COVID Cases Fill More City Hospital Beds, Threatening Halt on Elective Surgeries

Yves here. This article makes explicit something that’s not hard to infer from coverage of Covid strain on hospitals: in the first wave, the limiting factor was physical capacity, in particular beds. Now the constraint more often is manning…which is harder to measure well and can be stretched in the short term.

By Greg B. Smtih (gsmith@thecity.nyc). Originally published at THE CITY on December 29, 2021

With hospitalizations for COVID patients rising rapidly, the number of available beds at several city-run hospitals has dropped to levels that could trigger a suspension of elective surgeries.

The state Department of Health has the power to impose this restriction on hospitals with low numbers of available beds in regions experiencing a high rate of COVID hospitalizations. Areas averaging more than 4 new COVID patients per 100,000 population each day over a seven-day average trigger the department’s potential intervention.

On Sunday New York City passed that threshold, with the average number of new patients with COVID entering city hospitals hitting 4.76 per 100,000 over the previous seven days, according to the city Department of Health and Mental Hygiene.

On Monday, that rate rose even higher to 5.48 new COVID patients per 100,000, city data show. Both are well above the 4 new patients per 100,000 cutoff.

The state Health Department told THE CITY on Wednesday that so far the influx of COVID patients has not yet triggered the imposition of an elective surgery suspension.

Agency spokesperson Erin Silk wrote in an emailed response, “​​New York City does not currently meet either of the gate criteria to be included in the elective surgery guidance.” She did not specify those criteria.

On Tuesday, Mayor Bill de Blasio mentioned the 4.76 rate from Sunday but did not mention the newer data. He conceded that the rate was “very high,” but insisted that hospitals within New York City have the situation under control.“Thank God, because of all the actions that have been taken, all the vaccination, our hospitals are handling the situation well,” he said.

Strained Nurses

Health care workers see the situation as more dire.

On Wednesday, nursing union officials expressed concerns that with the rising number of COVID hospitalizations, staffing has again reached inadequate levels reminiscent of spring 2020, when health care workers struggled with overwhelming COVID patient caseloads.

“What good is a physical hospital bed if there is not a nurse to take care of the patient occupying that bed?” said Pat Kane, an RN and director of the New York State Nurses Association.

“At a time when COVID-19 cases are skyrocketing and our health care system is once again coming under enormous strain due to the highly transmissible Omicron variant, health systems and policymakers should meet the challenge by staffing safely and protecting the frontlines.”

Kane said the union is “very concerned that federal and state agencies and hospital administrators are instead cutting corners on staffing levels, infection control, and other health and safety measures exactly when we need to protect health care workers and our patients the most.”

The patient squeeze appears to be hitting public hospitals the hardest.

The seven-day average bed capacity data for Tuesday show overall, New York City hospitals reported 26% of beds available. In contrast, five of the 11 hospitals run by the city’s Health and Hospitals Corporation register bed availability rates of 15% or lower, state figures show.

Over the last few days, several public hospitals have reported bed availability at or below 10% — the level Gov. Kathy Hochul Wednesday labeled “the danger zone.”

The most recent single-day figures suggest the situation is growing more urgent.

On Tuesday, Coney Island Hospital in Brooklyn dropped to the 7% mark, while Kings County in Brooklyn reported a 9% open bed capacity. That same day Elmhurst in Queens — one of the hardest-hit hospitals when the pandemic first arrived in spring 2020 — hit the “danger zone” mark of 10%.

The state hospital capacity data does not make a distinction between COVID and non-COVID patients — but federal stats suggest COVID’s growing role. U.S. Centers for Disease Control reporting for the week ending Dec. 26 show 11% of all hospital beds in Brooklyn and Queens occupied by COVID patients, 8% in The Bronx and Staten Island and 7% in Manhattan.

As of Tuesday, 3,178 people were hospitalized with COVID in New York City, according to the state health department — up from about 1,000 in mid-December.

HHC spokesperson Stephanie Guzmán said the agency is ready to rearrange staffing and add beds if required.

“We’re expediting safe discharges and utilizing our level-loading to ensure capacity is manageable by the second,” she wrote in an email. “Additionally, we’re prepared to scale up necessary capacity on an ongoing basis, which we haven’t had to do just yet.”

Guzmán said that the 10% capacity standard “is of current beds as they’re equipped. As a reminder, we tripled ICU capacity in the early days of the pandemic and have mechanisms to flip that switch even faster two years into the pandemic.”

Michael Lanza, a spokesman for the city Department of Health and Mental Hygiene, said the agency “supports the State’s efforts to preserve hospital capacity for serious illness, particularly those with severe COVID-19.”

The department is working with the Greater New York Hospital Association to coordinate efforts across all city hospitals “to provide support as we collectively work to end this wave,” Lanza added.

Short on Gear

Hospitals are also grappling with a state requirement to keep at least a 60-day supply of personal protective equipment (PPE) on hand.

Hospitals must report their supply level to the department on the first Tuesday of each month. In November and so far this month, more than 20 hospitals reported being out of compliance with that rule, according to records obtained by THE CITY via Freedom of Information Law.

Two are in the city: The public Woodhull Hospital in East Williamsburg, and University Hospital of Brooklyn, part of the SUNY Downstate state-run hospital system.

Woodhull is also short on beds: On Monday, Woodhull reported a 7-day average of available beds of 10%.

Guzmán said because all 11 HHC hospitals operate under the same management, Woodhull can obtain whatever PPE it needs from a central storehouse serving all city-run medical centers.

“We function as a health system of 11 hospitals and utilize central stockpiles to ensure our healthcare workers have the proper PPE while on the job,” she said. “We remain within the state’s requirement.”

Dawn Skeete Factor, a spokesperson for SUNY Downstate, said, “One factor that may be contributing to the spike in hospitalization rates is the ease with which the Omicron variant spreads. A high percentage of patients admitted to hospitals in New York City for non-COVID related issues test positive for COVID. This result requires the same intensive response all COVID specific patients receive.”

