Future of Division III

[jamtod]

https://www.houstonpublicmedia.org/articles/news/health-science/2020/07/16/378108/texas-hospitals-head-towards-full-capacity-due-to-covid-19-uptick/

Feel free to ignore the media narrative if you'd like and just read quotes from Doctors and management on the ground. And this is with postponing elective surgeries and other measures.

"Picture it like this: Would you rather cook in your kitchen or cook in your bedroom?" said Roberta Schwartz, Executive Vice President of Houston Methodist. "I'm sure you could cook in your bedroom, right? You drive in the toaster oven and you know you can make it work. It's just not ideal."

He is afraid that operating at surge capacity for too long will lead to burnout of his staff and substandard care for patients.

Studies have shown a higher risk of mortality the longer a patient waits in the ER to be admitted.

[OzJohnnie]

Wait, your battle by anecdote had already been pre-empted.  I'll reiterate it here but before I do can you answer this question, please?  How do we choose which appeal to authority to listen to?  Just so it's easy to judge this exercise.

Texas Medical Center leaders explain reformatted ICU bed capacity data

"That's what happens normally in hospitals. They're at their full capacity and when it gets crowded, they add additional beds, ventilators, and staff so you get the same quality of care," Dr. James McDeavitt, senior vice-president and dean of Clinical Affairs for Baylor College of Medicine, said.

"Right now we don't have a crisis of beds today," said Dr. McDeavitt. "We have plenty of ICU capacity in the hospitals. We can take care of twice as many COVID-19 patients in the ICUs as we currently are."

[jknezek]

Wait, your battle by anecdote had already been pre-empted.  I'll reiterate it here but before I do can you answer this question, please?  How do we choose which appeal to authority to listen to?  Just so it's easy to judge this exercise.

Texas Medical Center leaders explain reformatted ICU bed capacity data

"That's what happens normally in hospitals. They're at their full capacity and when it gets crowded, they add additional beds, ventilators, and staff so you get the same quality of care," Dr. James McDeavitt, senior vice-president and dean of Clinical Affairs for Baylor College of Medicine, said.

"Right now we don't have a crisis of beds today," said Dr. McDeavitt. "We have plenty of ICU capacity in the hospitals. We can take care of twice as many COVID-19 patients in the ICUs as we currently are."

You do know the article you are citing is almost 3 weeks old? Here is the latest statement. They are 100% full for pre-covid emergency but have room for expansion in phases 2 and 3 of covid contingency plans. https://www.tmc.edu/coronavirus-updates/tmc-key-takeaways/

So yeah. No absolute issue right now, and the projected growth rate is fine for the next 2 weeks for emergency capacity, but they are through any normal scenario. In other words, both of you have something of a point and both of you are stretching to make it seem like truth when really it lies somewhere in the middle. Operating for a long term at emergency levels is bad for profit, staff, and facilities, but they do currently still have more room to give than they expect to need in the short term.

[OzJohnnie]

Wait, your battle by anecdote had already been pre-empted.  I'll reiterate it here but before I do can you answer this question, please?  How do we choose which appeal to authority to listen to?  Just so it's easy to judge this exercise.

Texas Medical Center leaders explain reformatted ICU bed capacity data

"That's what happens normally in hospitals. They're at their full capacity and when it gets crowded, they add additional beds, ventilators, and staff so you get the same quality of care," Dr. James McDeavitt, senior vice-president and dean of Clinical Affairs for Baylor College of Medicine, said.

"Right now we don't have a crisis of beds today," said Dr. McDeavitt. "We have plenty of ICU capacity in the hospitals. We can take care of twice as many COVID-19 patients in the ICUs as we currently are."

You do know the article you are citing is almost 3 weeks old? Here is the latest statement. They are 100% full for pre-covid emergency but have room for expansion in phases 2 and 3 of covid contingency plans. https://www.tmc.edu/coronavirus-updates/tmc-key-takeaways/

So yeah. No absolute issue right now, and the projected growth rate is fine for the next 2 weeks for emergency capacity, but they are through any normal scenario. In other words, both of you have something of a point and both of you are stretching to make it seem like truth when really it lies somewhere in the middle. Operating for a long term at emergency levels is bad for profit, staff, and facilities, but they do currently still have more room to give than they expect to need in the short term.

Support your argument.  Give us the data FROM TODAY ONLY which leads you to believe you're right.  Show us the research you've done to inform your opinion.

