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How many of you know the (non-vaccinated) Covid hospitalization rate without googling it?
kshama2001
Posts: 28,052 Member
in Debate Club
I ask because a recent Bill Maher episode made a big deal about people getting this wrong, and more importantly, an anti vax site, to which I will not link, is using this as a talking point.
Was the (non-vaccinated) Covid hospitalization rate widely discussed? I've had the death rate in my head for a year but my impression is that the hospitalization rate was not covered nearly as much, and I did not have that number in my head at all.
I am familiar with the rate of vaccinated people needing hospitalization - 0. (0.0005% to be precise, which is still 0 for purposes of this discussion, but as an anecdote it would stink.)
My anti-vax aunt sent me the link to the anti vax site without commentary and I'm deciding how or if to respond.
Was the (non-vaccinated) Covid hospitalization rate widely discussed? I've had the death rate in my head for a year but my impression is that the hospitalization rate was not covered nearly as much, and I did not have that number in my head at all.
I am familiar with the rate of vaccinated people needing hospitalization - 0. (0.0005% to be precise, which is still 0 for purposes of this discussion, but as an anecdote it would stink.)
My anti-vax aunt sent me the link to the anti vax site without commentary and I'm deciding how or if to respond.
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Replies
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I know it's much higher than among vaccinated people. I know a year ago people were being left to die because the hospitals were overrun. I know that many places have had their ICUs overrun by covid patients. I don't know the exact number but I believe I have the relevant info.
There are other areas of life where I know enough without having an exact number. Weight loss is a good example, in that there's some uncertainty in the number on the scale due to things like hydration status, the floor not being perfectly level, etc, but I'm doing what I know to do and my
clothess are fitting better.6 -
I think it might be around 15%? But I'm not sure because it is kind of hard to find the info - I was looking for it a while back. They generally show it by age group and not overall.
And yeah I was looking at it because our hospitals were overwhelmed and I was afraid that I might need care I couldn't access. Our hospitals are again overwhelmed (3 months later and even worse than last time), but now I am vaccinated so my worry is more for my kids in their 20's & 30's this time.1 -
Not the rate, because I think initially there wasn't enough testing to know how many people even had covid. The number of people hospitalized was discussed a lot -- one of the key numbers you heard along with positivity rate, deaths, and new cases. Also ICU beds available and so on.
At some point I stopped knowing all those numbers since it just became too much.
I don't know the rate now.
My state currently has 25% of ICU beds available, with about 15% of those in use occupied by those with covid.3 -
Ah, the coverage about people being left to die because the hospitals were overrun is probably why people think the number is higher than it is, but that's probably just a lack of excess ICU beds, and the whole point about the need to flatten the curve. (And also lack of reporting this specific stat.)
Here's the Bill Maher segment:
https://youtu.be/Qp3gy_CLXho0 -
To be fair, he is cherry picking that statistic. The truth is no one knows the answer because no one knows how many asymptomatic cases are missed. In the early days of the pandemic the OFFICIAL INFORMATION was that 20% of cases resulted in hospitalization. I don’t know who says what at the present time but I do know his answer is not the only one out there, it’s not undisputed, and it’s not even a fact - it’s always a guesstimate based on a model.4
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It never seemed like a terribly pertinent statistic to me, given that it would be affected by overall incidence of the disease and availability of ICU beds. That is, the degree of illness that would merit hospitalization is going to be depend on how many people there are who are sicker than you. I kept a much closer eye on deaths versus recovered cases.1
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lynn_glenmont wrote: »It never seemed like a terribly pertinent statistic to me, given that it would be affected by overall incidence of the disease and availability of ICU beds. That is, the degree of illness that would merit hospitalization is going to be depend on how many people there are who are sicker than you. I kept a much closer eye on deaths versus recovered cases.
See I think that hospitalization rates are pertinent - because if the hospitals are full and the hospitalization rate is say 10%, then if those 10% can't access hospital care wouldn't the death rate go up?
I guess I am assuming that those who require hospitalization would die without it - not sure if that is a valid assumption or not.
When the hospitals are full (like they are here now our ICUs are over capacity) I get real nervous about getting sick.
