Flatten The Curve

Published by Papa Giorgio

JUMP TO:

Media Confirms Opening Premise That Flattening the Curve Was To Protect Hospitals/Healthcare ★ A Debate on My Facebook About The Curve ★ Historical Stresses on the Healthcare/Hospital System  [192,446 Hospitalizations for Covid-19 as of May 27 2020 | 2017-2018 Flu Season: 810,000 Hosdptalizations (low: 620,000 | high:1,400,000) – CDC] ★ Ventilator Shortage Myths ★ Damages of Continued Flatten Curve Power Grabs: Hospitals Going Bankrupt

OPENING PREMISE:
Not To Overwhelm Hospitals

This first part of a multi-part post is merely to discuss what the Flattening the curve was for ~ AND THAT WAS ~ not over-burden our healthcare system.

The Los Angeles Times explains:

…The goal is no longer to prevent the virus from spreading freely from person to person, as it was in the outbreak’s early days. Instead, the objective is to spread out the inevitable infections so that the healthcare system isn’t overwhelmed with patients.

Public health officials have a name for this: Flattening the curve.

The curve they’re talking about plots the number of infections over time. In the beginning of an outbreak, there are just a few. As the virus spreads, the number of cases can spike. At some point, when there aren’t as many people left for the pathogen to attack, the number of new cases will fall. Eventually, it will dwindle to zero.

If you picture the curve, it looks like a tall mountain peak. But with containment measures, it can be squashed into a wide hill.

The outbreak will take longer to run its course. But if the strategy works, the number of people who are sick at any given time will be greatly reduced. Ideally, it will fall below the threshold that would swamp hospitals, urgent care clinics and medical offices, said Dr. Gabor Kelen, chair of the emergency medicine department at Johns Hopkins University…

(LOS ANGELES TIMES / SCIENCE, March 11, 2020)

No Other Reason

MORE CONFIRMATION

LOS ANGELES TIMES: Why We Should Still Try To Contain The Coronavirus

The coronavirus outbreak that has sickened at least 125,000 people on six continents and caused nearly 4,600 deaths is now an official global pandemic. But that doesn’t mean we should give up on trying to contain it, health experts say. The goal is no longer to prevent the virus from spreading freely from person to person, as it was in the outbreak’s early days. Instead, the objective is to spread out the inevitable infections so that the healthcare system isn’t overwhelmed with patients. Public health officials have a name for this: Flattening the curve. (Healy and Khan, 3/11)

ABC NEWS: Why Flattening The Curve For Coronavirus Matters (March 11, 2020)

NBC NEWS: What Is ‘Flatten The Curve‘? The Chart That Shows How Critical It Is For Everyone To Fight Coronavirus Spread. (March 11, 2020)

Confirming the above, you will see that the trend line was to spread out the disease, not to defeat it. And this endeavor would take two weeks at the least, six at the most:

Anywhere from 20 percent to 60 percent of the adults around the world may be infected with the new coronavirus SARS-CoV-2, the virus that causes the disease COVID-19. That’s the estimate from leading epidemiological experts on communicable disease dynamics.

[….]

So yes, even if every person on Earth eventually comes down with COVID-19, there are real benefits to making sure it doesn’t all happen in the NEXT FEW WEEKS.

(SCIENCE ALERT, March 11, 2020)

Dena Grayson, MD, PhD, a Florida-based expert in Ebola and other pandemic threats, told Medscape Medical News that EvergreenHealth in Kirkland, Washington, is a good example of what it means when a virus overwhelms healthcare operations.

[….]

Grayson points out that the COVID-19 cases come on top of a severe flu season and the usual cases hospitals see, so the bar on the graphic is even lower than it usually would be.

“We have a relatively limited capacity with ICU beds to begin with,” she said.

So far, closures, postponements, and cancellations are woefully inadequate, Grayson said.

“We can’t stop this virus. We can hope to contain it and slow down the rate of infection,” she said.

“We need to right now shut down all the schools, preschools, and universities,” Grayson said. “We need to look at shutting down public transportation. We need people to stay home — AND NOT FOR A DAY BUT FOR A COUPLE OF WEEKS.”

The graphic was developed by visual-data journalist Rosamund Pearce, based on a graphic that had appeared in a Centers for Disease Control and Prevention (CDC) article titled “Community Mitigation Guidelines to Prevent Pandemic Influenza,” the Times reports.