The number of new COVID patients arriving daily in New York City hospitals is nowhere near what it was when the pandemic first peaked in the spring of 2020, when the 7-day average of new admissions hit 1,667 on April 4. After the city locked down, that number dropped precipitously, then rose again in the winter of 2020 with the arrival of the Delta variant to peak at 385 on Feb. 10.

This past Thanksgiving, city hospitals were averaging about 53 new COVID patients daily, but then came the arrival of the highly contagious Omicron variant. The hospital admission numbers have since dramatically risen, reaching a 7-day average of 332 as of Tuesday.

One pattern remains constant: People who are unvaccinated are about 10 times more likely to be hospitalized with COVID infections than people who are fully vaccinated.

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81 comments

  1. GM

    then rose again in the winter of 2020 with the arrival of the Delta variant to peak at 385 on Feb. 10

    ????

    Delta had not yet appeared then.

    It wasn’t even Alpha at the time, Alpha was still to become dominant in the US.

  2. GM

    The number of new COVID patients arriving daily in New York City hospitals is nowhere near what it was when the pandemic first peaked in the spring of 2020, when the 7-day average of new admissions hit 1,667 on April 4

    Currently the 7-day average for new admissions in NYC is at 800:

    https://coronavirus.health.ny.gov/daily-hospitalization-summary

    So half of the all-time peak

    But that’s from the infections ~8 days ago when cases were a third of what they are now.

    So they better pray hospital stays are indeed short and there isn’t much demand for ICU beds or this will get worse than April 2020…

  3. Taurus

    When I read “ We’re expediting safe discharges…”, what I get is “ We’re expediting discharges …”

    While the slope of hospitalization curve clearly does not match the one of the cases, the sheer volume of cases worries me. I am hoping that admitted patients have a shorter stay in the ICU than in the beginning of the pandemic. (As in short and recover, not short and be wheeled out in a body bag). In the spring of 2020, serious cases stayed at the ICU often for weeks.

    Also regarding “ As a reminder, we tripled ICU capacity in the early days of the pandemic and have mechanisms to flip that switch even faster two years into the pandemic.”, color me skeptical. I am yet to see the Biden administration flipping a switch on anything pandemic related. Perhaps she meant to say “We will empower the patients to participate in our means-tested application process to be transferred to Mexico when the ICU at their local hospital fills up”?

    1. Juneau

      The hospitals owe thanks to the patients who agree to these expedited discharges. And many may do so out of a sense of service to the community. The most destitute city hospital patients can be very selfless in this way, hoping it doesn’t work against them.

      1. Brian Beijer

        I would do so out of fear of catching whatever variant of Covid I wasn’t admitted with. One thing this pandemic has taught me is that there is no “community”/ society anymore. When patients are placed in a Covid ward, are they placed in seperate wards for Delta or Omicron or ?? If not, then (from what information I can find) one is likely to be exposed to the other variants while in hospital for treatment for your variant of Covid. Does anyone have better information on this? Are hospitals creating seperate wards depending on the type of Covid one comes in with?

        1. GM

          Hospitals are near collapse. And not all tests actually distinguish Omicron from Delta. Nor is that information when available given to the hospital staff.

          Also, there is a version of Omicron (BA.2, as opposed to the more canonical BA.1) that does not show the SGTF signature as it does not have the S:69-70 deletion.

          So in short, no, highly doubtful anyone is trying to separate Delta and Omicron patients, most places could not do it even if they wanted.

          And yes, that means a lot of potential for coinfection.

          It remains to be seen what that means for patient outcomes (one would expect the coinfected to fare really poorly) and for viral evolution — will the super-recombinant arise? Prior to the last couple weeks it seemed like there is nothing that Omicron could gain from Delta, but now it seems that Omicron’s FCS is not working very well, and that is an obvious potential gain from Delta with the right recombination event.

          1. Jeotsu

            So I guess we wait for the co-infections, coupled with administration of the Merck anti-viral under a EUA. Then factor in over-capacity on the ward inducing early releases back into the community when the patients circulating concentration of the Merck drug has tapered to the level where it is not lethal to viral replication, just a top-notch mutagen.

        2. ambrit

          Given the track record of abyssmally poor testing so far, can the hospitals accurately tell all the different patient variants apart so as to segregate them?
          (Do the hospitals have their own in house testing labs?)
          As for ‘mix and match’ Covid wards; dosen’t this ‘drive’ mutations?
          As I mentioned near the beginning of the Pandemic, I’m waiting for some enterprising writer to do a “Covid Decameron.”

  4. Taurus

    BTW – on the question how bad are staffing shortages – data from NH:

    Openings from DHMC (which provides the bulk of healthcare in the western-central parts of the state) and serves a significant territory of Eastern Vermont.

    Nursing (347)
    Allied Health (236)
    LNA/MA (171)
    Physician (102)
    Secretarial/Clerical/Administrative Support (91)

    Total – 947 openings. There are another 500+ openings for other support staff. I have included the clerical support staff because without these people you simply cannot get an appointment and when they are missing, the nurses have to fill those jobs as well.

    There are about 5000 health care providers of all stripes at DH to get an idea of the overall scale of the operation.

    Source – https://jobsearch.dartmouth-hitchcock.org/results?paged=1

  5. Brian Beijer

    One pattern remains constant: People who are unvaccinated are about 10 times more likely to be hospitalized with COVID infections than people who are fully vaccinated.

    What an odd concluding sentence considering that the rest of the article doesn’t mention vaccinations at all. I wish Mr. Smith would have cited a source to this. I am trying to determine how vaccinated vs. unvaccinated and previously infected are faring with Omicron. So far, the numbers seem to be all over the place. A week or so ago, Denmark’s stats suggested that the vaccinated were much more likely to be hospitalized. When I checked the figures, it seemed to be driven by the 20-30 somethings whom I imagine were partiers, diners, etc. Now, I can find any stats on Denmark’s website about hospitalizations of vax vs. unvaxed. Dr. Campbell made a remark on a recent video that 90% of hopitalizations in the UK were now unvaccinated. Then, someone on NC said that for the UK, it was 23% unvaxed and 77% vaxed which approximtely mirrors the vaccination demographics. When I go to the UK’s website, I can’t find any breakdown of hospitalization numbers between the vaccinated and unvaccinated. Everyone keeps throwing out numbers which I either can’t find at all, or they seem to disappear after I do find them.
    I’m so sick and tired of living in a world of funhouse mirrors.

