Return to Play & Practice

[Ellejustus]

I don't believe I ever used the term running out of beds. I have always come at this by saying capacity issues. I used licensed bed as the basis. Of course there is the ability to expand the number of beds and FEMA is working on it right now. There is a 1,000 bed ship parked in San Diego right now and I know Fresno County who is experiencing the same issues is making plans to use their Convention Center. I have not heard anything from OC Health of what plans they have which now is the time they should be planning for it. I have watched press conferences with OC health and I am very scared. The leadership for LA Health is the bomb and is on top of everything. OC Health....they are a disaster waiting to happen.

Any way, like I said, we reach capacity of licensed beds in August if we keep increasing at the weekly rate we have been increasing for the last few weeks. The State seemed to realize this too which is why they pulled back on some openings and put enforcement in place. Hopefully these steps put in place slows the spread down thus slowing down hospitalizations and not requiring further levels of shut downs.

What is the reasonable # of beds that can be added? IDK because no one is reporting that. Considering counties from Central Cal on down are experiencing exponential weekly growth in hospitalizations, can we count on other counties and who gets that 1000 bed ship and how fast does it fill up. If we only get the hospitalization increase rate down to only 20% increase a week instead of 30% or more that we have been running, that gets us a few extra weeks and the reality is OC alone would need an additional 1,200 more beds per week. New York was able to deal with capacity issues because they completely shut down and New Yorkers were scared.

The point is, expect additional levels of shut down if we don't flatten the hospital bed increase percentage from week to week. I am expecting some level of flattening over the coming weeks from the recent mandates but the question remains will it be enough.

Also, as was explained to me from someone from FEMA, you can convert a certain amount of hospital beds to ICU beds if you have the proper equipment and the ICU trained staff. I see the shortage of ICU trained staff has been the problem in Arizona and Texas. They have been flying them in but it has still been the struggle.

I have tried every way I know how to explain this to you and a couple of others. Bottom line, shut downs are not about death rate rather hospitalization capacity. Expect some additional shut downs if the Hospitalization increase rate from week to week doesn't change.

I don't care whether you agree or not. I am done explaining it.

LA vs OC now? Please keeper mom, just please........ I know your very scared and are so many like you are scared of death. Some are scared to get the virus and some are scared that t will win and some are scared of both and because their scared out of their minds, they have blocked the kids from living and others from living, all because their scared and full of fear. The LA Health group 100% said go protest because it's essential or something like that. Now you have more cases. Here's where I'm at. Either we all go on lock down and lose our jobs together or those who can and want to, go outside and live life. This sucks!!!!

 

[Desert Hound]

Interesting article, but its not just about beds, i.e. from the article

"While hospitals were able to add beds more quickly than experts realized they could, some other resources were harder to come by. Masks, gowns and other personal protective equipment were tough to get. So were ventilators. Anesthesia agents and dialysis medications were in short supply. And every additional bed meant the need for more doctors, nurses and respiratory therapists."

Interesting quote at the end also

Lynam of Northwell said he's worried about what lies ahead. “You look back on the 1918 Spanish flu and the majority of victims from that died in the second wave. … We don't know what's coming on the second wave. There may be some folks who say you're paranoid, but you've got to be prepared for the worst."

Well at the beginning all the countries in the world were scrambling for gear...including the US. Since that time we have ramped up supplies dramatically.

In terms of 1918 and a 2nd wave. Yep we don't know if there will be a more deadly wave. As such the states and the feds keep stocking supplies. If the argument is we don't know what happens in the future therefore lets lock ourselves up, I am not for that approach.

 

[Desert Hound]

You call this "fairly flat"? Most would disagree.

View attachment 8078

It is fairly flat. We were pre open up seeing mid to high 20s deaths per day. Now we are seeing mid 30s to some high 30s deaths. So all of 5-10 more deaths per day than earlier. That in a population of 7 million or so. So yes pretty flat.

 

[Desert Hound]

Speaking of hospital beds in Cal.

The CDC shows that right now about 45k beds are in use in the state of Cal.

The state has a hospital bed capacity of 75K.

