Crossing now …
*HOUSTON ON PACE TO EXCEED INTENSIVE-CARE CAPACITY BY TOMORROW
(yes, it was YESTERDAY they said it would be 11 days before this would happen. An indication of how fast the virus is growing!)
— Jim Bianco (@biancoresearch) June 24, 2020
Harris County – Houston
Texas Medical Center 97% Occupied
At the Texas Medical Center in Houston, 97 percent of ICU Beds are Occupied.
As the number of patients hospitalized with the coronavirus has reached record highs 12 days in a row, there are warning signs that Houston hospitals are nearing a tipping point.
At the Texas Medical Center in Houston, 97 percent of ICU beds were occupied on Tuesday. Twenty-seven percent of those ICU patients have COVID-19.
Planned vs Unplanned
The Naysayers will be quick to comment that “only” 27% of the bed usage is due to Covid-19.
But Covid is precisely the problem. Last year 0% of the bed usage was due to Covid-19.
Not Just the Texas Medical Center
Hospital officials in other parts of Houston are also reporting that intensive care units — for seriously ill patients, like those on ventilators — are near or over capacity. Local leaders have warned that hospitals could get overwhelmed if the number of infections keeps climbing.
Texas Children’s Hospital said this week it is admitting adult transfer patients, with and without the virus, to help other facilities manage their capacity.
Tipping Point – Texas Eyes Stadiums for Emergency Use
“We appear to be nearing the tipping point,” Dr. Marc Boom, head of the Houston Methodist hospital system, wrote in an email to employees Friday. “Should the number of new cases grow too rapidly, it will eventually challenge our ability to treat both COVID-19 and non-COVID 19 patients.”
Elsewhere, counties like Travis and Harris, which includes Houston, have eyed local convention centers or stadiums as temporary hospital overflow facilities — reviving plans mapped out early in the pandemic that were largely abandoned due to lack of need at the time.
Governor’s Response
The governor struck a newly urgent tone Monday in a televised press conference to say COVID-19 was “spreading at an unacceptable rate” and that multiple metrics to gauge the virus’ spread and severity had significantly increased. Epidemiologists have attributed upticks in infections and hospitalizations to changes in behavior, including lax mask use and less social distancing.
Trump Blames “Too Much Testing”
Trump’s amazing response is to not only blame too much testing but act to limit testing by cutting funds.
Texas Case Projections – With and Without Masks
Charts from Worldometers.
Texas Death Projections – With and Without Masks
Typical Denier Reactions
My Response to the Deniers
- No doubt the initial models were overstated, but the denier claims this was much ado about nothing were even worse.
- The initial model projections were based on doing nothing. The deniers never took that into account.
- When states took aggressive that undoubtedly halted the curves, the deniers claimed this would have happened anyway.
- The deniers went on to project that warmer weather would finish the whole thing off in May, then June, and now?
- Now the deniers blame the models instead of their silly this will all go away if we do nothing projections.
Point 5 is particularly amusing in light McCarthy’s moan about forecasting 3 months out.
Houston may run out of beds tomorrow and is forced to eye stadiums to house patients.
Fake News of the Day
In the fake news of the day, which no doubt had his delusional followers cheering, Trump made the claim: States Testing Too Much
Trump’s remedy is to halt test funding for locations in five states.
Texas was especially hard hit. See the above link for details.
The EU Lifts Its Travel Ban But Not For the US
Meanwhile The EU Lifts Its Travel Ban But Not For the US.
Trump’s Campaign Visit to Arizona Church is Irresponsible at Best
Finally, Trump’s Campaign Visit to Arizona Church is Irresponsible at Best
Trump’s response has been amazingly wrong nearly every step of the way.
But putting his reelection campaign ahead of national health concerns and cancelling test funding goes far beyond “irresponsible”.
Mish
Better start looking for information on the D614G mutation of SARS-COV-2.