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How to respond to your anti-vax aunt? My suggestion: don't. You can't convince her. Ignore her comments about vaccination. People who are antivax think in a way that logic can't correct. All you're going to do is frustrate yourself and possibly alienate yourself from your aunt.17
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You can't convince someone that is anti science until it happens to them or someone very close to them. See Ted Nugent. Once enough people that are close to them either have it or have died from it, they will likely (in secret because this type of personality would NEVER admit they were wrong) get the vaccination.8
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My stats I watch have been positivity rate (I think it helps indicate if the state/city/area is question is testing enough that the case numbers are meaningful, and once testing is more consistent I think increases and decreases can be informative, and it can be informative when comparing across times and places) and then (of course) deaths.0
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Yes, because I went to health sites from the state to look at numbers and not random news articles.1
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Not sure of an exact number...I watched our local hospitalization rate pretty closely because NM has pretty minimal ICU capacity. We only have four hub hospitals in the state with ICU capacity. We were over capacity back in November/December/January and has since come down which I would attribute greatly to NM's really good vaccine distribution.
I'm not aware of NM ever getting to a point of turning people away to go die...but we did have beds in the hallways and we were sending people to other states, especially those in the more rural areas that border Tx, Co, and Az. We had and continue to have some of the strictest restrictions in the country which is largely due to our general lack of hospital availability and how easily they filled up with COVID...another issue was length of stay...those admitted with COVID tended to stay far longer than I generally see for ICU.0 -
How to respond to your anti-vax aunt? My suggestion: don't. You can't convince her. Ignore her comments about vaccination. People who are antivax think in a way that logic can't correct. All you're going to do is frustrate yourself and possibly alienate yourself from your aunt.
Not responding is very good advice, which I would give to anyone, but am not taking, lol. I'm not going to try to convince her though - I do realize that is pointless. I want her to know where I stand so she will stop talking to me about it, like she did with her 9/11 Zeitgeist nonsense.
As I said, she just sent me a link without commentary to the anti vax site which summarized the Bill Maher piece. I drew inspiration from the first three responses on this thread and responded:
"I saw the segment. What specifically are you referring to?
People probably think the (non-vaccinated) hospitalization rate is higher than it is because of all the news stories last year about people being left to die because of lack of ICU beds. I had to stop watching the news when it was showing mobile morgue trucks in NY and CA. I wouldn't call that "panic porn" though - it was a real issue of lack of capacity to handle a surge in need for ICU beds, which was the whole point of flattening the curve by lockdowns/implementing social distancing, etc., which Bill Maher has been irresponsibly complaining about for some time.
Also, the (non-vaccinated) hospitalization rate wasn't broadly covered, and when it was covered, tended to be broken down by age group rather than gen pop."1 -
My state has a very good graphic-heavy covid webpage and the hospitalizations have been part of the epidemiologic curve graph since the start.
Of course, living in the land of Microsoft and University of Washington may help with that really informative website.2 -
I consider myself an Independent, and I knew it! I so agree with Mahar about the news. What is up with cringey closeups of the shot going into arms every 2 minutes? Some days I depress myself watching world news all day, but most the time I just check in with the covid 19 tracker and watch Dr. John Campbell on youtube. Does anyone know why death rates so much higher in some places for April, though?(in US) I know about the new variants and spring break, but it's really a huge increase some places...0
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kshama2001 wrote: »How to respond to your anti-vax aunt? My suggestion: don't. You can't convince her. Ignore her comments about vaccination. People who are antivax think in a way that logic can't correct. All you're going to do is frustrate yourself and possibly alienate yourself from your aunt.
Not responding is very good advice, which I would give to anyone, but am not taking, lol. I'm not going to try to convince her though - I do realize that is pointless. I want her to know where I stand so she will stop talking to me about it, like she did with her 9/11 Zeitgeist nonsense.
As I said, she just sent me a link without commentary to the anti vax site which summarized the Bill Maher piece. I drew inspiration from the first three responses on this thread and responded:
"I saw the segment. What specifically are you referring to?
People probably think the (non-vaccinated) hospitalization rate is higher than it is because of all the news stories last year about people being left to die because of lack of ICU beds. I had to stop watching the news when it was showing mobile morgue trucks in NY and CA. I wouldn't call that "panic porn" though - it was a real issue of lack of capacity to handle a surge in need for ICU beds, which was the whole point of flattening the curve by lockdowns/implementing social distancing, etc., which Bill Maher has been irresponsibly complaining about for some time.
Also, the (non-vaccinated) hospitalization rate wasn't broadly covered, and when it was covered, tended to be broken down by age group rather than gen pop."
How my husband convinced his anti-vax father was to tell him he wouldn’t talk to him until he had the vaccine, because he couldn’t be bothered breaking his heart over someone who didn’t want to live. Then when his father called he would say, “have you been vaccinated yet?” And hang up on him. It took three calls but it worked.10 -
rheddmobile wrote: »kshama2001 wrote: »How to respond to your anti-vax aunt? My suggestion: don't. You can't convince her. Ignore her comments about vaccination. People who are antivax think in a way that logic can't correct. All you're going to do is frustrate yourself and possibly alienate yourself from your aunt.