    1. Yves Smith Post author

      This was a reported article and I suspect he was told this by a source/sources, and it’s so much part of conventional wisdom that he didn’t feel the need to provide a link or a source.

    2. jim truti

      That is an interesting point you raise.
      If you look at how the narrative has evolved on the vaccines, it seems the only current justification for them seems to be based on the statement “vaccinated suffer less than non vaccinated”.
      Yet studies seem to show that both vaccinated and non vaccinated shed and have same viral loads which is confusing as if the vaccinated suffer less, why would they shed same viral loads?
      Many stats from the hospitals seem to show that there are more non vaccinated in ICU units which may well be true but is correlation causation?

      1. juno mas

        No, it’s not. But if you get real sick from Covid, don’t say you weren’t given the data. If you die, it’s all moot.

    3. HH

      Let’s assume that we cannot rely on any comparative hospital statistics regarding the current efficacy of vaccinations. What, then, explains the obvious and undeniable diminution of deaths globally following the widespread vaccination programs, even in the face of dangerous new variants? I am baffled by how COVID vaccination has become a kind of pinata for resentment in the NC comment threads. Clearly, without the vaccines, there would have been a lot more deaths. Every nation on Earth has invested in vaccines and administered them. Are they all deluded? Meanwhile, some of the same people who parade statistics undermining vaccine efficacy are accepting unverified claims for Ivermectin and other magical “therapeutics.” Remember hydroxychloroquine?

      1. Basil Pesto

        Well, you seem to be conflating two groups of people. It is true there are some, I think it’s fair to say, uncritically anti-vax commenters here (different from the vaccine-hesitant, and also I think many of those commenters here, unlike anti-vaxxers generally, do take Covid quite seriously), and they can be a bit repetitive. But I think it’s equally fair to say that most NC commenters – and presumably readers – are vaccinated, and quite a few are boosted.

        I wouldn’t dispute for a second your claim:

        Clearly, without the vaccines, there would have been a lot more deaths.

        Certainly in the short term. But the issue, as I see it, is that there’s a vaccine paradox: the vaccines are an effective and useful tool as you say, but by making them the sole focus of anti-covid policy and ignoring their limitations, it makes the scope and scale of the covid problem worse, not better (and this is particularly acute in Australia where I live, where the vaccination programme has been used as a rationalisation to abandon one of the world-leading responses to Covid to date – it was a non-issue for most of the country for most of the last two years, Melbourne excepted – with increasingly bad consequences as we are seeing today). There are myriad better ways to control transmission, for example, all ignored and minimised for idiotic, unscientific political reasons – and who cares anyway because vaccines make Covid a non-issue, apparently. As I think GM has said in the past, people don’t understand that today’s vaccinated are tomorrow’s unvaccinated (I am double AZ and consider myself unvaccinated until I can get a booster, and even then the improvement in my protection will only be temporary). I have made the point repeatedly that this will ultimately harm the impression of vaccines among the wider public and be a boon to the wider anti-vax movement when people who thought they were fully protected find out they weren’t, and this bothers me as someone who is generically pro-vax. Relying on them is going to leave us behind the 8-ball, playing infernal immunity catch-up, for years to come – that is my impression at least (pray 4 intranasals).

        As to the final sentence, look, Ivermectin monomaniacals annoy me as much as vaccine monomaniacals do, and I have spent a lot of time here questioning their assumptions and Argumentum ad Tokyo Medical Associationum. I don’t think Ivermectin represents ‘the road out of the pandemic’ any more than vaccines do. But – and noting that I don’t necessarily trust the grassroots ivm organisations that have popped up, who are bound to have counterproductive bias issues that will undermine their analysis – there’s enough meaningful evidence that has accrued to suggest that there is something to Ivermectin and that it, equally, could be a useful tool. In a grown-up society we would be investigating this like adults and getting to the bottom of it instead of ridiculously stigmatising it as a ‘right wing drug’ and descending into a ridiculous, hysterical moral panic about the drug (possibly one of the most beneficent in the history of medicine) as we did in August this year.

  6. Henry Moon Pie

    The below is from my city’s online news site and consists mainly of interviews with nurses in the city’s hospitals. While most of these stories includes some of the requisite push for vaccination, there’s some hard, cold truth included along the way, like this:

    She said the toughest part of battling the pandemic is not having enough time and resources to provide patients the care they need and deserve.

    “Patients are not getting the best care, and that’s the truth,” Megan said. “It’s not the work that I signed up to do, and it makes me feel like a terrible nurse. I dread walking into work, which I never have before.”

    ‘I don’t know how much more we can take’: Northeast Ohio health care providers reveal what’s happening within hospital walls”

    1. SueLiz

      My niece is a nurse for a metro area hospital. She signed a 2-year agreement to stay at the hospital in return for a retention bonus that she put in a separate account because if you leave before 2 years you must pay it back with interest. A lot of her colleagues are openly hostile to signing this agreement. They think as soon as they sign it they will get the worst assignments as the hospital will assume they can’t quit. Shows the level of distrust. My niece thinks that if the hospital just treated their personnel OK, they wouldn’t need to pay bonuses.

      Apparently, they are under some crisis protocol that dictates that patients can’t sue for any substandard care because of the pandemic emergency overrunning hospital beds and staff. I don’t think that has been tested. Patients sometimes sleep on gurneys because there are no hospital beds/rooms. New nurses couldn’t get any clinical training last year because no one had the time. The new nurses they get now need a lot of hand-holding as they have little real world experience.