(MED SCAPE, March 13, 2020)

To slow down the spread of the pandemic virus in areas that are beginning to experience local outbreaks and thereby allow time for the local health care system to prepare additional resources for responding to increased demand for health care services (CLOSURES UP TO 6 WEEKS)

(CDC, April 21, 2017)

On the other hand, if that same large number of patients arrived at the hospital at a slower rate, for example, OVER THE COURSE OF SEVERAL WEEKS, the line of the graph would look like a longer, flatter curve.

(JOHN HOPKINS MEDICINE, April 11, 2020)

And, here is a conversation via my Facebook that elucidates how people have this idea of saving lives mixed up with not pressuring or overwhelming our healthcare system

EXCERPT FROM FACEBOOK CONVO

(ME)

  • Steve W — you do know Steve that the same amount of death from and infection due to Covid-19 exists under the trend line of doing nothing and the most strict quarentine rules…. right? In other words, we are not saving lives. And, in fact, we have made it worse for our economy next fall/winter because it is coming back as it makes its rounds around the world.

(STEVE W)

  • Sean Giordano I have heard that said but not seen it from a credible source. So I think that is false.

(ME)

  • Steve W what is false?

(STEVE W)

  • Sean Giordano “the same amount of death from and infection due to Covid-19 exists under the trend line of doing nothing”

(ME)

Steve Wallace now you are saying don’t listen to Dr. Fauci?

Many bemoan Trump for not listening to him (even though he has), and some I meet do not support Fauci in the idea that this was to elongate the process as to not put any undue stress on our health care system. Even though he clearly announced multiple times this was the reason to do so

WORLD ECONOMIC FORUM mentions the following, and all the graphs of the United States shown by Doctors Fauci and Birx have all used this idea as well (graph below from CDC and WEF)

CHRIS WALLACE: All right. You talk about slowing the virus down. You talk a lot, and I’ve very used to this now, you can either have a bump like this of cases or you could make it maybe the same total cases, but it’s a much more gradual and slower and longer curve. I want to put up some numbers. We have in this country about 950,000 hospital beds, and about 45,000 beds in Intensive Care Unit. How worried are you that this virus is going to overwhelm hospitals, not just beds, but ventilators? We only have 160,000 ventilators. And could we be in a situation where you have to ration who gets the bed, who gets the ventilator?

DR. FAUCI: OK. So let me put it in a way that it doesn’t get taken out of context. When people talk about modeling where outbreaks are going, the modeling is only as good as the assumptions you put into the model. And what they do, they have a worst-case scenario, a best-case scenario, and likely where it’s going to be. If we have a worst-case scenario, we’ve got to admit it, we could be overwhelmed. Are we going to have a worst-case scenario? I don’t think so. I hope not.

What are we doing to not have that worst-case scenario? That’s when you get into the things that we’re doing. We’re preventing infections from going in with some rather stringent travel restrictions. And we’re doing containment and mitigation from within. So, at a worst-case scenario, anywhere in the world, no matter what country you are, you won’t be prepared. So our job is to not let that worst-case scenario happen.

(…. STILL ME….)

STEVE W for you not to understand the goal of all this, and then get on here sharing insights is itself insightful. I am not blaming you STEVE… I just see this fundamental misunderstanding of the underlying factors and goals of this whole endeavor of bending the curve as applicable to MANY A PERSON in these discussions here and elsewhere on social media. I am giving you, in fact, the most respectful benefit of a doubt, but am merely in conversation with you at this moment. This conversation is just multiplied (others are having) across social media many fold. Blessings to you and yours friend. Yet, this foundational view is not known well by others… that is, the reason behind flattening the curve as well as the data underneath the trend line.

(CLICK TO ENLARGE)

Here I wish to switch gears a bit and start to discuss another “info graphic” post from MY SITES FACEBOOK I shared with my readers. And since the entire idea behind “flattening the curve” was to keep the health and hospital system working well by not getting inundated all at once, this should have lasted two or three weeks. Not as long as it has — our economy is important too! Damnit!

CAPACITY OF THE HEALTHCARE SYSTEM

The following was compiled after a conversation I had on Facebook. It touches on some of the issues above. Enjoy

  •  I note the bell curve because many are under the false impression we are doing this to “save lives.” This was never the case.

The quarantine was to lessen the apex of the bell curve as to not put pressure on the hospital/health system. The same amount of people in the elongated “quarantine bell curve” (the trend-line) would die and get sick. In other words, the same statistics exist below the line (POWERLINE). Here is a site cataloging the hospitalizations for the rona that POWERLINE used – US CORONAVIRUS HOSPITALIZATIONS  …they used both the CDC site and this one, but the CDC site has lower hospitalizations, so they opted for the most updated numbers. WHICH AS OF APRIL 21ST STAND AT 84,292 HOSPITALIZATIONS FROM JANUARY TILL NOW. This is important, because, the flu season of 2017-2018 we saw 810,000 hospitalization, and our health system didn’t collapse. Nor did the Swine Flu of 2009-to-2010, which saw 60-million American infected and 300,000 hospitalizations.