Not responding is very good advice, which I would give to anyone, but am not taking, lol. I'm not going to try to convince her though - I do realize that is pointless. I want her to know where I stand so she will stop talking to me about it, like she did with her 9/11 Zeitgeist nonsense.
As I said, she just sent me a link without commentary to the anti vax site which summarized the Bill Maher piece. I drew inspiration from the first three responses on this thread and responded:
"I saw the segment. What specifically are you referring to?
People probably think the (non-vaccinated) hospitalization rate is higher than it is because of all the news stories last year about people being left to die because of lack of ICU beds. I had to stop watching the news when it was showing mobile morgue trucks in NY and CA. I wouldn't call that "panic porn" though - it was a real issue of lack of capacity to handle a surge in need for ICU beds, which was the whole point of flattening the curve by lockdowns/implementing social distancing, etc., which Bill Maher has been irresponsibly complaining about for some time.
Also, the (non-vaccinated) hospitalization rate wasn't broadly covered, and when it was covered, tended to be broken down by age group rather than gen pop."
How my husband convinced his anti-vax father was to tell him he wouldn’t talk to him until he had the vaccine, because he couldn’t be bothered breaking his heart over someone who didn’t want to live. Then when his father called he would say, “have you been vaccinated yet?” And hang up on him. It took three calls but it worked.
I love it! I'm guessing your FIL was recently vax hesitant? My aunt has been anti-vax for decades and is deeply entrenched in her position, like an imbedded tick.1 -
I consider myself an Independent, and I knew it! I so agree with Mahar about the news. What is up with cringey closeups of the shot going into arms every 2 minutes? Some days I depress myself watching world news all day, but most the time I just check in with the covid 19 tracker and watch Dr. John Campbell on youtube. Does anyone know why death rates so much higher in some places for April, though?(in US) I know about the new variants and spring break, but it's really a huge increase some places...
nevermind, I was looking at it by county and the death rates were really confusing, but I think that it just took this long for the death from the holiday season to show up...
My mom won't get it, and while I'm not judging your approach.. I just tell her that it's her choice, but pointed out that we'd be able to get together more and tried to explain how rare fatalities are from vaccines. I think that once more people get the vaccines, especially once it's deemed safe for kids, a lot of people will feel more comfortable with it.rheddmobile wrote: »kshama2001 wrote: »How to respond to your anti-vax aunt? My suggestion: don't. You can't convince her. Ignore her comments about vaccination. People who are antivax think in a way that logic can't correct. All you're going to do is frustrate yourself and possibly alienate yourself from your aunt.
Not responding is very good advice, which I would give to anyone, but am not taking, lol. I'm not going to try to convince her though - I do realize that is pointless. I want her to know where I stand so she will stop talking to me about it, like she did with her 9/11 Zeitgeist nonsense.
As I said, she just sent me a link without commentary to the anti vax site which summarized the Bill Maher piece. I drew inspiration from the first three responses on this thread and responded:
"I saw the segment. What specifically are you referring to?
People probably think the (non-vaccinated) hospitalization rate is higher than it is because of all the news stories last year about people being left to die because of lack of ICU beds. I had to stop watching the news when it was showing mobile morgue trucks in NY and CA. I wouldn't call that "panic porn" though - it was a real issue of lack of capacity to handle a surge in need for ICU beds, which was the whole point of flattening the curve by lockdowns/implementing social distancing, etc., which Bill Maher has been irresponsibly complaining about for some time.
Also, the (non-vaccinated) hospitalization rate wasn't broadly covered, and when it was covered, tended to be broken down by age group rather than gen pop."
How my husband convinced his anti-vax father was to tell him he wouldn’t talk to him until he had the vaccine, because he couldn’t be bothered breaking his heart over someone who didn’t want to live. Then when his father called he would say, “have you been vaccinated yet?” And hang up on him. It took three calls but it worked.
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kshama2001 wrote: »rheddmobile wrote: »kshama2001 wrote: »How to respond to your anti-vax aunt? My suggestion: don't. You can't convince her. Ignore her comments about vaccination. People who are antivax think in a way that logic can't correct. All you're going to do is frustrate yourself and possibly alienate yourself from your aunt.
Not responding is very good advice, which I would give to anyone, but am not taking, lol. I'm not going to try to convince her though - I do realize that is pointless. I want her to know where I stand so she will stop talking to me about it, like she did with her 9/11 Zeitgeist nonsense.
