re: Normal (pre-Covid) Hospital occupancy rates and ICU rates

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alarming levels.

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Well, there’s that phrase again Nancy

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shortage of staff.

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Therein lies one of the issues. Hospitals more than not are at capacity based on staff available to offer care.

I would say hospitals absolutely do not pay there staff such as nurses, respiratory, radiology, etc fair. They would rather pay travel agencies triple than what they pay loyal employees. So when this shite happens, people leave and hospitals are having to bring in military (olol). On top of that, there is a large shortage of Icu staff to care for patients. We have been admitting people in the icu that have been in emergency rooms for close to 48 hours. That is unacceptable.

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I think the whole hospital shortage deal has been the biggest COVID fallacy that the largest amount of people have eaten up hook, line, and sinker.

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Do you actually talk to people who work in hospitals? It’s not a fallacy. It’s real.

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If hospital capacity was such an issue, why haven’t the large hospitals around the country asked their state legislatures to remove Certificate of Need requirements so they can build as many beds as they want?

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Because by the time they build them, hospitals will be back to normal numbers.

Now that we’ve been through the stages of being up and down multiple times Im fairly tired of the hospitals bitching.

Are we just going to have a bunch of empty hospital floors waiting on the next pandemic in 25 years? No.

This is what is required. Close down and delay electives and move staff to work a pandemic. In any other business this is perfectly normal. I’m tired of medical staff acting like 1.5 years in they can’t have some cross trained staff. That’s on you.

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For profit hospits want people sick so they can pay their debt service and administrators and CEO 8 figures.

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Extremely common fallacy. ALL hospitals are for profit. All, of them, every one. The only difference is that your so called non-profits do not pay property taxes. That is it. Except the for profits do not allow wanton waste and do not buy new equipment each year solely so their budgets won't decrease next year.

If non's ran the hospital as efficiently as the for's, hospitals could afford not to raise prices every 4 months.

I remember when North Monroe was sold by HCA to St Francis. The local politicians were all dancing in the street like they have defeated a dragon. Then 10 months later when they saw the city was not going to get the nearly million dollars in taxes they were all screaming and hollering and cursing God.

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From BIL who is a nurse there.

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lol....a murse.

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have you not seen that black guy on one of the social media platforms went to all the hospitals in LA when the news was saying they were turning people away, and they were ghost towns.

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Now think a layer deeper.

Start with a hospital on a normal non-COVID day it is very busy.

Shift to a hospital with mainly COVID patients

Almost no visitors

Almost no outpatient tests and procedures

Colocated Dr's offices (especially in the first wave) were not seeing patients in the office

If it wasn't shift change very little staff going in and out


So a hospital during a COVID wave looking like a ghost town from the outside is perfectly logical.

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What’s the basis of your skepticism?

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I seem to read a lot on here that people “don’t believe” or are skeptical of what hospital resource scarcity is/means. For anyone interested, here is an hour-long video of all the Chief Medical Officers on the north shore talking about what it’s like right now.


A sort of summary of the video (from memory, I watched a few days ago):
each CMO gives a census report and COVID/non-COVID
They take some questions- some ask about the vaccinated/unvaccinated ratio. They report it’s more unvaccinated in and recommend getting vaccinated, particularly if you’re high risk.
A philanthropic organization asks where the best use of funds from their standpoint would be.
They all sort of acknowledge some amount of fatigue on the shoulders of healthcare workers (nursing, mainly). Suggest it’s busier than ever and there isn’t the community “support” we saw early on.
There’s some comments on social media news supplanting health official recommendations- they suggest anyone who has questions sit and talk with the doctor they’ve trusted in the past, assuming you have one. There is a ton of bad information everywhere, and the amount of bias in most reporting and information is high


And then it ends with a “give us a story as to what it really means,” in particular with regards to canceling elective surgery. The panelist/moderator (no idea who/what she is) points out that her understanding of what “elective” surgery is seems to be way off- she was thinking facelifts/tummy tucks, not bypass surgery outside of an acute heart attack. The first guy probably hits the boundary of “too dramatic” in his retelling of a case (2-part surgery for brain aneurysm where guy has interventional radiology do one part, then neurosurgery does an additional part the next day). He actually had to wind up pushing Part 2 by a day or two for this brain aneurysm case. He mentions “looking into the eyes” of this guy’s daughter and telling him they have to cancel/push the case, but he reels it back in pretty quick and is trying to illustrate the difficulty that doctors have with making the decision of what CAN wait a day or two, what can’t. When is the magic moment a cancer metastasizes or a blood vessel blocks off. If you can stomach his one or two somewhat melodramatic statements, the rest of the sentiment is worth a listen as to “what’s really happening.”

Another point he makes that I’ll share here is that “all elective surgery eventually becomes emergent.” He doesn’t exactly explain it, but he’s pretty close to right- basically every case we are talking about here is not simple cosmetics- those tend to happen in non-hospital surgical centers. But gallbladders full of stones eventually become emergent. Cancers, hearts, aneurysms, etc. most of them can wait days/weeks/months, but this is what makes up the majority of surgical cases which leads to a fair amount of hospital stays and, as he points out, a huge chunk of the income for the hospitals.


Now, not that anyone reads anything I write or gives a shite what I think, but I was extremely critical of Dr O’Neal’s anecdotes at the governor’s conference a while back. These are far more contextual and do a good job of showing examples of what it’s like for us in the hospital right now, with about one little dramatic statement a bit on/over the line (I say this for warring because it’s early on in the anecdote portion, and it made me consider dismissing the whole segment but thought in the end it was a worthwhile listen.)



Long video. Long post summarizing it. But again- I see that there’s a lot of concern about the “lie” of strain on the healthcare system. It’s not unusual for a hospital to fill up. It is unusual for most area hospitals to be full in August.

Again, an anecdote, but I had a friend who works at a hospital that is truly in the boonies. No ICU. He hasn’t touched a ventilator since residency, and no one else in that hospital has either, because they tend to get shipped out long before that point. He has 2 or 3 on vents on the floor right now. He is in Louisiana and has called as far as Memphis and was unable to find anyone to take the patient. So the patient is being cared for by a doctor doing things he doesn’t normally do with a staff that also rarely does them. My buddy is brilliant. We call each other with unique scenarios. The guy is getting good care- it’s not like a CNA is running a vent. But this is not a normal “systems stressed” scenario. It is an extreme one. It may continue. It may rapidly improve starting tomorrow, but as they pointed out in the video- we tend to learn a bit better from anecdotes than numbers, but both need to be taken in context for it to make sense. This scenario isn’t happening everywhere. But it’s never happened to him or where he’s at before.



ETA- don’t know these CMO personally, but the position is typically held by a physician with a previous significant life of practicing that sort of transitions to an administrator. Some practice still. Some are just administrators, but they generally have decent clinical experience prior to taking on that role.