I'll help you out.  Today, at this very second, the Houston area has 100 ICU beds unoccupied and ready for service.  They have 1,794 hospital beds unoccupied and available for service.  They do not list ICU capacity (but as we know specifically for Houston, that is rapidly and highly flexible) but we do know that Houston has 12,516 beds in total so are running at just over 85% capacity, a three point improvement from just yesterday which was running at 88% capacity.  That translates into 375 net discharges in a single day.  It looks to me like Houston has adequately managed this challenge.


I am under no misunderstandings about the seriousness of a novel virus.  I'm extremely aware of them.  As such I have made sure my opinion is informed by fact.  By source data.  And not emotionalism or media hysteria.  I am clearly focused on a way to overcome this challenge, not retreat in the face of it.  The easy path here is to roll over and give up.  I won't take that path.

[jamtod]

Wait, your battle by anecdote had already been pre-empted.  I'll reiterate it here but before I do can you answer this question, please?  How do we choose which appeal to authority to listen to?  Just so it's easy to judge this exercise.

Texas Medical Center leaders explain reformatted ICU bed capacity data

"That's what happens normally in hospitals. They're at their full capacity and when it gets crowded, they add additional beds, ventilators, and staff so you get the same quality of care," Dr. James McDeavitt, senior vice-president and dean of Clinical Affairs for Baylor College of Medicine, said.

"Right now we don't have a crisis of beds today," said Dr. McDeavitt. "We have plenty of ICU capacity in the hospitals. We can take care of twice as many COVID-19 patients in the ICUs as we currently are."

The article I referenced is from 3 days ago. If the CEO of the health system and multiple doctors there are concerned, I don't think it's crazy to be concerned.

[OzJohnnie]

Wait, your battle by anecdote had already been pre-empted.  I'll reiterate it here but before I do can you answer this question, please?  How do we choose which appeal to authority to listen to?  Just so it's easy to judge this exercise.

Texas Medical Center leaders explain reformatted ICU bed capacity data

"That's what happens normally in hospitals. They're at their full capacity and when it gets crowded, they add additional beds, ventilators, and staff so you get the same quality of care," Dr. James McDeavitt, senior vice-president and dean of Clinical Affairs for Baylor College of Medicine, said.

"Right now we don't have a crisis of beds today," said Dr. McDeavitt. "We have plenty of ICU capacity in the hospitals. We can take care of twice as many COVID-19 patients in the ICUs as we currently are."

The article I referenced is from 3 days ago. If the CEO of the health system and multiple doctors there are concerned, I don't think it's crazy to be concerned.

I don't think it's crazy to be concerned, either.  In fact I think it's prudent.

[Dave 'd-mac' McHugh]

Oz,
  Beds are only one part.  You also need the nurses and doctors and other equipment.

Come on, you reckon the Dept of Health neglected to consider that detail when stating how many beds they can sustain?

(A) You do realize there is a significant difference between hospital beds for those recovering from elective surgeries and simple illnesses and those needed for extreme cases, right?

If someone is in a regular hospital bed and their health goes south they are MOVED to a different section/wing of the hospital where more equipment, differently trained staff (nurses, etc.) are available, and other things are available to handle their more complicated case. (B)You can't just make all beds ICU beds. That isn't possible. There isn't enough equipment, the air handling standards are different, the staff training is VERY different (nurses have all kinds of different training; my sister in law had far more complex training as a Surgical ICU nurse than one who works in a different wing). The number of staff is also different. I spent the night in surgical recovery last year because there wasn't a bed available that was previously planned. The disadvantage is it isn't a comfortable or private, but I had a nurse one-to-one assigned to me. C) If I was in the other wing, I would have been one of maybe ten patients a nurse would have been assigned.

(D)You can't look at raw hospital bed numbers because they don't tell you how many beds are available for ICU and other severe illneses and such. The number of ICU and severe case beds are the ones to pay attention to - only. I have a dear friend in Houston. His constant updates are they are basically out of ICU and severe case beds. In other words, if he were to be in bad car accident right now, there might not be a place that can handle him case as we would expect because the staffing, beds, equipment, etc. are taken up by COVID cases. THAT is the problem NO ONE (especially you) seems to grasp from this illness. When we overwhelm our medical systems due to COVID, ALL cases take a significant back seat. (E)So now the heart attack, car accident, stroke, etc. case is more at risk of turning out badly than they were if we had more of a control on COVID.