 

[espola]

It is fairly flat. We were pre open up seeing mid to high 20s deaths per day. Now we are seeing mid 30s to some high 30s deaths. So all of 5-10 more deaths per day than earlier. That in a population of 7 million or so. So yes pretty flat.

You might ask Izzy for some help on your math there.

 

[kickingandscreaming]

Wife just told me that her hospital is no longer accepting socal patients as of yesterday.

Sorry if I missed this, but where is her hospital based?

 

[chiefs]

Since LA has the vast majority of Calif cases and deaths, has anyone thought of just isolating them in place? Why should anyone in Orange or San Bern or SD county have to be concerned what those loons have done?

 

[MacDre]

She's one of the lucky ones. Does she know how much capacity has been lost and workers laid off / furloughed since March?

The hospitals in NorCal were laying folks off. My wife volunteered to take a month of vacation so others more in need wouldn’t be laid off.
You see, the good thing about growing up poor, is that I don’t trip on material things. As long as I have my health and can get whatever I lose back. Man makes money, money doesn’t make the man.

Are you to good to eat beans, rice, & cornbread until things get better. Or do you want some cheese to go with that WINE?

 

[Desert Hound]

The hospitals in NorCal were laying folks off. My wife volunteered to take a month of vacation so others more in need wouldn’t be laid off.
You see, the good thing about growing up poor, is that I don’t trip on material things. As long as I have my health and can get whatever I lose back. Man makes money, money doesn’t make the man.

Are you to good to eat beans, rice, & cornbread until things get better. Or do you want some cheese to go with that WINE?

I would prefer a good whisky or and IPA instead of wine. Cheese sounds good too : )

 

[Kicker4Life]

Since LA has the vast majority of Calif cases and deaths, has anyone thought of just isolating them in place? Why should anyone in Orange or San Bern or SD county have to be concerned what those loons have done?

Then isolate the City of LA, not the county

 

[Copa9]

I agree with almost everything you said. I do believe the boarder plays a role but I have seen no evidence that it is "significant" t"

And show anything at all that shows that it fizzles out before overwhelming hospitals and/or causing 40% more deaths. Why don't you start with Florida, Texas, and Arizona to see the fizzling out theory is working.

So concerned for the daughter of a friend of mine who is finishing her last rotation to become a PA in Arizona. She is on course to take her boards in the fall. A lot of hard work for her. Hope she stays safe.

 

[MacDre]

Sorry if I missed this, but where is her hospital based?

Northbay Healthcare Fairfield & Vacaville.

 

[whatithink]

Well at the beginning all the countries in the world were scrambling for gear...including the US. Since that time we have ramped up supplies dramatically.

In terms of 1918 and a 2nd wave. Yep we don't know if there will be a more deadly wave. As such the states and the feds keep stocking supplies. If the argument is we don't know what happens in the future therefore lets lock ourselves up, I am not for that approach.

I'm not for locking up either. The intent has always been, afaik, to manage capacity as the virus isn't going away, flattening the curve and all that.

Adding beds isn't adding ICU beds with all that entails. Adding ICU beds & equipment isn't adding trained staffed to run the ICUs. So adding 2,000 beds in 2 weeks reads great but that doesn't mean that they are effective for patients who need ICU. The stories out of Italy & Spain from the medical professionals there was of them having to decide who got the ICU, in the knowledge that the other person could die as a result. The goal is to avoid medical professionals from having to make that choice.

Anyway, I think the shut downs are for shit. This isn't going away and we need to get a new temporary norm in place. Masks & distancing help, so everyone should be in on that. Businesses should be allowed to open with sensible restrictions and if they are ignoring those restrictions then shut them down, e.g. the Scottsdale bars. That will stop that shit pretty quick and we can all get back to living. Shutting all bars or gyms etc because of a few bad players is plain stupid IMO. Businesses, employees and consumers shouldn't all suffer because of a few "bad players".

 

[Copa9]

Since LA has the vast majority of Calif cases and deaths, has anyone thought of just isolating them in place? Why should anyone in Orange or San Bern or SD county have to be concerned what those loons have done?