As I said, she just sent me a link without commentary to the anti vax site which summarized the Bill Maher piece. I drew inspiration from the first three responses on this thread and responded:
"I saw the segment. What specifically are you referring to?
People probably think the (non-vaccinated) hospitalization rate is higher than it is because of all the news stories last year about people being left to die because of lack of ICU beds. I had to stop watching the news when it was showing mobile morgue trucks in NY and CA. I wouldn't call that "panic porn" though - it was a real issue of lack of capacity to handle a surge in need for ICU beds, which was the whole point of flattening the curve by lockdowns/implementing social distancing, etc., which Bill Maher has been irresponsibly complaining about for some time.
Also, the (non-vaccinated) hospitalization rate wasn't broadly covered, and when it was covered, tended to be broken down by age group rather than gen pop."
How my husband convinced his anti-vax father was to tell him he wouldn’t talk to him until he had the vaccine, because he couldn’t be bothered breaking his heart over someone who didn’t want to live. Then when his father called he would say, “have you been vaccinated yet?” And hang up on him. It took three calls but it worked.
I love it! I'm guessing your FIL was recently vax hesitant? My aunt has been anti-vax for decades and is deeply entrenched in her position, like an imbedded tick.
Yes, and he’s also a lung cancer survivor with very limited lung function, so if he gets it he’s pretty much doomed. He’s a smart man, it’s just rough when all his friends are stupid. I don’t know what to do with the epidemic of people believing insane stuff.5 -
lynn_glenmont wrote: »It never seemed like a terribly pertinent statistic to me, given that it would be affected by overall incidence of the disease and availability of ICU beds. That is, the degree of illness that would merit hospitalization is going to be depend on how many people there are who are sicker than you. I kept a much closer eye on deaths versus recovered cases.
See I think that hospitalization rates are pertinent - because if the hospitals are full and the hospitalization rate is say 10%, then if those 10% can't access hospital care wouldn't the death rate go up?
I guess I am assuming that those who require hospitalization would die without it - not sure if that is a valid assumption or not.
When the hospitals are full (like they are here now our ICUs are over capacity) I get real nervous about getting sick.
I think the percentage of infected who "require" hospitalization (i.e., who will be actually be admitted, which is what hospitalization rate measures, not those who "require" hospitalization by some constant objective measure of symptoms) will depend on the local, current incidence of disease, as will the range of severity of disease in those who are hospitalized. Low incidence of disease means those who are hospitalized will on average be less sick and stand a better chance of surviving without hospital care.
It is at least theoretically possible (and I think practically likely) that maximum hospital capacity would be reached before maximum disease incidence in the local population is reached. Once that happens, % hospitalization won't change, but triage procedures should mean that the average severity of disease in hospitalized patients should increase as cases increase -- or perhaps at some point start to decrease, when conditions become so bad that they don't bother with those whose survival chances even with hospital care are rated too low.2 -
My mother in law who had the first shot is overweight, in her 70's, closet smoker, and has COPD. We'll she got COVID pneumonia after Easter.
She has been in the hospital still to this day and doing much better, but it was scary at first. She got out of the ICU 2 days ago. The doctor in the ER said if she didn't have that first dose, she may have not made it. Folks who have these preexisting conditions are prime candidates for the virus to cling to and wreak havoc.
You have the right to NOT vax, but all I can say is those who don't vaccinate (with the exception of those who have a medical reason), we can thank you for wearing these damn masks longer. Some of the people who want everything opened up, are the same ones who won't vax. Oxymoron I guess...
Sorry for being a little off topic.5 -
rheddmobile wrote: »
How my husband convinced his anti-vax father was to tell him he wouldn’t talk to him until he had the vaccine, because he couldn’t be bothered breaking his heart over someone who didn’t want to live. Then when his father called he would say, “have you been vaccinated yet?” And hang up on him. It took three calls but it worked.
My daughter and SIL) did similarly with his mother. She was told if she wanted to see the new grandchild she would get vax. So she did.2 -
lynn_glenmont wrote: »It never seemed like a terribly pertinent statistic to me, given that it would be affected by overall incidence of the disease and availability of ICU beds. That is, the degree of illness that would merit hospitalization is going to be depend on how many people there are who are sicker than you. I kept a much closer eye on deaths versus recovered cases.
See I think that hospitalization rates are pertinent - because if the hospitals are full and the hospitalization rate is say 10%, then if those 10% can't access hospital care wouldn't the death rate go up?