BTW - hospitals will go out of business from this as well. They stay open not because of emergency care - that is a money losing business. They stay open because of elective surgeries and the like. If they don't have enough surgical rooms, beds, staff, etc. for elective surgeries - or can't figure out a way to put systems in place to keep people safe from COVID ... they have to limit or shutdown elective surgeries. That will shutdown hospitals in the long run.

(F)I am blown away with your cavalier attitude towards all this. You cherry pick information that fits your narrow, narrow thinking. You refuse to understand the larger problems a foot. And you do not care about anything but your selfish needs.

We ALL want athletics back up and running. We want student-athletes in schools and teams on the fields/courts, but it seems a majority of us are well aware that things are not good right now. That we are overwhelming our hospital systems, we are putting people at risk in danger (even if they are trying to be safe), and we are allowing a virus to get out of control. Compared to most of the rest of the world, we look like idiots ... but you keep arguing things are good. Mindblowing.

A) What a ridiculous question.  If your disagreement with the information I clearly provide supporting every post I make relies on such ignorance from people who disagree with you then I can see why your posts are always so emotional.

B) Oh the problems with this fatalistic statement.  Obviously it isn't true, how the did the first bed get made?  Additionally, it flies in the face of the information from the TX department of health.  Lastly, it's steeped in ignorant fear.  Hear's an article from the Texas Medical Centre explaining exactly why your believe is wrong: "That's what happens normally in hospitals. They're at their full capacity and when it gets crowded, they add additional beds, ventilators, and staff so you get the same quality of care," Dr. James McDeavitt, senior vice-president and dean of Clinical Affairs for Baylor College of Medicine, said.

C) I know what the average nurse to bed ratio is in the USA.  I also know what it is in every major country because I have looked it up.  Hint, it's nothing like your make-believe number from the expertise of your single stay in hospital.  I'll leave it to you to discover the actual numbers.  Let's see if you have it in you to absorb information which doesn't fit your fatalistic world view.

D) I don't know why I bother responding to you as you clearly don't read my posts.  I listed ICU bed counts in my post.  Usage.  Availability.  I clearly do you the courtesy of reading what you type.  I guess I shouldn't be surprised that you don't do the same in response since you're so eager to demean rather than discuss.

E) Show us where the quality of care is actually dropping.  Stick with Texas, if possible.  I've already presented the Texas numbers that show non-Covid related patients have remained steady.  Show us the drop in quality of care.  Not a fact-free argument.  If all you can bring to this discussion is your imagination then let us know that now, thanks.

F) Cherry picking?  You present no evidence I cherry pick other than once again the offensive, bald assertion.  You're free to post any information you like in support of your argument.  Yes you choose none.  You're free to demonstrate how my presented information is wrong or incomplete.  You fail to do so.  I am, frankly, stunned by your inability to look at this rationally rather than emotionally.  In the face of data which doesn't fit your world view you lash out with insult and invective.  The projection is strong with you.

I look at the data and draw a less emotional conclusion that you.  I'm able to look at information and separate my brain from the pitter-patter of my heart.  I'm really tired of every post from you being an emotional, informationless attack.  If only your passion for understanding matched your passion for endorphin hits.

As to looking like idiots in comparison to the rest of the world, you have no idea.  Again you are projecting your views onto the rest of the world and drawing comfort.  That is what is truly embarrassing.

Do you know understand the difference between rational discussion and emotional discussion?

You may not realize it ... but much of what you think about my experience is inaccurate ...

I'm skipping A because you didn't realize what I was pointing out ... clearly.

B - What you use an example is still not accurate. You cannot make every bed in a hospital an ICU bed. There isn't enough equipment nor are the hospitals capable of doing it. How do I know? First off, my father has been a general surgeon, family practitioner, surgical doctor, medical examiner, and nearly anything else including head of medical staffs at hospitals from Chicago to rural Maine and he is called upon for his experience and knowledge at state and national medical conferences ever year ... I have learned a LOT from him and continue to learn. I live in the Baltimore area, home of the best hospitals (Johns Hopkins AND University of Maryland) in the country. I happen to have friends and relatives who work in the JHU and UMaryland systems and have learned a lot from all of them - some of them as nurses and doctors and some as administrators who help run these massive systems. They inform me of how things operate and work especially recently as I haven't been able to have an elective surgery that I badly need. Explaining much of why it isn't possible even things seem plentiful. Of course, my doctor and his staff explaining that the need for ORs is more important than hospital beds and the need for ICU beds, which can be expanded, doesn't take up the entire hospital for the reasons I shared. So I discuss this stuff from being educated and having my eyes and ears open to better understand these things ... probably comes from my numerous years as a producer and journalist.