Let's isolate every community. Ladera Ranch started with seven cases, now they are over fifty. Isolate now and stop the spread! Isolate RSM, Mission Viejo, Lake Forest, Irvine, San Juan Capistrano, Newport Beach, Garden Grove, Costa Mesa, Hungtington Beach. , Tustin, Orange, Oceanside, Santa Ana, Anaheim, oh wait, that's where Disneyland is, people would protest and freak over that! After all, we now have over 20,000 cases with over a 1,000 new cases every day. Hey and San Diego isn't far beyond at 18,000 cases.

... seems like your answer to a perceived bed capacity issue is to follow NY and "completely shut down and be scared." To which I find completely unacceptable and completely unAmerican.

You're welcome to completely stay home and be completely scared... but if it's all the same to you, I'll go with Land of the Free and Home of the Brave.

You mean "Home of the Stupid"?

 

[Justafan]

Since LA has the vast majority of Calif cases and deaths, has anyone thought of just isolating them in place? Why should anyone in Orange or San Bern or SD county have to be concerned what those loons have done?

Sorry, but that's what happens when the father pawns off the greatest responsibility of his lifetime to his 50 children and 1000's of grandchildren.

 

[Justafan]

... seems like your answer to a perceived bed capacity issue is to follow NY and "completely shut down and be scared." To which I find completely unacceptable and completely unAmerican.

You're welcome to completely stay home and be completely scared... but if it's all the same to you, I'll go with Land of the Free and Home of the Brave.

OK Mr. Brave Man, I'm still waiting for your response because that "....ultimately we the people" response was sissy like.

 

[Desert Hound]

Adding ICU beds & equipment isn't adding trained staffed to run the ICUs. So adding 2,000 beds in 2 weeks reads great but that doesn't mean that they are effective for patients who need ICU.

What will happen is this. I have friends in the medical field here in AZ. In March/April when AZ had nothing going on, they went to NY to help out.

If today certain states need help, I suspect strongly that medical professionals from states past the wave come out here to help. It is what we do.

The stories out of Italy & Spain from the medical professionals there was of them having to decide who got the ICU, in the knowledge that the other person could die as a result. The goal is to avoid medical professionals from having to make that choice.

Italy and Spain have socialist health care systems and have far fewer resources available vs the US. Less beds, less equipment, less trained people, etc. So in this case an apples and oranges comparison.

Businesses, employees and consumers shouldn't all suffer because of a few "bad players".

Agreed. Further I dislike the idea that politicians dictate which businesses get to live and which die. Rather arbitrary.

 

[MicPaPa]

The hospitals in NorCal were laying folks off. My wife volunteered to take a month of vacation so others more in need wouldn’t be laid off.
You see, the good thing about growing up poor, is that I don’t trip on material things. As long as I have my health and can get whatever I lose back. Man makes money, money doesn’t make the man.

Are you to good to eat beans, rice, & cornbread until things get better. Or do you want some cheese to go with that WINE?

LOL! Once a victim always a victim. Let me guess, you were the kid at the birthday party always crying because others got a bigger piece of cake. Oh wait, too poor for parties...my bad!

 

[chiefs]

Let's isolate every community. Ladera Ranch started with seven cases, now they are over fifty. Isolate now and stop the spread! Isolate RSM, Mission Viejo, Lake Forest, Irvine, San Juan Capistrano, Newport Beach, Garden Grove, Costa Mesa, Hungtington Beach. , Tustin, Orange, Oceanside, Santa Ana, Anaheim, oh wait, that's where Disneyland is, people would protest and freak over that! After all, we now have over 20,000 cases with over a 1,000 new cases every day. Hey and San Diego isn't far beyond at 18,000 cases.

You mean "Home of the Stupid"?

Facts are LA is the massive problem; read, study and go right to the root cause.

 

[MicPaPa]

OK Mr. Brave Man, I'm still waiting for your response because that "....ultimately we the people" response was sissy like.

Referring to the first three words of the US Constitution as "sissy like" tells me two things about you; First, the original point was way over your head. And second, you believe in the stay home and be scared approach.

My starting point is twofold.

1. Recent protests revealed Government officials and experts remained silent or allowed en masse activities, legally and/or illegally.

2. Important to understand who works for who.

Much can be accomplished from this point.