      My sister is a Medical Assistant in a rural hospital. She doesn’t think Americans understand how little care is available if they need it. They don’t have a lot of facilities for critical care and have always transferred the hard cases to urban hospitals, but that isn’t happening now. Some woman with a stroke languished for days with no specialized care because they just didn’t have it available and no hospitals would accept her. She finally moved on, but my sister isn’t sure how much her condition deteriorated before that. Her advice: don’t get cancer, don’t have a stroke, and don’t break anything!

  7. BeliTsari

    They’ll maximize throughput, code us up. Infected clinicians will obfuscate “out-of-network “surprise billing” (are these crude shucks & jives algorithm based now?) Then, we’ll breed all sorts of thrilling new variants; mandating “standards of care” our leaders bought up, as we were funding research?

    https://scheerpost.com/2021/12/29/experts-warn-mercks-fda-authorized-covid-pill-could-create-breeding-ground-for-mutant-viruses/

    https://www.wsws.org/en/articles/2021/12/30/pers-d30.html

    https://gothamist.com/news/nycs-home-covid-positives-go-unreported-and-unsupported

  8. Dr. John Carpenter

    FWIW, I had an elective scheduled Dec 3rd in Indiana and it was canceled before thanksgiving due to staffing issues they were already having. We are still in “head in the sand” mode regarding Covid at large here, but when I got that call, it was confirmation that things were not going to go so well this next surge. If they were seeing issues here that long ago, I can only imagine how bad the situation is elsewhere.

    1. Joe Well

      So, the Blue state governors will make this official policy while the Red state governors will just let it fly under the radar, with their voters thinking everything is fine unless they need a hospital.

      1. Dr. John Carpenter

        For my surgery, this was coming from the Franciscan Alliance network itself, who were projecting worker shortages thorough December, not a government thing yet. I’ve heard we’ve got National Guard helping in some places now, but I really haven’t been keeping up that much with what’s going on as I’d just as soon wait until things are (hopefully) better. If it matters, Indiana is a blue governor but a red state (which should give you a hint as to how blue we’re talking.)

    1. GM

      They were asking for it.

      After repeated breaches of quarantine, most Chinese entry points ended up moving to a 3+1 week quarantine — 3 weeks in managed isolation quarantine, then 1 week home quarantine, which is also strictly enforced (your doors are sealed and monitored).

      And they are building dedicated quarantine centers with isolated units because of too many instances of the virus jumping from one person to another while in hotel quarantine.

      Which is probably how they are still getting cases sneaking through, the other hole being the enormous domestic border through which people get smuggled from Myanmar, Vietnam, Russia, etc.

      New Zealand has all the advantages in the world when it comes to quarantine — there is no land border.

      And they were recently down to 30 cases of only, which is quite a bit less than what they gave up at back in September. With a little effort they could have eliminated it again, kept the border shut and watched the Omicron fireworks from the safety of their isolated islands.

      But no, that would be too sensible.

      So one week managed isolation plus three days domestic quarantine that nobody is enforcing it is instead.

      And these are the results…

        1. ChrisPacific

          I don’t believe the political will is there to implement stricter measures (and by “political will” I mean “belief that we won’t lose the next election if we do this.”)

          It’s easy to forget in NC comments, but there is a powerful and growing echo chamber in the Western world in favor of reopening. I’m not convinced that Jacinda or the Labour government believe it, but once public opinion and the media reaches a certain pitch, it really doesn’t matter any more whether they believe it or not. You can stand against a hurricane for only so long. I kid you not: there was recently a widely-published opinion piece entitled something like “Don’t let Omicron keep us from reopening.” Sadly it’s probably an accurate reflection of a large chunk of society. There are still plenty of us out there who would prefer stricter controls – the indigenous Maori community foremost among them – but the ones who want reopening tend to have the loudest voices and the best funding.

          We have always had a kind of national insecurity which manifests as hunger for the approval of our larger Western neighbours (one of the favorite pastimes of New Zealand media has always been obsessively tracking how we measure up statistically against Australia, the UK or the USA, with particular focus on areas where we are falling behind). Right now those countries all consider that we’ve gone ridiculously over the top in our Covid response (you should have seen the “NZ locks down the country over a single case” headlines) and regard us as a pariah. We at NC know that this is a rationalization based on their own failure to manage it properly, but to the layperson this is a very powerful influence, to the point where asserting a contrary position amounts to an extraordinary claim requiring extraordinary evidence. That evidence, of course, exists, and the government has it, but a large proportion of society don’t have the patience to look at it, or just plain don’t want to believe it.

          Unfortunately there is a kind of credibility laundering effect that happens when a government adopts a sub-optimal position due to public pressure. They feel the need to justify it, and then it has the force of official policy (“we aren’t experts so all we can do is rely on the government and health ministry guidance” is a phrase I’ve heard a lot).

          1. MarkT

            Never underestimate the power of the commercial media! Pieces have appeared in Stuff and NZ Herald that make me want to vomit. And I don’t even have covid yet.

          2. ChrisRUEcon

            I dunno, though … do the media-believing masses in NZ not see the alternative (just across the way in Oz)? I’ll have to do some digging, but it was my impression that lockdowns came with social assistance and so on. I have a dear friend in NZ on a certain *cough* social *cough* network, and I’ve been jealous – tequila walking tours, camping, and now beaches while we’ve all been masking, social distancing and avoiding indoors over here (US-midwest). I also saw NZ Labor taking some flack a while ago for also ostensibly “aligning with China”. Why is it that countries in the west want China to buy their wares, while decrying China as totalitarian and unworthy at the same time?!

            1. MarkT

              Because business! The dollars need to keep flowing. They know nothing else. Their minds cannot conceive of anything other than “me me me”. The system is so designed, as NC has been pointing out for ages.

              1. ChrisRUEcon

                LOL … I deserve a Captain Obvious award for that … I guess I was trying to articulate how does the cognitive dissonance of the messaging not become apparent in the consent manufacturing.