I guess I am assuming that those who require hospitalization would die without it - not sure if that is a valid assumption or not.
When the hospitals are full (like they are here now our ICUs are over capacity) I get real nervous about getting sick.
One other point about this is that depending on where you are, there are ways to increase hospital space significantly (the real capper being medical professionals available). We had additional space added for less seriously ill patients by converting non hospital space, and also a lot of non covid usage is for things that can be put off. It actually turned out to be less of a problem here when things were really bad than anticipated. They still give us the dramatic "hospital space is decreasing" stuff, even though at the moment the numbers of hospital beds available are really not a problem, and only 9% of current beds in use are covid or suspected covid.
Things were of course way worse here earlier, especially about a year ago and lasting for quite a while.2 -
lynn_glenmont wrote: »lynn_glenmont wrote: »It never seemed like a terribly pertinent statistic to me, given that it would be affected by overall incidence of the disease and availability of ICU beds. That is, the degree of illness that would merit hospitalization is going to be depend on how many people there are who are sicker than you. I kept a much closer eye on deaths versus recovered cases.
See I think that hospitalization rates are pertinent - because if the hospitals are full and the hospitalization rate is say 10%, then if those 10% can't access hospital care wouldn't the death rate go up?
I guess I am assuming that those who require hospitalization would die without it - not sure if that is a valid assumption or not.
When the hospitals are full (like they are here now our ICUs are over capacity) I get real nervous about getting sick.
I think the percentage of infected who "require" hospitalization (i.e., who will be actually be admitted, which is what hospitalization rate measures, not those who "require" hospitalization by some constant objective measure of symptoms) will depend on the local, current incidence of disease, as will the range of severity of disease in those who are hospitalized. Low incidence of disease means those who are hospitalized will on average be less sick and stand a better chance of surviving without hospital care.
It is at least theoretically possible (and I think practically likely) that maximum hospital capacity would be reached before maximum disease incidence in the local population is reached. Once that happens, % hospitalization won't change, but triage procedures should mean that the average severity of disease in hospitalized patients should increase as cases increase -- or perhaps at some point start to decrease, when conditions become so bad that they don't bother with those whose survival chances even with hospital care are rated too low.
Why would people who are "less sick" be hospitalized if they don't need to be, even if the local incidence is low? I don't think that happens here.
If say 10% who are symptomatic are sick enough that they might die without hospital care, then if the hospitals are full and they are turned away, the death rate would go up. I'm not sure how those who are "less sick" even play into that scenario, they would be at home recovering regardless.
At any rate we will find out here shortly how this will play out - we are about to start triaging ICU patients because we have nowhere to put them. One year later and our government has *kitten* up so bad that people are gonna be dying for lack of available care. I mean I can see how it happened last year, but there is no reason that we should be in this position now.1 -
lynn_glenmont wrote: »lynn_glenmont wrote: »It never seemed like a terribly pertinent statistic to me, given that it would be affected by overall incidence of the disease and availability of ICU beds. That is, the degree of illness that would merit hospitalization is going to be depend on how many people there are who are sicker than you. I kept a much closer eye on deaths versus recovered cases.
See I think that hospitalization rates are pertinent - because if the hospitals are full and the hospitalization rate is say 10%, then if those 10% can't access hospital care wouldn't the death rate go up?
I guess I am assuming that those who require hospitalization would die without it - not sure if that is a valid assumption or not.
When the hospitals are full (like they are here now our ICUs are over capacity) I get real nervous about getting sick.
I think the percentage of infected who "require" hospitalization (i.e., who will be actually be admitted, which is what hospitalization rate measures, not those who "require" hospitalization by some constant objective measure of symptoms) will depend on the local, current incidence of disease, as will the range of severity of disease in those who are hospitalized. Low incidence of disease means those who are hospitalized will on average be less sick and stand a better chance of surviving without hospital care.
It is at least theoretically possible (and I think practically likely) that maximum hospital capacity would be reached before maximum disease incidence in the local population is reached. Once that happens, % hospitalization won't change, but triage procedures should mean that the average severity of disease in hospitalized patients should increase as cases increase -- or perhaps at some point start to decrease, when conditions become so bad that they don't bother with those whose survival chances even with hospital care are rated too low.
Why would people who are "less sick" be hospitalized if they don't need to be, even if the local incidence is low? I don't think that happens here.
If local incidence is low, there's plenty of room to admit people who might be at 10% risk of dying without hospitalization and maybe 1% risk of dying if hospitalized (just pulling number out of air here for purposes of explaining what I mean). I'm pretty sure during normal times if I present in an emergency room with some combination of immediate symptoms and medical history that puts me at 10% risk of dying if they don't admit me and 1% risk of dying if they do admit me, they're going to admit me.
