Covid 19 Struggle: Southern California

[Lake-Effect]

Originally Posted by valhalla360

Different state but my sister is head of one of the convention centers that were converted to treat covid patient overflow. She can't get the local hospitals to send the low severity patients to her center because the hospitals don't want to give up the big govt payments associated with treating a covid patient. Basically it's more profitable to run the staff ragged paying overtime than to send some to other facilities.

Do you have anything more substantive to confirm that, besides your sister? How is the head of a convention center qualified to determine where a covid patient should be treated?

[Thumbs Up]

Originally Posted by Lake-Effect

Do you have anything more substantive to confirm that, besides your sister? How is the head of a convention center qualified to determine where a covid patient should be treated?

Trolling?

[Lake-Effect]

Originally Posted by Thumbs Up

Trolling?

Serious question.

[Chotu]

Originally Posted by jmschmidt

Covid Alert: Do you know how to determine if your mask is working? If it dangles from your ears it doesn't. If you wear it on the tip of your nose it doesn't. If you wear it below your nose over your mouth it doesn't. And, if you wear it on your chin it sure as hell doesn't. If it is not a certified N95 with dual straps that run behind your head to hold it firmly in place it probably doesn't.

Using 3M n95 masks, my test is:


-can I smell the surroundings?
- does it fog my glasses breathing out.

I carefully fit and refit the mask until it satisfies those tests.

[Phyrcooler]

Originally Posted by JPA Cate

It was with great sadness that I read this article this morning. We have friends and family there. https://www.abc.net.au/news/2021-01-...o-die/13035334

Part of what it means is a huge increase in everyone's stress levels, because EMTs (emergency medical technicians) are not generally trained in triage (the separating out of the ones they can help from the ones they cannot). They are also not usually allowed to declare death; that is an emergency room doctor's job. There's also the question of where do they put the people they have to triage out?

*Snip*

Ann

Actually, just about everywhere in SoCal, you will be getting a paramedic - usually FD based - on the first arriving engine or squad, and not just an EMT. The medics are highly trained and equipped, and most often if the patient can’t be revived in the field, they realistically aren’t going to be in the hospital. Those that get transported while still being coded are frequently just “Hail Mary” runs, or honestly runs where the situation at home/family/bystanders are so emotional or volatile it’s better to transport. This directive just curtails those runs and tells the medics “hey, let’s get real here”.

While much of what has been said here is true about the hospital staff being overwhelmed, exhausted, and potentially providing less than optimal care, I am not overly concerned that this specific directive will leave any viable patients dying in the streets. It is a smart move, because every non viable full arrest still saps critical ED resources and bed space, as most MD’s will run at least a 10, if not 15+ minute code regardless as a CYA. In regards to what happens at the scene if not transported - medics call patients in the field all the time. The coroner is called, and usually LE stands by until a coroner rep arrives.

As others have noted... not a good time to need the hospital. So be careful out there.

[valhalla360]

Originally Posted by Lake-Effect

Do you have anything more substantive to confirm that, besides your sister? How is the head of a convention center qualified to determine where a covid patient should be treated?

Well for starters, she's not head of a convention center. She's a medical professional and head of the program that took over the convention center to convert and run it for covid patient care.

But as I said, I'm not providing additional details. If you choose not to believe, that is your option.

[S/V Illusion]

Originally Posted by Cpt Mark

California, especially so cal is a very densely populated state. That alone would account for the higher numbers. I know people down there personally who still don't think covid is a big thing and will travel out of state to Arizona so they can party, go to restaurants and not wear a mask. Never mind the fact that Arizona just made it to the top of the world list as the highest rate of covid. Sadly, you can't fix self entitlement attitude's and stupid.

The hard hit portion of California is no more densely populated than parts of Florida. Thus far, Florida has vaccinated a few hundred thousand residents. Our hospitals are not overwhelmed and we don’t have the onerous shutdown California has imposed. And while Florida is in the middle rank of Covid related deaths per million, California ranks second from the top (worst). Maybe it’s how the virus is being managed so differently and ineffectively in some places.

There is definitely a difference between locations and particularly between Florida and California in this as well as many other ways.

[fourlyons]

Originally Posted by S/V Illusion

The hard hit portion of California is no more densely populated than parts of Florida. Thus far, Florida has vaccinated a few hundred thousand residents. Our hospitals are not overwhelmed and we don’t have the onerous shutdown California has imposed. And while Florida is in the middle rank of Covid related deaths per million, California ranks second from the top (worst). Maybe it’s how the virus is being managed so differently and ineffectively in some places.

There is definitely a difference between locations and particularly between Florida and California in this as well as many other ways.

Where are you getting your numbers? California is well below Florida in deaths per million; 722 vs 1027, according to today's Worldometer numbers. New York is actually second.