No quarantines then.

No exaggerated respirator shortages then.

SOME VENTILATOR MYTHS

  • The Ventilator Shortage That Wasn’t (NATIONAL REVIEW)
  • Report: New York City Auctioned Off Ventilator Stockpile (BREITBART)
  • New York City auctioned off extra ventilators due to cost of maintenance: report (THE HILL)
  • Gov Cuomo Refused To Buy Ventilators In 2015 Despite Knowing They’d Be Needed (INDEPENDENT SENTINEL)
  • Trump Was Right: Cuomo Admits New York Has ‘Stockpile’ of Ventilators, Says ‘We Don’t Need Them Yet’ (DIAMOND and SILK | BREITBART | WESTERN JOURNAL)

(What was different I wonder? Maybe the Orange Man Bad Syndrome?)

This then may explain why all the field hospital’s the ARMY CORE OF ENGINEERS built are being dismantled without a single bed being used.

  • The panic and fear among the people who cannot be bothered to read the actual statistics about this pandemic is what should concern most preppers. In fact, this virus has been so overhyped that the Army’s field hospital in Seattle, an “epicenter” of the pandemic has closed after three days without seeing one single COVID-19 patient. According to a report by Military.com, the hastily built field hospital set up by the Army in Seattle’s pro football stadium is shutting down without ever seeing a patient. [….] The decision to close the Seattle field hospital comes amid early signs that the number of new cases could be hitting a plateau in New York, the epicenter of the coronavirus epidemic in the U.S., and other states. At a news conference Friday, New York Governor Andrew Cuomo said, “Overall, New York is flattening the curve.” — ZERO HEDGE (see: MILITARY TIMES | DAILY CALLER)
  • Unlike the Mercy, the Comfort is treating COVID-19 patients on board as well as patients who do not have the virus. The ship has treated more than 120 people since it arrived March 30, and about 50 of those have been discharged, said Lt. Mary Catherine Walsh. The ship removed half of its 1,000 beds so it could isolate and treat coronavirus patients. [The Mercy has seen 48 patients, all non-Covid related] (THE STAR)

And literally handfulls of patients on the Comfort (New York City) and the Comfort (Los Angeles) — *see comment below. There was never a shortage of respirators (NATIONAL REVIEW), and we may surpass the 2018-to-2019 flu death rate, but come nowhere close to the 2017-to-2018 flu death rate:

(CLICK TO ENLARGE)

And it seems that we are reaching a plateau with The Rona, so there is good news in this regard (POWERLINE).

* Here is a comment from the Military Times article from a few days ago:

So, why did we spend all that Taxpayer’s money to move the Comfort to NYC and all the added Military medical personnel to staff the Javitt’s Center? Because Cuomo was crying WOLF.

“So far, the thousands of beds provided by a converted convention center and a hospital ship have not been needed, but the extra personnel are coming in handy for the city’s civilian hospitals.

About 200 doctors, nurses, respiratory therapists and others are working in New York’s medical centers, where bed space has not been overwhelmed, but where hospital-acquired coronavirus cases have sidelined civilian staff.”

…TO WIT…

HOSPITALS GOING BANKRUPT

VOX actually has a decent story on this:

  • Medical University of South Carolina in Charleston is laying off 900 people from its 17,000-person staff and asking full-time salaried employees to take a 15 percent pay cut, according to the Post & Courier; the hospital says it’s not laying off front-line workers at this time.
  • Essentia Health, a major medical system of clinics and hospitals in Duluth, Minnesota, is laying off 500 workers, per KBJR.
  • The Cookeville Regional Medical Center in Tennessee will be furloughing 400 of its 2,400-person staff, and a few hundred others will see a cut in their hours, Fox 17 Nashville reports.
  • Boston Medical Center is furloughing 10 percent of its staff, about 700 people, according to the Boston Globe.
  • Trinity Health Mid-Atlantic, which runs five hospitals in the Philadelphia area and employs 125,000 people there, will furlough an unspecific percentage of its staff, per the Philadelphia Inquirer.
  • Mercy Health, the largest health system in Ohio, is temporarily laying off 700 workers.
  • Two hospital systems in West Virginia are furloughing upward of 1,000 employees combined, Metro News reports.
  • The largest hospital system in eastern Kentucky is laying off 500 workers, according to the Lexington Herald-Leader.