Did the governors of these spiking states issue guidance to protect seniors in assisted living and nursing homes?
I have it on good authority that Covid-19 is all a hoax. Wonder who said that.
You’re a broken record Mish. You used to be interesting. Now you’re a bore.
I don’t understand politics and I don’t keep up with it, but now that Biden has the lead in the polls, can’t he secure a victory by simply declaring that Trump’s corporate tax cuts must be reversed and Trump’s trade deal is a joke, we need to be tougher on China? Surely, the stock market will crash it will be all Trump’s fault.
Any position Biden takes will cost him votes. His best bet, for now, is to hide in a basement and say nothing controversial, and let Trump keep shooting himself in the foot.
This is exactly right. Biden is better off doing nothing more than smiling and waving for as long as he possibly can.
The greatest single danger for him right now is having to debate Trump live and in person.
When (and if) those happen, we will get a much clearer picture of where the fight stands. Until then, everything else is smoke and mirrors.
United States hit 2million Covid 19 cases on Jun 10th, 2020.
Today it is 2020/06/24 (2 weeks or 14 days later) and we’re at 2380000
An increase of 380k cases in 2 weeks, or 190k per week.
Of these 190k new cases per week ~ 40k per week are new hospitalizations or 20%.
20% hospitalization rate is very similar to Chinese and European data.
You want to talk about hospitalizations? There it is!
Hospitalization rates per 100k of different age groups.
2020/06/13 week:
[0.7+0.2+2.4+4.1+6.2] = 13.6 people hospitalized
per 100k.
Total COVID-NET network is 32 million.
Therefore total new weekly hospitalizations
within the COVID-NET network of 32 million (10% of US population) is:
= 32 million * 13.6 / 100k = 4352 people per 32 million population.
Multiply by 10 for the full US population of 100% or 300million = 43000 hospitalizations for the week of 06/13/2020.
I wonder if Trump wants to lose. He talks every day about a coming corrupt election – and most States are Republican run so that’s insane! He wants to lose the election and then start his own lifestyle channel. I think Trump plans to steal all the Fox News viewers. I guarantee his hotel empire is destroyed – so he has to find his next job and President doesn’t pay well. His hotels were flailing before the virus. He has the most despised brand in the world but the media business is in his wheelhouse.
I am positive he does not want to lose.
But if he loses he wants to be able to blame as many people as possible
Yeah, I can’t imagine that Trump would desire an election loss. He’s done his utmost to associate the whole Trump brand with winning.
The irony is that should he win, another four years would erase any remaining doubt that he is NOT playing 4D chess, and would lead to a red team malaise akin to the one GWB left behind.
“ He’s done his utmost to associate the whole Trump brand with winning”.
You have to be kidding right? Trump businesses declared bankruptcies 6 times between 1991 and 2009”. He has blocked the release of his college transcripts and his personal tax returns. Tends to suggest he is a long way from the stable genius he professes to be and nowhere near as wealthy as he would have us believe. I have no doubt he will leave the White House significantly more wealthy courtesy of the bills passed during his presidency. Our Donnie boy is both corrupt and clueless.
I’m not talking about my view of Trump, I see him as a total blowhard.
He’s like a rapper, always talking himself up. Everything is bigly and tremendous. Whether or not the rhetoric reflects reality is up to the public, but that’s my point. Another four years of nonsense will destroy his legacy, whereas if he loses this year he may be able to preserve some of it.
He should also be tried for war crimes given that he has declared fight against the Covid virus to be a war.
tRump is the most stable genius of the mankind! The king Donald can reduce the number of new cases to 0 , by stopping all tests.
We knew very little about Covid-19 in February. Here in Colorado, we closed all the ski areas because the counties they were in were spiking. We know now it wasn’t the ski areas or the tennis courts that were the problem. It was the bars the skiers went to after a day on the slopes.