So you can pretend to read something about expanding ICU beds and decide it must mean ALL beds are available to become ICU beds, but that isn't accurate. I also had that confirmed from my dear friend in Houston who I mentioned earlier ... who happened to work in a field that directly helps hospitals and doctors (and their practices) and has to be up to speed on things. But if you need me to help more, I am sure to discuss this more with my SICU trained sister in law (she's just going to repeat this stuff), countless other high-end trained nurses and nurse practitioners, many doctors, and others I know personally ... but I suspect you still have your assumptions you will stick with.

C - You can still try and pretend the "average" nurse to bed ratio somehow disputes my point, but if I have one-to-one care in the recovery room and then go up to a room where it is 10:1 the average is 5:1 - doesn't really help your argument. I was told in the hospital that I would be one of ten patients on the level I was to go to for each nurse and I know I was the only patient for the nurse in recovery. I didn't just rest on my laurels with that information, I checked with that sister in law I mentioned prior - who informed me what the average patient load is in ICU, SICU, NICU, and every other place in the the hospital (I was at Johns Hopkins main hospital, but the way - and it is spelled with an 's' at the end of "John") and it turns out the info I was given in the hospital was accurate. But do tell me what the average nurse to bed ratio is in the ENTIRE country and I will be sure to know how that average changes what each and every hospital in the country is able to do. I am sure the average tells me everything, right? In reality, it just helps the argument you are trying to make and that's the only reason you are using it.

D - I read your posts... hard to miss. You don't seem to have anything else to do. I try not to read them ... but sadly, I haven't found the block feature. From what I read, you were trying to indicate that there are many more beds available but not being used. I simply disagree and pointed out not all beds are able to be ICU beds. But the bigger problem I had with it all was my friend in Houston giving me constant updates on things - because I find it both interesting and sad - and you seemed to be making assumptions of more availability than there really is.

E - Quality of care dropping is part and parcel with why not only medical experts but also competent leaders are trying to keep covid cases down. If you max out the hospitals especially for longer period of times, they have to make horrific decisions like who gets to live and who doesn't because there aren't enough ventilators or other equipment to keep people alive. There have been countless stories, especially early on, on how hard those decisions are to make. But if you are in an area that gets slammed and there aren't enough OR rooms, then someone in bad need of an operation can't get it because the ORs are being used suffers because of it. It was also mentioned that overworked people can't keep up the quality of care - how could they? Medical people are human, too, and if they are overworked and burned out they will make mistakes. This doesn't need to have articles for proof, it is simply known. Again, look to those I've mentioned I have talked to in my life in general and especially now ... do you think I'm talking to any medical expert or one who works in the field who says, "hell, we can handle ten times these cases plus every car accident that comes along ... it won't be a big deal." Hell no. If the medical system is slammed with covid cases ... ALL medical cases suffer. Period.

When there is a bad storm, why do you think they tell people to stay home and off the roads? It is so we don't overwhelm the EMS system so it gets bogged down with everything from stupid spin outs, stuck cars, to major wrecks ... because then people are tied up dealing with something trivial (like the person who had to get more milk from the store in the middle of a blizzard) when an actual serious emergency strikes and crews are late to arrive or not able to arrive. It is the same with hospitals. If we can keep the numbers low and keep our hospitals from being overwhelmed especially for long periods of time (covid cases seem to run from weeks at the lowest to over 90-days), then ALL patients have a better chance of getting the treatment they deserve. I can't believe you need "proof" of the system not working to understand or appreciate that.

F - Yes, cherry pick. The examples have already been shown. You pick articles that work for your argument and when it's shown the info is weeks old you seem to just move on. You grabbed data from Britain the other day. Best I could tell, that was data about Britain which has things well under control. How does that relate to our country where things are out of control in many parts. Even in my state the R0 number is rising above 1.0 again ... but I wouldn't look to Germany to see their data and say "see, it isn't that bad... we should have athletics, damn it!"