But if local incidence is high, hospital beds might be filled to an extent that triage requires them to raise the admission standard to being at 25% risk of dying if not admitted.If say 10% who are symptomatic are sick enough that they might die without hospital care, then if the hospitals are full and they are turned away, the death rate would go up. I'm not sure how those who are "less sick" even play into that scenario, they would be at home recovering regardless.
Death rates do go up when people who are at lower risk of dying can't get care. Statistically, 10% of those in the 10% risk group die when sent home. But they haven't "wasted" 90% of the beds that would have been used for the rest of the 10% risk group if they were admitting them all, instead of using those beds for people in a higher risk group. Those who are "less sick" are admitted in a scenario with lots of hospital capacity relative to local incidence, and maybe only 1% of them die. In the scenario with strained hospital capacity, those who are "less sick" get sent home in favor of admitting those with higher risk of death without hospitalization, and 10% of the low-riskers sent home die (using 10% risk we coincidentally both adopted for the low-risk group).At any rate we will find out here shortly how this will play out - we are about to start triaging ICU patients because we have nowhere to put them. One year later and our government has *kitten* up so bad that people are gonna be dying for lack of available care. I mean I can see how it happened last year, but there is no reason that we should be in this position now.
That's very sad. I hope things turn out better than circumstances seem to make likely. Right now in my area I'm worried about more deadly variants circulating among people who are unwilling to get vaccinated.
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It's sad across the world, and India is very worrying.
It is kind of interesting to compare Ontario to the US, where I think we are jaded.
The current Ontario numbers appear to be:
3682 new cases
40 deaths (7-day average of deaths peaked at 60, in the second wave)
Total deaths 7829
Case numbers (happily) supposedly plateauing.
Ontario has a population of about 14.6 m.
Illinois (as just one example of a US state, not too far away) has a population of only 12.6 m.
Current new cases: 3170 [huge improvement, but we do seem to be testing more as our positivity rate is a lot less, it was much higher in May of last year, though)
Deaths: 33
Total deaths: 21,755
Worst coronavirus death dates here: 192 deaths on May 31, 2020 (16th day in a row with more than 100 deaths, only 1677 cases on that day, since testing was still far too little). 12/20/20 had 196 deaths. Most of the May deaths were in Chicago or close, a much smaller area.
However, because our current stats are WAY better than the worst of this (and because of how long this has been a serious issue here) and of course bc of vaccines, we are seeing the current numbers as huge improvements rather than really bad, comparatively, based on most I've talked to. It's certainly nothing like May of '20 or even last winter. It almost feels like it's finally almost over here.3 -
lynn_glenmont wrote: »lynn_glenmont wrote: »lynn_glenmont wrote: »It never seemed like a terribly pertinent statistic to me, given that it would be affected by overall incidence of the disease and availability of ICU beds. That is, the degree of illness that would merit hospitalization is going to be depend on how many people there are who are sicker than you. I kept a much closer eye on deaths versus recovered cases.
See I think that hospitalization rates are pertinent - because if the hospitals are full and the hospitalization rate is say 10%, then if those 10% can't access hospital care wouldn't the death rate go up?
I guess I am assuming that those who require hospitalization would die without it - not sure if that is a valid assumption or not.
When the hospitals are full (like they are here now our ICUs are over capacity) I get real nervous about getting sick.
I think the percentage of infected who "require" hospitalization (i.e., who will be actually be admitted, which is what hospitalization rate measures, not those who "require" hospitalization by some constant objective measure of symptoms) will depend on the local, current incidence of disease, as will the range of severity of disease in those who are hospitalized. Low incidence of disease means those who are hospitalized will on average be less sick and stand a better chance of surviving without hospital care.
It is at least theoretically possible (and I think practically likely) that maximum hospital capacity would be reached before maximum disease incidence in the local population is reached. Once that happens, % hospitalization won't change, but triage procedures should mean that the average severity of disease in hospitalized patients should increase as cases increase -- or perhaps at some point start to decrease, when conditions become so bad that they don't bother with those whose survival chances even with hospital care are rated too low.
Why would people who are "less sick" be hospitalized if they don't need to be, even if the local incidence is low? I don't think that happens here.