An Australian Skier tourist was the n=1 first case. In Costa Rica, a New York City tourist was the n=1 first case. The Airlines, Cruise and tourist industry are all about the SARS-CoV-2 transmissibility cosmetic steps, meaning it’s passenger roulette.
…cases will rise for 90ish days then bend downwards (using Jun 1st)…
What is this? Numerology? No, the downward bend comes after stringent enforcement happens. Look at Arizona–where’s the downward bend
after 90 days?
…the curve started to bend BEFORE the measures could have any effect…
Really? The reality is that in most places, people instituted distancing and hand-washing and masks BEFORE the shutdowns because they could see it coming. What you have now is people being extremely stupid in the rising states.
“Poof”, it will just go away.
/s
“The reality is that in most places, people instituted distancing and hand-washing and masks BEFORE the shutdowns because they could see it coming.”
Which means the shut downs were not necessary, as back dated R0 was declining before the shutdowns began. A Nobel prize winning scientist later said that the shutdowns were a huge mistake. Simply, protection of the most vulnerable should have been the priority, not shutting down everything considered non essential.
“What you have now is people being extremely stupid in the rising states.”
Social unrest was predicted to occur within 4 to 6 weeks after the shutdowns began. When Newsom finally opened the hiking trails, they were mobbed. People had been pent up too long. Being mobbed, there was little ability to practice social distancing. The government over reacted, shutting most everything down and got an over reaction when they opened things up. One of those Newton’s laws things.
“Mother Nature and COVID-19 are in the process of electing the next President.”
― Steven Magee
Dow 700K ?
[1] ICU beds will not run out. Why not? Because in every country so far they have showed an amazing ability to increase the numbers of ICU beds when needed. 97% utilization in one hospital is what is called cherry picking — it’s not the whole picture.
[2] Ventilators. Why do we need them? You’re a goner if they put you on one. Invasive ventilation means the doctors are still following WHO protocol and treating for ARDS when we already know this is primarily a thrombotic disease and that it is the inflammation that kills. That would mean the doctors are still killing people unnecessarily because they’re sticking with protocol instead of trying things that have proved effective.
[3] There is absolutely no scientific evidence that the shape of the curve correlates with the various kinds and degrees of measures introduced by the public health authorities. In virtually all cases, the curve started to bend BEFORE the measures could have any effect (5 days incubation, 7 days disease progress = 12 days on average).
[4] I would like Mish to explain why the Imperial College study (non-peer reviewed, and afterwards shown to be shitty Fortran software) and the IHME have constantly been the pre-eminent sources of modeling, despite the fact that there are thousands of other institutions engaged in similar efforts. IHME & Imperial College & the WHO are all funded by Gates. How can this be a coincidence?
“Ventilators. Why do we need them? You’re a goner if they put you on one.”
My son in law’s brother was on one for a long time, 53 years old with a wife and two children, now recuperating at home. I’m sure he & his family are very pleased they tried to save him.
That does not mean it was the optimal therapy intervention. Any treatment that has a one year survival horizon of less than 10% seems sub-optimal to me.
They try other alternatives first, now, before a ventilator, but there are still those that need them. Also, with more refined protocols, particularly the administration of corticosteroids, the survival rate is now nearly 71%.
That seems a little ad hominem and whacked out. Did I ever say anything about a life worth living or not? I said invasive ventilation didn’t seem like a therapy with very good odds.
1–You do realize in Spain and Italy and NYC, due to shortages, decisions were made to not treat some people because it was seen they were in the most likely to die category. They were eased out of this world with sedatives. You may be able to have a bed somewhere, but do you have advanced or skilled care?
2–Knowledge advances, and there are steroids and blood-thinners that help some but still, for some the ventilator is one of the last options that does save lives.
3–Cases have been present in CA, AZ, FL and TX for quite a while–tell me where the magic 90 day turn-around is in those places?
4–Why should Mish or any other layperson defend a model made by an independent organization? It is clear that IHME f’d up from early on up but Trump jumped on it because it was ridiculously low. That’s how it became famous–it was the lowestof all models.