Believe it or not ... I'm not emotional. Yeah, I'm frustrated and angry about the situation we are in, but I don't tend to write in that manner. I am simply expressing my thoughts. And I certainly am not projecting anything. I have friends around the world. I know how this virus has affected them personally and their countries. I have friends around this country. I know how this virus and affected them personally and their states and counties. I am not projecting anything. And I certainly am not finding anything comfortable at all. Sadly, the one who is embarrassing seems to be you ... at least from what others seem to be saying.

Now ... where is that block feature.

[jamtod]

https://abc13.com/amp/health/patients-wait-while-med-center-says-100s-of-beds-still-available/6310321/

Some discussion of capacity as pertains to beds vs staffing.

Thursday afternoon, the Southeast Texas Regional Advisory Council (SETRAC), a government agency that coordinates hospital use in our area, told 13 Investigates there were 271 patients waiting for a bed in Houston area emergency rooms. Sixty of those patients needed an Intensive Care Unit (ICU) bed.

At the same time, the Texas Medical Center's website showed 813 ICU beds that could be added. "Phase 2 beds are 17 percent occupied," according to the TMC COVID-19 dashboard

Statistics are like bikinis. What they reveal is suggestive, but what they conceal is vital.

[Caz Bombers]

Dave, click on your own profile, summary, modify profile, buddies/ignore list, edit ignore list, type the member you want to ignore in the space at the bottom.

[Gray Fox]

Oz,

Here is some info for you to pick apart.

https://coronavirus.jhu.edu/

https://coronavirus.jhu.edu/us-map

[OzJohnnie]

Can't discuss so now it is block, d-Mac?  A real profile in courage there.  All you have to contribute is another invective filled rant. I can see why you want to block. You very passionately believe what you believe but are unable to explain why you believe it either calmly or substantively.  I can sense your frustration and it's justified.

[OzJohnnie]

https://abc13.com/amp/health/patients-wait-while-med-center-says-100s-of-beds-still-available/6310321/

Some discussion of capacity as pertains to beds vs staffing.

Thursday afternoon, the Southeast Texas Regional Advisory Council (SETRAC), a government agency that coordinates hospital use in our area, told 13 Investigates there were 271 patients waiting for a bed in Houston area emergency rooms. Sixty of those patients needed an Intensive Care Unit (ICU) bed.

At the same time, the Texas Medical Center's website showed 813 ICU beds that could be added. "Phase 2 beds are 17 percent occupied," according to the TMC COVID-19 dashboard

Statistics are like bikinis. What they reveal is suggestive, but what they conceal is vital.

Remember back three weeks ago when Houston hospitals were overwhelmed and dead where lying in the streets?

https://www.beckershospitalreview.com/data-analytics/texas-medical-center-hit-100-icu-bed-capacity-then-didn-t-report-data-for-3-days.html

Yeah, me neither.

Look, I'm not saying this bug isn't serious. It is. Note I've said this. I'm not saying this bug isn't a challenge. It is. Note I've said this. I'm not saying we should be concerned and informed about the magnitude of that challenge. We should. Note I've said this.

What I am saying is that we have all the tools and capabilities available to us to achieve a roaring victory here. There's no need to be fearful or stressed. The hospitals will easily cope. Individual hospitals will face moments of stress hit the system will easily handle the challenge.

Why?  Because the bug is far less deadly and serious than first feared as I've documented here. And because our hospitals have far more capacity and capability than is commonly acknowledged, again as I document here.

The bug is serious. Check.
We should be very aware. Check.
The tools and systems we have in place are more than adequate to deal with what has developed into a slightly worse than routine challenge.

The fact that people are unable to discuss or acknowledge this argument without resorting to insults and blocking is a sad state of affairs. What I'm saying is not unreasonable. The inability to engage in the discussion like an adult is.

[OzJohnnie]

A powerful argument from the president of the University of Dubuque concerning COVID and university this fall.  I highly recommend every person read and consider his article.  It has much to consider whether you're inclined to agree with it or not.

An Inoculation of Common Sense

[jamtod]

https://twitter.com/d3football/status/1285682888617472001?s=19
D3 recommending cancellation of D3 playoffs this year.

[Oline89]

https://twitter.com/d3football/status/1285682888617472001?s=19
D3 recommending cancellation of D3 playoffs this year.

Plus giving the OK to Spring football.....