If local incidence is low, there's plenty of room to admit people who might be at 10% risk of dying without hospitalization and maybe 1% risk of dying if hospitalized (just pulling number out of air here for purposes of explaining what I mean). I'm pretty sure during normal times if I present in an emergency room with some combination of immediate symptoms and medical history that puts me at 10% risk of dying if they don't admit me and 1% risk of dying if they do admit me, they're going to admit me.
But if local incidence is high, hospital beds might be filled to an extent that triage requires them to raise the admission standard to being at 25% risk of dying if not admitted.If say 10% who are symptomatic are sick enough that they might die without hospital care, then if the hospitals are full and they are turned away, the death rate would go up. I'm not sure how those who are "less sick" even play into that scenario, they would be at home recovering regardless.
Death rates do go up when people who are at lower risk of dying can't get care. Statistically, 10% of those in the 10% risk group die when sent home. But they haven't "wasted" 90% of the beds that would have been used for the rest of the 10% risk group if they were admitting them all, instead of using those beds for people in a higher risk group. Those who are "less sick" are admitted in a scenario with lots of hospital capacity relative to local incidence, and maybe only 1% of them die. In the scenario with strained hospital capacity, those who are "less sick" get sent home in favor of admitting those with higher risk of death without hospitalization, and 10% of the low-riskers sent home die (using 10% risk we coincidentally both adopted for the low-risk group).At any rate we will find out here shortly how this will play out - we are about to start triaging ICU patients because we have nowhere to put them. One year later and our government has *kitten* up so bad that people are gonna be dying for lack of available care. I mean I can see how it happened last year, but there is no reason that we should be in this position now.
That's very sad. I hope things turn out better than circumstances seem to make likely. Right now in my area I'm worried about more deadly variants circulating among people who are unwilling to get vaccinated.
OK yeah that makes sense - I get what you are saying about the hospitalizations.
We have the opposite of vaccine hesitancy here - we don't have enough vaccine for the demand. My daughter and one son are both technically eligible based on the areas where they live being "hot spots" for transmission - but as soon as they open slots up the appointments are taken.1 -
It's sad across the world, and India is very worrying.
It is kind of interesting to compare Ontario to the US, where I think we are jaded.
The current Ontario numbers appear to be:
3682 new cases
40 deaths (7-day average of deaths peaked at 60, in the second wave)
Total deaths 7829
Case numbers (happily) supposedly plateauing.
Ontario has a population of about 14.6 m.
Illinois (as just one example of a US state, not too far away) has a population of only 12.6 m.
Current new cases: 3170 [huge improvement, but we do seem to be testing more as our positivity rate is a lot less, it was much higher in May of last year, though)
Deaths: 33
Total deaths: 21,755
Worst coronavirus death dates here: 192 deaths on May 31, 2020 (16th day in a row with more than 100 deaths, only 1677 cases on that day, since testing was still far too little). 12/20/20 had 196 deaths. Most of the May deaths were in Chicago or close, a much smaller area.
However, because our current stats are WAY better than the worst of this (and because of how long this has been a serious issue here) and of course bc of vaccines, we are seeing the current numbers as huge improvements rather than really bad, comparatively, based on most I've talked to. It's certainly nothing like May of '20 or even last winter. It almost feels like it's finally almost over here.
That is an interesting comparison. Our case rates, hospitalizations and ICU rates are higher than they have ever been right now. We are in a six week modified lockdown with a "stay at home" order in place because "modelling" was showing that without interventions our cases could climb to 18,000 per day with the variants, and limited vaccine coverage. Cases have stopped climbing the last couple of days but I'm not sure it is enough to show a pattern yet.
There is a lot of anger at the gov't because we are having workplace outbreaks, which are hitting younger, low income and racialized people who aren't yet eligible for vaccines, have no paid sick coverage, and can't work from home (factories, food processing, etc) so they are pivoting away from age based eligibility and trying to hit the hot spots where transmission is high.
The thing that kind of shocks me is how "easily" our hospitals seem to get overwhelmed - we have 805 people in ICU right now and there is a lot of doom and gloom in the news about how 900 is the number when they are going to have to start "triaging" people for ICU beds. They have cancelled all elective and non urgent surgeries and procedures in the province. I guess I never realized how health care capacity works, or else ours is really bad here, but I would have never expected that in a province of almost 15 million people 900 in ICU would crash the entire system. I also heard on the news today that there are 1-2 people per day they are finding dying at home, they are sick and then deteriorating so quickly that they don't even get to the hospital before they die - that is something new that hasn't been happening here before.
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@33gail33
We had that exact same scenario about triaging here in the PNW, U.S. It didn't actually happen, but I think it did scare people enough to start being more cautious. I know NY had a lack of availability and many people allegedly were sent home to die (last year.) How much of that is true and how much of it is just alarmist messaging, I don't have any way to know.