Re: 90 days – Since this is an R3 +/- (it varies) than cases should be growing at 10% daily, aka where TX has been the last few days. We can look at the data and see social distancing brings spread down to at or below R1, roughly 1-2% daily case growth, this will keep hospital beds open but not eliminate C19. As people resume normal-ish life, it bounces back, where the 90 days kicks in. Since the US is a large area with dispersed urban areas – expect to see hotspots rise and fall regionally.
Not asking Mish to defend anything, but the models that the MSM features all come from the same stables all the time. There are plenty of alternatives.
And that applies to ventilation as well. There are a whole host of ways to support ventilation without resorting to invasive intubation. Tons of papers out now on how to improve on this aspect of therapy.
As for Gates, it’s not a coincidence. He has been been very concerned about the possibility of a pandemic for a very long time, and has been trying to get people interested in preparing for it. Thus, the fact that he donated to multiple causes that here oriented to preparing for pandemics is not surprising at all. Sadly, however, no one listened to him, and we were woefully unprepared.
If you could go back to December 2019, would you nuke Wuhan?
That’s a question that makes no sense at all. No one could seriously think that the millions or billions of deaths that would result from a global nuclear war are in any sense comparable to the inconvenience of a pandemic.
Paul Ehrlich, James Hansen and others, Deep ecologists, contemplated daily the Unthinkable for a model-projected Sustainable 500 million global human pop. Even “The Day After Tomorrow” SciFi imagines a global winter. A Pandemic is the ultimate dream of deep ecologists, natural selection.
Thank you Dr Webej for your analysis of lives worth living, acceptable procedures, and your 1 year prognosis of Scooot’s relative through tele(pathic)-medicine.
Where are you licensed to practice?
Nothing that a little chlorox bleach can’t cure.
Just like the other hotspots, cases will rise for 90ish days then bend downwards (using Jun 1st)… just as folks completely freak out. The graph above will not be accurate through October, it will bend in September.
ICUs are near worthless, we know 88% of folks on vents die. I would like to see the double-blind clinical study that shows 12% is better than nothing at all – but that won’t happen for obvious reasons. Time for a sanitarium model, just like we used polio – why don’t we learn from history???
PS – I am not a “denier”, I am all for facemasks, but the trends are observable across basically all hotspots and ventilator data is well published.
Also, we 100% use facemasks and vigorous hand washing to reduce the spread. But, reducing is the best we can do with this one – it will pop up again and again. Americans culturally have an independent streak and are in the middle of the worst political divide of my lifetime – as a Realist myself, I realize we will not follow in the footsteps of more conforming cultures. So, I am taking personal responsibility, not “hoping” someone will do it for me.
12% was the recovery rate for ventilators when they were putting a lot of people on it. The reason was that ventilators made the problem worse. Now that they have learned to pronate people, a lot less go on ventilators. Also, now that they use MATH+, the recovery rate is much higher for those on ventilators. The British study on dexamethasone showed that adding corticosteroids reduced the death rate of those on ventilators by 35%. That makes the odds about 50:50 for those on ventilators now, not 1 in 8.
The biggest problems of course is that the people who are on the front lines managing this situation, either medical or public health workers, are not nearly as bright or well trained as their critics.
My apologies. I was wrong about the Dexamethasone trial. The death rate for patients on mechanical ventilation who were given Dexamethasone was 29.0%, not 50.0%. Care has improved a lot from the early days when the death rate was 88%.
Memorial Day plus a week
This will be a lesson in stupidity and hubris for the ages.
Agree. Likely to replace the Titanic as history’s most spectacular failure from arrogance. Unlike the Titanic this is not the failure of excessive trust engineering and science, it is the failure of political will and human behavior to use available science and engineering. It can be considered a failure of marketing…. those with knowledge and foresight were unable to persuade those with the power to make a difference.