                Another rhetorical … all too familiar from experiences here. #GoldfishBrain

                1. MarkT

                  I work in a scientific organisation where we view all the corporate/commercial bullshit with disdain. Yet they govern us. We are a public service. But priorities lie elsewhere.

        2. MarkT

          It is my understanding that she did a stint with the UK Labour Party when a certain untried war criminal was in charge. I’ve often wondered whether her PR skills are natural, or learnt.

  9. Joe Well

    But what if hospital administrators just ignore the order? Any consequences for administrators?

    One of the most famous hospitals in Massachusetts was accused by nurses of doing just that.

    Patients who need emergency brain surgery waiting for operating rooms, apparently.

  10. Joe Well

    Matthew Stoller is saying on Twitter that the blame lies not with COVID but with hospital administrators for spending CARES Act money on mergers rather than expanding capacity.

    But if the capacity is people who can’t be trained in less than several years?

    1. GM

      If you are talking about expanding capacity as a “solution”, you are a bad actor in this story.

      First, there is no hospital system that can absorb a fully unmitigated COVID epidemic.

      Second, and most important, that perpetuates the sick perverted idea that infections don’t matter and as long as there are beds in which to put the sick people in, everything is fine.

      But nobody that I am aware of has gotten the ICU survival rate to much better than 25%. And very few of the other 75% leave it without serious lasting damage.

      Most hospitalized are left with various long-term damage too, and so are a huge number of those who never qualify as sick enough to be admitted.

      How is that OK?

      And that’s still round 1 of mass infection — Omicron will infect whoever hasn’t been infected yet and half of the previously infected and we will just begin round 2, to be completed later in 2022 by Pi, Rho, etc.

      Again, if someone is talking about expanding hospital capacity, that someone has to be immediately attacked and put down for it, for this is playing right into the hands of the the ruling oligarchy that is implementing the current genocidal mass murdering mass infection policies.

      Matt Stoller had a lot of useful things to say in the beginning of the pandemic, but this is not helpful at all.

      P.S. None of this is to imply that hospital administrators have not spent CARES Act money wastefully on mergers. I am sure they wasted most of it. But that is not the important point

      1. Solarjay

        But isn’t added hospital ( people and material) capacity helpful for things other than Covid related cases?

        1. Joe Well

          Very true but he specifically said that misspent CARES Act money was the root cause of this crisis when there wasn’t enough time to have trained that many nurses assistants, let alone nurses, let alone MDs. It is just basic logic and it is amazing anyone would write that in public.

          Of course, if they had started training new people in 2020 we would be better off in 4 years when this is still happening.

          1. NotTimothyGeithner

            Stoller is weird at times. He’s stuck in his the President should have focused on Covid bubble and ignored policies in BBB which amount to making it easier for people to stay at home.

            Its like that nonsense about Obama should have focused on the economy before healthcare line. Besides Biden would have the majority of the popular vote even if he lost
            the popular vote and didn’t say a word about Covid. There aren’t enough Republicans to win outright anymore. Eventually you have to appease those people too.

            1. Lois

              Stoller is super weird / bad about COVID. I follow him on monopoly where he is great. But on COVID he’s called the vaccines a magic bullet and even here in December 2021 he’s saying “the emergency is over” and Democrats should stop with crazy public health rules. COVID is an area where he is frankly a crank.

                1. TBellT

                  They’re just following populism. This is the popular position. It’s a clear indication of the limits of using popularity to determine your position on issues.

                2. Basil Pesto

                  They are using a political analytical skillset to analyse a biological/physical problem (albeit one that does have political consequences). The former is not remotely equipped for the latter. To understand the true nature of the problem (broadly, as I understand it: we’re slow shuffling our way into a markedly lower standard of living bc freedom/tHe EcOnOmY – very late-USSR style ideological stupidity) would require quite a lot of reading and patience on their part, which these men apparently don’t have and aren’t interested in obtaining. This problem has been exacerbated by the marketing of the vaccines as a miracle cure that have/will make the problem go away, which they aren’t, even though they are important weapons in the fight. Thus Stoller today proclaims that ‘cases don’t matter’ and that the pre-occupation with them is some sort of MSM frippery. Schade.

      2. Synoia

        Hmmm…

        for this is playing right into the hands of the the ruling oligarchy that is implementing the current genocidal mass murdering mass infection policies

        Wasn’t this an “Ultimate Solution” not so far in the past?

        Personally, I am unable to distinguish between malice and incompetence among out beloved leaders.

        1. drumlin woodchuckles

          Well . . . . there is this saying about “conspiracy theories” . . . ” Its not a theory if it happened”.
          Or is happening today and tomorrow into the future.

    2. The Historian

      I can think of jobs that would take care of many of the practical things that nurses do which would relieve some of the pressure on them and don’t require a 4 year or 8 year degree.
      Paramedics – they can start IV’s, give meds, intubate and it only takes 6 months to train a paramedic. Hospitals could use some of their CARES Act money on paying them while they learn.
      LPNs – who can do many of the hands-on things that take up a nurse’s time – can be trained in 9 months. CARES Act money could pay these people while they are learning.
      OJT Respiratory Therapists can be trained in about 3 months to set up the machines and give breathing treatments – again CARES Act money could be used to train them.

      I am sure there are a lot more jobs that the hospitals could use the CARES Act money for but of course that would cut into the hospitals’ profits.

      1. Joe Well

        Building out the training capacity would have taken the kind of war mobilization the federal government is best equipped for. Of course, the government is in thrall to the hospitals, so, in the end they might still be responsible…

  11. Brian Beijer

    One pattern remains constant: People who are unvaccinated are about 10 times more likely to be hospitalized with COVID infections than people who are fully vaccinated.