I think hospitals operate on a pretty small margin of ICU availability as it is. My understanding from talking with people who work in hospitals is that it is possible to ramp up ICU availability and they do when it becomes necessary but their profits are driven by elective and emergency surgeries, medical treatments, and procedures like chemo and dialysis. ICU is super expensive, and the problem is lack of qualified staffing...so part of the messaging is from a PR/hospital viewpoint, too. It's a balancing act that is difficult to do for them, and part of the messaging has to be dollar driven I'm sure.
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lynn_glenmont wrote: »lynn_glenmont wrote: »lynn_glenmont wrote: »It never seemed like a terribly pertinent statistic to me, given that it would be affected by overall incidence of the disease and availability of ICU beds. That is, the degree of illness that would merit hospitalization is going to be depend on how many people there are who are sicker than you. I kept a much closer eye on deaths versus recovered cases.
See I think that hospitalization rates are pertinent - because if the hospitals are full and the hospitalization rate is say 10%, then if those 10% can't access hospital care wouldn't the death rate go up?
I guess I am assuming that those who require hospitalization would die without it - not sure if that is a valid assumption or not.
When the hospitals are full (like they are here now our ICUs are over capacity) I get real nervous about getting sick.
I think the percentage of infected who "require" hospitalization (i.e., who will be actually be admitted, which is what hospitalization rate measures, not those who "require" hospitalization by some constant objective measure of symptoms) will depend on the local, current incidence of disease, as will the range of severity of disease in those who are hospitalized. Low incidence of disease means those who are hospitalized will on average be less sick and stand a better chance of surviving without hospital care.
It is at least theoretically possible (and I think practically likely) that maximum hospital capacity would be reached before maximum disease incidence in the local population is reached. Once that happens, % hospitalization won't change, but triage procedures should mean that the average severity of disease in hospitalized patients should increase as cases increase -- or perhaps at some point start to decrease, when conditions become so bad that they don't bother with those whose survival chances even with hospital care are rated too low.
Why would people who are "less sick" be hospitalized if they don't need to be, even if the local incidence is low? I don't think that happens here.
If local incidence is low, there's plenty of room to admit people who might be at 10% risk of dying without hospitalization and maybe 1% risk of dying if hospitalized (just pulling number out of air here for purposes of explaining what I mean). I'm pretty sure during normal times if I present in an emergency room with some combination of immediate symptoms and medical history that puts me at 10% risk of dying if they don't admit me and 1% risk of dying if they do admit me, they're going to admit me.
But if local incidence is high, hospital beds might be filled to an extent that triage requires them to raise the admission standard to being at 25% risk of dying if not admitted.If say 10% who are symptomatic are sick enough that they might die without hospital care, then if the hospitals are full and they are turned away, the death rate would go up. I'm not sure how those who are "less sick" even play into that scenario, they would be at home recovering regardless.
Death rates do go up when people who are at lower risk of dying can't get care. Statistically, 10% of those in the 10% risk group die when sent home. But they haven't "wasted" 90% of the beds that would have been used for the rest of the 10% risk group if they were admitting them all, instead of using those beds for people in a higher risk group. Those who are "less sick" are admitted in a scenario with lots of hospital capacity relative to local incidence, and maybe only 1% of them die. In the scenario with strained hospital capacity, those who are "less sick" get sent home in favor of admitting those with higher risk of death without hospitalization, and 10% of the low-riskers sent home die (using 10% risk we coincidentally both adopted for the low-risk group).At any rate we will find out here shortly how this will play out - we are about to start triaging ICU patients because we have nowhere to put them. One year later and our government has *kitten* up so bad that people are gonna be dying for lack of available care. I mean I can see how it happened last year, but there is no reason that we should be in this position now.
That's very sad. I hope things turn out better than circumstances seem to make likely. Right now in my area I'm worried about more deadly variants circulating among people who are unwilling to get vaccinated.
OK yeah that makes sense - I get what you are saying about the hospitalizations.
We have the opposite of vaccine hesitancy here - we don't have enough vaccine for the demand. My daughter and one son are both technically eligible based on the areas where they live being "hot spots" for transmission - but as soon as they open slots up the appointments are taken.
That's how it was here for a long time (still in some places, and I know people here and some other places who badly want it but haven't managed to get it yet). But now that the people who really wanted it have mostly gotten it, and it's more available, we are going to find out what percentage of the population is actually resistant, even after many others have gotten it.
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