.

[Isgrimnur]

Head for Nebraska.

[Daehawk]

[Ralph-Wiggum]

I wouldn't trust that Nebraska data:

COVID-19 data in Nebraska, which already has been scarce since the state stopped publishing a dashboard of information at the end of June, has become even scarcer.

The expiration of an executive order on Saturday means Nebraska's health districts can no longer publicly report COVID-19 statistics, such as case numbers and vaccinations, for counties with fewer than 20,000 people.

[Skinypupy]

Data is just for nerds and liberal eggheads. Real 'Muricans don't need none of your fancy data!

[Smoove_B]

COVID outbreak linked to overnight cabin camping back in July, via the CDC staple MMWR. Who would have thought camping in a cabin could lead to more cases. I sure hope there wasn't a local school district that organized a multiple night cabin-based camping event for teenagers the week before school started. I can only imagine the problems that might cause.

Where was I? Oh yes, what have we learned:

This investigation underscores the impact of secondary SARS-CoV-2 transmission during large events such as camps and conferences when COVID-19 prevention strategies, including vaccination, masking, physical distancing, and screening testing, are not implemented.

[malchior]

~280K reported cases of COVID-19 yesterday for America. We're closing in on the January 8th peak of ~308K cases - the highest it ever went.

This is beyond mind-boggling. Why the F isn't there a national mask mandate recommendation at this point???

It's a mystery though cynically I can't help but think a messy combination of polls and a reluctance to stir up an already angry and very dangerous mob.

[Smoove_B]

Nationwide there's overwhelming support (in polls, to be fair) for masking. And yet here we go into September and the CDC and states are shrugging their shoulders. I honestly don't know what needs to happen at this point for things to change. Hospitals are regionally overburdened. There are more kids in ICUs now than ever before, at least in our collective lifetimes. Even our own state - there's ~1600 new cases a day for the last few weeks and hospitalizations and ICU beds are creeping up. Deaths are steady. But I guess because they're at some magical low level, we can just solider on.

And yet people are standing around and saying, "Eh, it is what it is."

At least the PA governor finally did *something* by mandating masks. Can't wait to see how rural PA reacts.

[Isgrimnur]

Stay away from Nebraska

[malchior]

Nationwide there's overwhelming support (in polls, to be fair) for masking.

Wrong polls. A particular President's poll numbers are in the dump for some strange reason. Maybe the mask mandate would be popular and buoy him a little but I think the administration is keeping a low profile for the time being.

At least the PA governor finally did *something* by mandating masks. Can't wait to see how rural PA reacts.

Ah the freedom of not having an election or crisis. When it comes down to it, every time now I just assume the leader is in it for themselves. When they don't have much on the line they can act principled. It's sad as hell how bad how far we have fallen.

[Zaxxon]

Boy, just wait until we get into election season which starts checks notes far too fucking soon.

[Isgrimnur]

They're working on redistricting at the moment.

[El Guapo]

Nationwide there's overwhelming support (in polls, to be fair) for masking. And yet here we go into September and the CDC and states are shrugging their shoulders. I honestly don't know what needs to happen at this point for things to change. Hospitals are regionally overburdened. There are more kids in ICUs now than ever before, at least in our collective lifetimes. Even our own state - there's ~1600 new cases a day for the last few weeks and hospitalizations and ICU beds are creeping up. Deaths are steady. But I guess because they're at some magical low level, we can just solider on.

And yet people are standing around and saying, "Eh, it is what it is."

At least the PA governor finally did *something* by mandating masks. Can't wait to see how rural PA reacts.

You're kind of missing the reality of where we are as a country if you're citing overall public support numbers. The reality is that GOP politicians aren't really accountable to public opinion. They're first and foremost accountable to the Republican base, to the conservative media bubble, and to donors - those are the ones that matter in terms of getting elected as a Republican.

[El Guapo]

Boy, just wait until we get into election season which starts checks notes far too fucking soon.

I'm so jealous of countries which have like 6 - 8 week election cycles.

[Smoove_B]

You're kind of missing the reality of where we are as a country if you're citing overall public support numbers. The reality is that GOP politicians aren't really accountable to public opinion. They're first and foremost accountable to the Republican base, to the conservative media bubble, and to donors - those are the ones that matter in terms of getting elected as a Republican.

Indeed. It's just amazing to me that a core, smaller group of death cultists is able to take us down with them. At some point (to use a phrase I haven't uttered in a long, long time), bullshits got to stop.

[Smoove_B]

Hospital situation:

Alabama, Georgia, Texas, Florida and Arkansas have less than 10% left of their ICU bed capacity, according to data from the Department of Health and Human Services.

In Georgia, the CEO of Northeast Georgia Health Systems said it had 287 Covid patients Monday morning, which is more than the hospital has had since January.

"So, in essence, our hospitals are full," Carol Burrell said. "We're looking to add space in hallways and conference rooms in waiting areas. Our emergency rooms and our urgent care centers are seeing higher volume than they've seen throughout this pandemic," she said.

And it's not just the South now. On Tuesday, Idaho had just four ICU beds available out of the 400 beds total in the state, Gov. Brad Little said.

I wonder why Mitch McConnell was finally saying something?

The effect of the low vaccination levels can be seen in Kentucky, where hospitals are overwhelmed with record numbers of Covid-19 patients and 58 of the 96 hospitals are reporting critical staffing shortages, Gov. Andy Beshear said Monday.

Oh, right.

How about kids?

In the past week, about 204,000 children tested positive for Covid-19, a five-fold increase from a month earlier, the AAP said. That's the second week that pediatric cases are at levels not seen since the surge last winter, the AAP said.

Unreal.

[Smoove_B]

Remember all the calls for how important it was to get kids back in school to help improve their mental health?

https://twitter.com/JesseRodriguez/stat ... 9525942282

TX Junior High School closes after second teacher dies of COVID-19

I'm guessing having two of your teachers die isn't helping. I see these headlines and it's like a gut-punch.

[Daehawk]

Im surprised they dont just keep the gates open until the last one falls.

[Kraken]

I wonder why Mitch McConnell was finally saying something?

McConnell has been consistently, if quietly, pro-vaccine because he is a polio survivor. There are many reasons to hate the man, but he's on the right side this time.

[Smoove_B]

McConnell has been consistently, if quietly, pro-vaccine because he is a polio survivor. There are many reasons to hate the man, but he's on the right side this time.

Oh, he's been for it. But he's never been on TV begging people to get it. Now I know what finally needed to happen in order for him to make a plea.

Also, F Mitch McConnell.

[LawBeefaroni]

Remember all the calls for how important it was to get kids back in school to help improve their mental health?

https://twitter.com/JesseRodriguez/stat ... 9525942282

TX Junior High School closes after second teacher dies of COVID-19

I'm guessing having two of your teachers die isn't helping. I see these headlines and it's like a gut-punch.

Yesterday was my daughter's second day in middle school. For the second day in a row, there was a full on fist fight at lunch. Number of such fights the previous 4 years? 1.

Mental health? What mental health?