    (I wrote a comment on this earlier, but it seems that Skynet ate it. Apologies if this becomes a double post.)
    This seems to be a strange way to end the article when nowhere else are vaccination rates and hospitalizations even mentioned. Mr. Smith doesn’t even cite the source for this.
    As someone interested in hospitalization rates for the vaccinated versus unvaccinated and previously infected, i find the lack of sources and seemingly disappearing information very frustrating. For example, Dr. Campbell remarked in one of his recent videos that the unvaccinated accounted for 90% of hospitalizations (no source given). Then, a commenter on NC recently wrote that the hospitalization rate for Covid in the UK was 23% unvaxxed and 77% vaxxed. Again, no source given. When I go to the UK.gov website, I can’t find any stats breaking down the hospitalization rates by vax vs. unvaxxed.
    Another commenter on NC gave the stats for Denmark as an example of Omicron hitting the vaccinated much harder than the unvaxxed. It was something like 90% of hospializations were among vaccinated. I found that info on the link to Denmark Health Ministry kindly provided by the commenter. The problem was that it was early on in the Omicron wave and most of the hospitalizations were in the 20-30 something group. In other words, the least cautious and most likely to be exposed. When I go to the Denmark website now, I can find the breakdowns in hospitalizations anymore. The info seems to have disappeared, or deemed no longer relevant.
    I’m just so sick and tired of trying to navigate my health and safety through this world of funhouse mirrors.

    1. katiebird

      Deliberately posting duplicate comments violates site policies. Also, “ If your comment triggers a tripwire, it will be routed to our moderation team and not posted for public view until it has been checked. This may take up to 24 hours, depending on workload.”

      1. Brian Beijer

        Thanks for the information. I see others post their comments again after waiting an appropriate time with the assumption that their comment was lost. Other commenters usually confirm that this happens from time to time. I guess it isn’t widely known that it can take up to 24 hours. I will keep that in mind before assuming it was lost. I apologize if my comment triggered any tripwires.

    2. Whats Up Doc

      This is a very good question. People keep saying this, but no one is reporting the numbers. Aren’t hospital staff asking about vaccination status upon entry to the hospital. NPR reported some number a couple days ago, but no source was given. I would love to see these numbers. I suspect they are being suppressed because we can’t undermine the vax only strategy. That, or they really aren’t collecting the data. I noticed there are no more stories coming out Europe and the UK other than cases are rising and Omicron is mild.

      1. Yves Smith Post author

        No, that didn’t happen when my mother, her aide and I went to an Ascension hospital here (ER and then hospital where she died) in Alabama. But I also reported the masking discipline there was shockingly poor. Doctors with NO masks on sitting at the nursing station doing extended dictation! Other guy at nurses’ desk with no mask. MD pulled mask down to talk to my mother. Many poor quality masks and masks below noses.

        In early December, I went to the Hospital for Special Surgery. Some of the buildings which are MD offices and imaging are connected to the main hospital via an enclosed walkway at the second floor level over the street. Once you are in the “mainly MD building” you can walk to the main building. Admittedly you can’t get to hospital patient rooms without having the patient put the visitor on an “approved” list, but you can walk across to the main hospital and visit the areas with yet more imaging and access the main lobby from inside the hospital.

        All that took was a temperature check and wearing a mask.

        Getting a surgery requires a PCR test…and when I got it, it could be as early as 5 days before the surgery, which stuck me as silly.

    3. IM Doc

      I work in a highly vaxxed county – greater than 80% among adults – in the USA

      Our big winter surge started here about 2 weeks ago – and has dramatically escalated in the past few days.

      So we are just now starting the hospital aspect of this issue.

      Our stats from December 1st to now – is about 60% vaccinated – 40% unvaccinated in the hospital. I do not know the exact booster numbers for the vaccinated – but let’ just say several.

      Even though the numbers have clearly gotten worse for the vaccinated – the 90/10 ratio was commonplace until about a month and a half ago – it is still the case the the unvaccinated account for almost all of the ICU patients.

      Of note, our overall hospitalization rates per capita have been much lower than average throughout this whole affair.

      It must also be said I am in a rural area – with many other factors – people here are much more healthy, they are not crammed together like sardines, and there is much much more community mitigation efforts than I am seeing displayed from our big cities. There is a community wide effort to educate people about low pulse ox – and not to sit at home and get sicker by the day. Family members and friends abound for almost everyone – to keep an eye and ear out for those who are ill. The outpatient doctors here also have much more aggressiveness in caring for patients and keeping them out of the hospital than is going on in the big cities where corporate medicine rules.

      1. Skip Intro

        So with 80% vaxed population, zero effectiveness would lead us to expect 80-20 hospitalization as well (ignoring so many important confounding factors…). Instead we have it seems like the unvaxed are 2x as likely to be hospitalized, and the vaxed are 3/4 as likely to be hospitalized.

        1. Yves Smith Post author

          It is too early to tell anything with Omicron. And as GM says above, a lot of hospitals can’t test for it even if they wanted to. There are lots of hospitalizations of toddlers and babies. Vaccines ineffective on those under 5. So those “unvaxxed” are starting to include the very young.

          1. Thistlebreath

            Ever since the “mild” term has been bandied about with abandon, something’s been nagging at my memory, like Joyce wrote in ‘Ulysses,” “…the agenbite of inwit.” (from the middle English, the remorse of conscience).

            It’s an advertising slogan from the 1950’s through the ’60’s for Pall Mall cigarettes. “Outstanding….and they are mild.”

            Kurt Vonnegut, who was a Pall Mall smoker himself, used the brand in several of his novels. He was quoted as saying that they were “a classy way to commit suicide.”

            History rhymes.

            1. GM

              The “mild” thing was a deliberate and well organized propaganda campaign.

              It actually sent me into complete despair when it happened — how can you fight the whole propaganda apparatus of the world combined? You can’t.

              People have forgotten or never paid any attention, so let me remind you how this went:

              It was the week of Thanksgiving.

              On Tuesday the new variant was identified in the sequencing data from Botswana, Hong Kong and Gauteng

              And it was also noted that cases are growing rapidly (from a very low base) in Gauteng.

              By Wednesday evening that trend had been confirmed, the SGTF signature had been identified and based on it was clear it was growing everywhere in South Africa and we had a very big problem.

