For the Love of All that is Holy

She is... but as much as I have been annoyed by the approach I will defend her a bit. (just a bit...)

The underlying risk profile of the hospitalizations has changed and while most of us at OHA saw this immediately, the Governors office was slow to recognize that the surge in hospitalizations is far more to do with hospitals just admitting more patients (i.e, lower acuity cases that may not of been admitted in the winter surge) than anything else. Let me be really clear when I say at OHA all we do is hand off information, the Governor's office is making all the decisions from it...

If we think back to our winter surge, when our hospitalizations were spiking, our death rate did as well. they trended together. Also, the hospital association was right there in step with the Governor's office imploring for lockdowns and potential new restrictions on elective procedures. Some systems voluntarily did their own pauses. 

This time, death rate is not trending with hospitalizations. it remains low. Likewise the hospital association has been oddly silent through this surge. There has been scant few public comments about resurging hospital cases from them.

Bottom line: hospitals are parking lower acuity, younger people in a hospital bed on oxygen and rolling in some dolla bills right now. If things start getting hairy, they will just stop admitting as many lower acuity cases.

All evidence points to the case surge being young people, 18 to 40, the major missing population from vaccines until very recently. Cases and hospitalizations among older people remain low. 

Our issue with this new surge is less about hospital capacity and deaths, and more about being a petri dish for COVID to mutate in. allowing this virus to continue to fester in people is playing with fire... Bottom line, this virus still kills 10x the number of people the flu does. Everybody needs to get their shot, as soon as possible. 

In a situation where the pandemic has change form and evolved, standards need to evolve. I do not have an issue with moving the goalposts per se, but we have done a really, really, really bad job of showing our data and our reasoning and the bottom line why. It is not good, not good at all our cases surged, but the effort from OHA needs to be about getting young people to take the vaccine as fast as humanly possible, not policing restaurants and large football stadiums at 15% capacity in which their existence as a source of major community spread is dubious at best. 

But isn't it people like kate brown.....people in power.....making the decisions to make it lucrative for hospitals to have covid patients?

Oregon is doing okay, not great, but nobody is in the poor house. 

And to be sure, I should of been a little more clear. stuffing your beds with low cost, lower acuity patients that largely are just going to hang out on oxygen for few days isn't making anybody rich... it is stemming the bleeding. 

My point is that covid hasn't been lucrative and probably won't be lucrative. Getting covid done with and getting it to where hospitals go back to what life was pre-covid would be more lucrative. Thing is, Atown would probably have a lot better feel for this, my bet is things won't necessarily go back to pre-covid normal at the snap of a finger even if covid "ended" today.

If a patient is admitted to a hospital with COVID, they get 20% more than a patient with the same treatment, who does not have COVID.  That was one of the things that was included in the original CARES Act.  If a person goes on a ventilator, which, originally, was one of the primary treatments for individuals with COVID, the hospital can bill more than triple the amount of the same individual, who does not utilize a ventilator.  The hospital then can claim the extra 20% on top of that.  The result is that hospitals were financially incentivized to identify individuals as COVID-positive and then to treat with a ventilator.  That typically resulted in a hospital earning approximately 263% more than an individual who with similar symptoms and treatment, who was not identified as being COVID-positive.

At one point in time, there was an independent audit of Colorado's COVID reporting, just as an example, indicated that deaths identified as being COVID deaths were overreported by approximately 24%.  If I remember that audit correctly, people who died from gunshot wounds, who were found to be COVID-positive were identified as "COVID deaths."

The fact is that hospitals were getting killed, because people were delaying procedures, which hospitals could typically bill more for anyway.  So, they basically had to try and make up the lost money by aggressively finding that patients were COVID positive and then treating with a ventilator just to try and weather the storm.

OK, as a weather weenie, basic FEMA trained guy with more understanding of severe weather than a lot of degreed mets (never bashful), I can tell you that this Meme must die.  For a guy totally unqualified for the position (I think he managed a horse farm before), he believed the National Hurricane Center's forecasts and advisories but could not get anyone in the Bush Administration to sign off on anything.  And of course the $ billions that somehow ended up lining the pockets of the Louisiana commission that was supposed to be improving the flood control systems so that they hired 3 year olds with Tonka trucks to maintain things (and I don't mean to disparage 3 year olds with Tonka trucks, but relative experience again) were directly responsible IMO  for the massive flooding and thousands of deaths.

Brownie did a heck of a job under the circumstances, no one else did, except for many heroic volunteers, and General Honore, when they finally decided that the Federal gov response in general was horrific and gave him the reigns.

Just think of the poor (hurts my feelings all the time   )  North Carolina 2nd baseman who gets blamed for the "throwing error" in the title game in 2006, when it really was the fact they had Federovich, a catcher who didn't know how to play the position well, at first and he straddles the base so he can't move to get to an easily catchable throw.

Yup, Brownie actually did his job. The Bush administration recommended evacuations 2-3 days prior to the landfall of Katrina and the Governor of Louisiana and the mayor of New Orleans basically refused. The Federal government actually mobilized in the days before the hurricane hit. I've got a friend, an OSU alum, that was flown out a day or two in advance to be in charge of one of the supply efforts for the Army Corps of Engineers. He said it was a total cluster because just about every move, every truck even, had to be approved by someone in Congress and he wasn't allowed to send the supplies directly to where it were needed, lots of stuff never even got to where it was needed. He got so fed up he said he'd never volunteer to do that again.  Part of the problem with that storm was the nature of the storm itself, it hit land head on and went straight inland and messed up infrastructure for a hundred miles or more, the vast majority of hurricanes skirt the coast and only really damage 4-10 miles or so of roadways/powerlines/etc so they can get in real fast. There was a lot of blame to give in that event, and most of it was blamed on the wrong people.