I’m sure there are many more stories like these. But you get the idea.

Hospitals have typically said in these announcements that they are starting with nonmedical staff for furloughs and reduced hours, which is no solace to those workers but softens the impact on our medical capacity.

But it’s not clear how long medical systems can avoid cutting doctors and nurses as well, and some of them clearly cannot. I heard from a nurse in Texas, who asked that neither she nor her hospital be named for fear of professional repercussions, who has been furloughed because of the ongoing economic crisis.

She said how constrained she felt by the news. If she wanted to help with the coronavirus response by taking a job with a travel nursing service offering temporary postings in Covid-19 hot spots, for example, she would lose her old job and her health insurance.

”It really is frustrating to hear that you’re a hero but also we don’t value you enough to prepare or pay you,” she said. “I would be happy to temporarily relocate, work in a hot spot, and make the same wages as I normally would. I can’t afford to work for free, exactly, but it’s frustrating if I can’t work at all.”

Hospitals have taken huge revenue losses as they postpone elective surgeries and other routine care so they can make more staff and space available for the Covid-19 response. Some hospitals expect to lose half their income, and the top industry trade groups have warned that hundreds of hospitals could close after this crisis.

Congress pumped $100 billion into US hospitals as part of its first stimulus package, and Democratic leaders are already calling for another $100 billion in the next stimulus bill they hope Congress will pass.

But that may still not be enough, in the end. When one in four rural hospitals were already vulnerable to closure before the coronavirus struck, the current pandemic is almost certainly going to leave some hospitals with no choice but to close, no matter how much money the federal government provides….

And to compliment the Left leaning VOX article is the “Right” leaning FEDERALIST article:

….During a press conference Wednesday, Florida Gov. Ron DeSantis noted that health experts initially projected 465,000 Floridians would be hospitalized because of coronavirus by April 24. But as of April 22, the number is slightly more than 2,000.

Even in New York, where Gov. Andrew Cuomo said last month he would need 30,000 ventilators, hospitals never came close to needing that many. The projected peak need was about 5,000, and actual usage may have been even lower.

Other overflow measures have also proven unnecessary. On Tuesday, President Trump said the USNS Comfort, the Navy hospital ship that had been deployed to New York to provide emergency care for coronavirus patients, will be leaving the city. The ship had been prepared to treat 500 patients. As of Friday, only 71 beds were occupied. An Army field hospital set up in Seattle’s pro football stadium shut down earlier this month without ever having seen a single patient.

It’s the same story in much of the country. In Texas, where this week Gov. Greg Abbott began gradually loosening lockdown measures, including a prohibition on most medical procedures, hospitals aren’t overwhelmed. In Dallas and Houston, where coronavirus cases are concentrated in the state, makeshift overflow centers that had been under construction might not be used at all.

In Illinois, where hospitals across the state scrambled to stock up on ventilators last month, fewer than half of them have been put to use—and as of Sunday, only 757 of 1,345 ventilators were being used by COVID-19 patients. In Virginia, only about 22 percent of the ventilator supply is being used.

Meanwhile, hospitals and health care systems nationwide have had to furlough or lay off thousands of employees. Why? Because the vast majority of most hospitals’ revenue comes from elective or “non-essential” procedures. We’re not talking about LASIK eye surgery but things like coronary angioplasty and stents, procedures that are necessary but maybe not emergencies—yet. If hospitals can’t perform these procedures because governors have banned them, then they can’t pay their bills, or their employees.

To take just one example, a friend who works in a cardiac intensive care unit (ICU) in rural Virginia called recently and told me about how they had reorganized their entire system around caring for coronavirus patients. They had cancelled most “non-essential” procedures, imposed furloughs and pay cuts, and created a special ICU ward for patients with COVID-19. So far, they have had only one patient. One. The nurses assigned to the COVID-19 ward have very little to do. In the entire area covered by this hospital system, only about 30 people have tested positive for COVID-19.

If Hospitals Can Handle The Load, End The Lockdowns

I’m sure the governors and health officials who ordered these lockdowns meant well. They based their decisions on deeply flawed and woefully inaccurate models, and they should have been less panicky and more skeptical, but they were facing a completely new disease about which, thanks to China, they had almost no reliable information.

However, in hindsight it seems clear that treating the entire country as if it were New York City was a huge mistake that has cost millions of American jobs and destroyed untold amounts of wealth. Now that we know our hospitals aren’t going to be overrun by COVID-19 cases, governors and mayors should immediately reverse course and begin opening their states and communities for business…..