              Within 48 hours it had become officially a VOC with a name,

              And then on Friday all media worldwide starts blasting reports how it is “mild”.

              Which was based on an interview with a random South African doctor who had never stepped foot in an ICU.

              Of note, this was one of two interviews given the previous day. The other one was with an actual ICU doctor in Gauteng, who was almost crying about how she was having to deal with multiple children and teenagers with serious COVID pneumonia, which had only been rarely seen before.

              But that second interview was not given any attention.

              Again, it was all media worldwide — I checked as many sources and as many languages as I can understand when I noticed what’s happening. US, Canada, UK, Australia, New Zealand (where even Saint Jacinda Ardern propagated the lie at a press conference she gave), Germany, France, several countries in Eastern Europe, etc.

              In some cases the prime time news started with how “the new variant only causes mild illness”

              How does that happen — all major news outlets push hard a baseless assertion as a fact within hours of it being initially disseminated — if it is not an organized and coordinated campaign?

              It is not as if journalists have completely forgotten the rules of their profession — right now there is a rather important interview I had given on a different subject that is being held because the journalist can’t get a reply from another side involved in the matter and it will not be released until that is resolved. Because those are the rules and the journalist is following them.

              So how did an unverified obvious rumor get blasted immediately as a fact by all media worldwide (except probably in China) simultaneously within hours?

              And, of course, from then on it became firmly entrenched as an idea. I saw countless interviews with “experts” in early December who were asked “What do we know about Omicron other than that it causes mild illness” to which they replied as if the premise of the question was true; nobody corrected it. But at that time there had been no actual data at all, only the meme that had been planted. Which tells you how much of experts those bozos are — they assumed it was indeed mild without ever having looked at any actual data, then went on TV and propagated the lie…

              As chance would have it, it turned out that it is indeed milder than Delta, and perhaps even a little bit milder than the WT (it has of course been forgotten that Delta is 2-3x more severe than the WT).

              But that does not mean that those initial claims it is “mild” were not a lie — they were based on no actual data, and at the time we just had two anecdotal reports, one of them saying the exact opposite.

              1. The Rev Kev

                You have to admit GM that that was a very impressive effort by the media of the world, especially the fact that it happened so fast. But it tells me something else. It tells me that there is now world-wide coordination between governments and media to spin any new serious developments with this pandemic and ready to go within hours. This implies that there is also an actual coordinating body to do this and I am willing to bet that it was set up after the G7. So if a new variant developed that had a 20% fatality rate like MERS (they probably had this in mind when setting it up), they would be ready to go to spin stories to suit their needs. But it seems that Omicron has gotten them to show their hands prematurely.

                1. Joe Well

                  Worldwide coordinating body?

                  How about Fox Corporation? Thomson Reuters Corporation? ViacomCBS?

                  Not many editorial offices need to be given the memo.

              2. rowlf

                When I was a journalism student in a university a professional newspaper reporter who taught one of the classes said was what people say is interesting but go see if it is true.

                I am too far away from him now to ask if he was following the Kalama Sutta

                1. Basil Pesto

                  or, as related by Hersh in his memoir:

                  “If your mother says she loves you, check it out”

                  His other key bit of advice is: read, read, read before you write.

                  Journalists are, almost by definition, professional idiots. It’s how they rise to these two challenges that makes them. Lots of failures on both fronts so far.

        2. ptb

          the usual statistical pitfall applies … age as a quite significant co-variable. Should compare subgroups of similar age when comparing vaxed/unvaxed. Hospital admission tends to also be a proxy for age, confusing the direct comparison above

      2. GM

        Even though the numbers have clearly gotten worse for the vaccinated – the 90/10 ratio was commonplace until about a month and a half ago – it is still the case the the unvaccinated account for almost all of the ICU patients.

        So vaccines have successfully broken the link between being put on supplemental oxygen and ventilation.

        What is it that anyone is complaining about then?

        Party on!

    4. Kris Alman

      Most recent report from Denmark is here, showing only 69 cases of Omicron hospitalized, with <5 in ICU.
      https://files.ssi.dk/covid19/omikron/statusrapport/rapport-omikronvarianten-29122021-ub46

      Previous reports were more thorough, comparing hospital rate of Omicron with other variants and disaggregating cases by vaccine status.

      Last time this data was included was in the December 24th report.
      https://files.ssi.dk/covid19/omikron/statusrapport/rapport-omikronvarianten-24122021-w95k

      At that time, .7% of omicron cases were hospitalized as compared to 1.1% of other variants. (Data included in the table were from 22 November to 18 December 2021.)

      In other words, the hospitalization rate of omicron is only .4% lower than other variants.

      Also very, very concerning: Of the omicron cases, 76.5% were double vaxed. Additional 13.5% boosted. So 90% fully vaxed.

      Of the other variant cases, a total of 73.1% were double vaxed and boosted. So lots of breakthroughs with ALL variants.

      This is in context of Denmark having a 78.43% fully vaxed rate.

      https://ycharts.com/indicators/denmark_coronavirus_full_vaccination_rate
      (Includes any person that has received at least a full recommended course of Coronavirus vaccine, which may be 1 or 2 doses depending on exact vaccine received.)

  12. BeliTsari

    My posting of TheCity.NYC links was comparison with our Acela Corridor BS lie machine’s Panglossy HAPPY authoritative sources’ verbatim, hive-mind uniquity. Right about the time The Atlantic’s: “we’re IMMUNE, everything’s back to NORMAL, for us!” To: “Oops, I’m DYING, but at least I’ve infected the help!” “Trump’s evil, scary vaccine’s SAFE and EFFECTIVE, now… THANKS President Joe Biden™ The 70’s SciFi aspect of being cast as stereotypical extra, in White Wilderness Meets They Live, got old real fast. But, we’re reaping our “LOTE Blue no matter who” craven accession to our reactionary liberal betters’ need to sacrifice “essentials” to save retirement portfolios. So all the librul “could,” “should,” “might” and “MUST” imprecations by lefty blog-aggregators as to “urging nice ol’ Joe, or just giving Nancy & Chuck a chance,” worked out quite well, as S&P soared up to join NASDAQ over this fall’s hierarchical hijinx. The notion, that we’ve NO usable, accurate, timely information; aside from various Twitter accounts, liable to be censored, spun and cherry-picked to fit corporate agenda, is nothing new. But the uniquity of our boss, landlord, creditor… pulling up ladders, simultaneously, certainly resembles a comet flick?