[Lake-Effect]

Originally Posted by valhalla360

Well for starters, she's not head of a convention center. She's a medical professional and head of the program that took over the convention center to convert and run it for covid patient care.

But as I said, I'm not providing additional details. If you choose not to believe, that is your option.

I'm sure you understand that this idea that there's big money for hospitals in calling someone a covid patient (and/or treating them) is widespread, yet for the most part not fully justified. Your anecdote is interesting, but equally unsubstantiated. For example, what are the actual economics of a covid patient in an existing hospital vs this convention center? Are enough staff in place there but twiddling their thumbs? If the convention center has not received patients yet, what are the startup costs for it to do so? Is there a minimum viable patient load below which the convention center is a poor use of resources? (eg respiration technologists with not enough to do?)

Let me hasten to add that I think it's great that there are such preparations in place to handle potential surges in cases that might overwhelm hospitals. But one seldom gets those preparations just right. Some areas will see those facilities underused, and others might see their additional facilities overwhelmed.

We're just into January, after the Christmas season. I think we all hope your sister's facility remains underused... but there's 2+ months to get through before we can really start to assess whether resources were optimally deployed.

[Tin Tin]

Interesting comparing to FL. The number of hospitals per state per head of population is the same, however the number of active Covid cases per hospital is 20% higher in CA. One difference is though is that FL has a lot more public hospitals per head than CA. So maybe the inundated hospitals in CA are the fewer public ones in proportion which would exacerbate the case load averages, as the privates may require insurance or cash, just postulating, no other data than off Google searches.


. CA FL
Active cases C19 1.46m 0.65m
Pop 39.5m 21.5 m
Hospitals 341 186
Public Hos 21 29


More info here - look at the heat map of hospital beds by July 2021 CA not looking good

https://www.aha.org/statistics/fast-facts-us-hospitals

[S/V Illusion]

Originally Posted by fourlyons

Where are you getting your numbers? California is well below Florida in deaths per million; 722 vs 1027, according to today's Worldometer numbers. New York is actually second.

I’m looking at CURRENT rates of infection, hospitalization and mortality, not cumulative historical totals which are not relevant to what is CURRENTLY happening. Corrected for both population and testing variables

Also, current trends are the only basis on which to make predictions of future conditions, also not looking good for California.

The distinction is apparent. As it can’t be explained by population density, testing availability, climate or geography, the only other variable is how the situation is being managed or mismanaged.

[valhalla360]

Originally Posted by Lake-Effect

I'm sure you understand that this idea that there's big money for hospitals in calling someone a covid patient (and/or treating them) is widespread, yet for the most part not fully justified.

Not fully justified? It's right there in the emergency laws that were passed.

I understand the financial drive behind the hospitals they are hurting also because pretty much everything else they do is shut down or reduced. Covid related payments are the one bright spot on the balance sheet.

If you choose not to believe that...again...that's your choice and I can't force you to believe the truth.

[valhalla360]

Originally Posted by Tin Tin

Interesting comparing to FL. The number of hospitals per state per head of population is the same, however the number of active Covid cases per hospital is 20% higher in CA. One difference is though is that FL has a lot more public hospitals per head than CA. So maybe the inundated hospitals in CA are the fewer public ones in proportion which would exacerbate the case load averages, as the privates may require insurance or cash, just postulating, no other data than off Google searches.

Yes, you almost need a hospital by hospital break down. A few times over the past year, there have been reports of hospitals overrun and the articles imply it's statewide but when you look it's specific cities or even specific hospitals.

Age distribution might also play a role.
- Florida has a higher percentage of retired folks (particularly in the winter). While it's more serious if they catch it, they are better able to control their public interactions since many are retired and can choose how they interact with others.
- California is much less of a retirement destination. Working people have less ability decide if they are going to go out and interact with others.

The idea that it's because California is more densely populated than Florida is just incorrect.

[Capn Jimbo]

Latest Public Health Update:




California is in chaos, with both facilities and personnel unable to provide proper care. Patients and ambulances are being turned away. Wartime triage necessary, no ordinary care possible. I would expect Florida to explode soon as well as the Florida trend is now exponential (see above), not to mention the presence of the variant. The effects of the variant in California are significant.


CJ
Public Health, 30 years

[flightlead404]

Originally Posted by ArmyDaveNY

This is a great idea, and should be continued even after they declare an end to the epidemic. There are a lot of visits to the ER that really don't require a trip to the ER.

In the the US that is frequently because we don't have a health system (or at least, its the worst or 2nd worst among industrialized first world nations). So those that have no health insurance (not really insurance, more of an installment payment plan) wait until it becomes an ER issue and then go there.

Hopefully that situation will be rectified soon, but it is definitely exacerbating the COVID related issues.