The bad news: bureaucracy and mismanagement prevented hospitals who did need more space from using them.
The awful news: NY recommended people to stay home from the hospital even if they needed care, probably causing extra deaths and complications.
People without jobs had to get surgery now, before their CORBA ran out.
So yes, we definitely cut down transmission, but it's not clear that we would have incurred excess deaths due to capacity overrun. The biggest botteleneck is the presence of people on invasive ventilation; other clinical outcomes result in either the individual dying quite quickly (imagine a nursing home patient with multiple comorbidities), or in the patient recovering in 1-2 weeks. But there's that uncanny valley of people healthy enough to not immediately die but in bad enough shape that they need these aggressive interventions.
This is a big part of why I think we could have exposed much more people to the virus with only marginal increase in hospitalizations, by encouraging those who are not at risk to live as normally. It also makes it easier to centralize the resources where you do need it. For example it's much more feasible for government programs to handle food delivery, grocery delivery, and all these other logistical concerns when you only need to provide it for 10-40% of the country as opposed to 80% of it.
Serology in NY has shown us that we have maybe 1/8 of the population with antibodies as of a few weeks ago, which does mean that there was room for another doubling or too before transmission started naturally slowing down to a noticeable extent. So we absolutely could have had a lot more patient volume, but again the # of hospitalizations/invasive ventilation cases is much more related to the # of vulnerable people infected as opposed to the number overall.
(The classic argument here is that by fighting transmission in all members of the population, that the at-risk are better protected. For a number of reasons I think such an approach is misguided but I won't go into the full argument against that here)
I think there is an argument the system was overrun, at least in part. Sharing ventilators is an extreme situation, and the lack of PPE is a deadly risk. Staff wearing rubbish bags is not a sign of a system coping.
https://www.nytimes.com/2020/03/26/health/coronavirus-ventil... https://www.9news.com.au/world/coronavirus-new-york-hospital...
> it's not clear that we would have incurred excess deaths due to capacity overrun. The biggest botteleneck is the presence of people on invasive ventilation
I think it is an important point. What is implicit in your comment but I think is worth reminding people is that the survival rate of covid patients under invasive ventilation is about 10%. If everything else could scale up, it means we would only increase the death rate by less than 10% if the ICUs would be overrun.
This is largely what Sweden has been doing. They've succeeded in that they've kept a healthy margin of hospital/ICU beds free, but people are unhappy with the overall number of deaths. They've also largely failed at keeping the spread out of nursing homes (they have a similar 50% deaths-from-nursing-homes ratio to other countries).
Perhaps 15% of NYC has been infected, but not the US as a whole. And the efficacy of the antibody tests has proven problematic.
And good like trying to control the rate at which you "exposed much more people to the virus." As we've seen, all it takes is a few superspreaders to blast your "controlled" exposure into an exponential growth rate.
> And the efficacy of the antibody tests has proven problematic.
This statement is too vague to be of use. You should probably try to debunk specific serology studies rather than making hand-wavey dismissals..
---
(BTW I didn't respond to your other comment because it was in very bad faith as far as the "sacrificing at the altar of herd immunity" comment goes)
https://www.npr.org/sections/health-shots/2020/05/06/8504549...
This concerns me because my dad has congestive heart failure and can't get proper medical support right now.
What we should be doing is segregating hospitals, keeping some focused on COVID and others focused on non-COVID medical emergencies.
> ER admissions are down 50% or more depending in county.
But then spins it into some kind of conspiracy BS:
> ...missing people... ...swept under the COVID rug...
People did not magically recover from heart conditions during lockdown
Those people died, or skipped on critical treatment that would have made their condition improve.
One cannot help but wonder if those missing people are going to be swept under the COVID rug...
Meanwhile, field hospitals sit empty...
This isn't as significant as you might think... There is a large (very large in some communities) percentage of ER visits that aren't for real emergencies; rather, they are used for routine stuff, for which people with good insurance would go to their pediatrician or Urgent Care Clinic.
If you are broke, have crappy or no insurance, and can't afford a scrip of antibiotics, when your kid gets a fever or sore throat, you go to the ER. That's routine for -- I would bet -- hundreds of thousands of people throughout the year.
I think the effect you're describing does exist, but its certainly not the whole story. The fact is as well there's PLENTY of actual data available on this so we need not even be extrapolating based on our assumptions. The problem is any data that doesn't line up with our assumptions gets discarded because we don't know which datasets are good and reliable.