    Excuse me, it’s the fever talking!

    https://www.thecity.nyc/2020/4/14/21247112/memo-ordering-nyc-schools-to-keep-virus-cases-quiet-probed

  13. Jack

    Some anecdotal info from a Doc friend at a hospital in Columbus, GA this morning. He texted me urging me to get a booster shot if I had not already done so (I have). “We care seeing 90 to 100 patients a day with Covid. No pace to put them. Send them home to isolation. Today the hospital has no ventilators. 65 people on life support with many of those extremely ill patients housed in the hallways. Seeing people age 18 to 30 dying from Covid here. Most are not vaccinated and come in not wearing a mask. I often here these words; “I thought I was healthy enough to not get Covid.” All of the nurses in the ER are traveling nurses. I can’t think of a single one who is a regular employee”. The DHEC website here in SC (DHEC is the state health dept) shows today greater than 20% of Covid tests are showing positive as of 12/28.
    I don’t trust anything the government tells me anymore. As NC has reported before the CDC has no interest in tracking cases or reporting on the numbers. The advice we get from the leaders, both elected and bureaucrat, appears to be driven by politics and profit seeking rather than the health outcomes of citizens.

    1. Dave in Austin

      Columbus Ga is the home of Ft. Benning and the county is surprisingly diverse because military enlisted people often marry local girls they meet overseas. And the enlisted retirees tend to stay on in places like Columbus.

      I’m a bit surprised that every nurse is a contract traveling nurse.

      Also the quote: ” Today the hospital has no ventilators. 65 people on life support with many of those extremely ill patients housed in the hallways.” So possibly the transfer system to Atlana, which doesn’t yet have a crisis, is breaking down or Columbus for some reason is not transferring.

  14. allan

    Florida Mayor Calls Out Gov. DeSantis For Being MIA During Omicron Surge [CBS]

    As Florida goes through the latest wave of COVID-19, the mayor of one of the state’s largest counties has called out Gov. Ron DeSantis, saying he has been missing in action as some municipalities have brought back mask mandates and opened up new testing sites in response to overwhelming demand.

    Orange County [Orlando area] Mayor Jerry Demings said local governments have been forced to figure out on their own, without help from the state, how to respond to the omicron variant that has rapidly overtaken the delta variant as the dominant strain of the coronavirus in Florida. …

    … All over the state, testing sites have been overwhelmed with people waiting for hours to get a test. One testing site in Orange County had a five-hour wait. …

    I’m so old that I remember when* DeSantis was going to ride monoclonal antibodies to the White House.

    * two weeks ago

    1. ChrisRUEcon

      Horrid … so the bouncing ball of duty dereliction goes thus:

      President says not a federal issue, and punts to states –> States (like Florida) will go MIA, and leave municipalities to deal with it —> ?

      As has been stated by many over the last week or so: you’re on your own.

      1. juno mas

        Medical mistakes in hospitals abound under normal conditions. With stressed working conditions it can only get worse. Don’t Get Sick!

  15. David Harrison

    My first cousin had a mild stroke and was placed in a rehab center the second week of December. Due either to previous health problems or the stroke he is having trouble accepting food and water., He became dehydrated and was moved to Nortons Suburban hospital in Louisville, Ky. The hospital was so full of COVID-19 patients that he was sitting in the ER days later. Someone who is trying to look after him said that when she was in the ER they were bringing in babies and children with COVID-19 in large numbers. My sister and I were going to visit him in the hospital when she left to go back to the Chicago area (where she lives and works) after the Christmas holiday. We were not allowed to visit him because of the COVID-19 situation.

    1. GM

      How does one avoid getting COVID in the ER in such a situation?

      In the case of your cousin COVID could finish him off very easily given his condition

  16. Iseeyoudock

    The nursing staff shortage is quite real. After nearly two years of this and two separate brutal waves of cases and elective case shutdowns, it’s had its toll on those who have cared for people during this time period. There were some younger nurses who refused the vaccine and then left. There were some older nurses with Co-morbid conditions who retired or opted out of direct patient care.

    Burnout and I think also the relative futility of many of the cases have left their mark in terms of the strain on staff. During the winter wave last year they were paid overtime and worked 60+ hours a week to make up for the shortfall.

    I’ve seen over half of the ICU nurses turn over during this time period. Very good people who are highly skilled have left, sometimes permanently.

    During the initial wave there was an air of heroism and duty. Local churches and clubs would buy food for the staff. People were appreciative our efforts.

    During the fall wave this year was an entirely different social atmosphere around care. There were no meals or accolades. Families had lots of questions. There were several distasteful displays.

    I think this atmospheric change has also played into the demoralization of all who care for this group. It’s terribly disheartening.

    I think the mixed messages and changing goalposts at a high level have contributed to the distrust which has driven the more recent change in the care environment. Frustrating when you have no control over the latest change in definition or expectation set and it ends up filtering through. People have in general lost a large amount of trust in the system. It ends up being another hurdle to jump during communication with families.

    What is lost is not just staffing. It is experience and expertise and synergies which develops on a team over time. It is those synergies which enable excellent care. They are the first casualty of a loss of key people and a broken link in the chain. They are often replaced by entirely inexperienced people who operate at lower efficiency and safety margins simply by virtue of their youth.

    Administrators may be able to fill the gaps with extenders or Locums but the guts have been pulled out of the system. Unfortunately few are in tune or enlightened enough to perceive what is really going on or, even more rare, address it.

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