Gov DeWine deploys National Guard to hospitals as COVID deaths surpass 2020 | Hacker News Reader

Gov DeWine deploys National Guard to hospitals as COVID deaths surpass 2020

ohiocapitaljournal.com

38 pointsGeekette117 comments

I have a friend in southern Ohio who is an ICU doc. They’ve been dealing with +140% occupancy for the last few weeks. Staff shortages in their hospital are due to people leaving the field entirely (either worn out, tired of patient abuse, or actually dead). Vaccine mandates had almost zero impact.

95% of Ohio deaths were the unvaccinated.

Vaccine mandates clearly helped.

9 of 10 patients in Ohio hospitals are unvaccinated.

The issue with vaccine mandates is they weren't strict enough.

I think what they mean is nobody got vaxxed

They meant the number of healthcare workers leaving the field due to vaccine mandates was negligible.

> Your antiscientific rhetoric is bullshit.

I didn't read it that way.

> The issue with vaccine mandates is they weren't strict enough.

That was how I interpreted GP's statement.

You caught me before my edit. I realized I was wrong in the read on the comment and revised it within a minute of posting.

I think that they are commenting specifically on the reasons for the staff shortage, in response to the popular claim that people are quitting their jobs over the vaccine mandates.

That’s absolutely my point

is this 9 out 10 stat real ? Where i live, govt has tried to spread those numbers, but they were actually incorrect: That 9 out of 10 number they talked about was actually the chance of ending in hospital if infected depending on vax or not ( aka : you're 9 times more likely to end up in hospital if you're not vaxed)

But hospitals were actually in majority filled with vaxed people.

From what I've read the hospitalization ratio between vaxxed and not tends to mirror the death ratio between the two. Within ~10% or so. E.g. 9:1 might become 8:1

It's the stat in the article.

In my hospital (located in Ohio), yes it's about that. We are seeing the overwhelming majority of deaths from unvaccinated individuals. I don't have the exact number in front of me but I believe before I logged off on Friday it was somewhere in the upper 90%s. Like basically every other hospital system in the state we've been above capacity for months.

99% of the death certificates my friend has written in the last few months have been for unvaxxed people. More than 90% in their care are unvaxxed.

To be clear, the vaccine mandates for healthcare staff had little to no impact on actual care. Very few professionals were unvaxxed and even fewer left/were dismissed as a result of not vaxxing (i.e. they got vaxxed). The staffing is low because providers are leaving or have left the field due to horrid conditions. However, the real issue here is that the bed count didn’t go down just because there was no one to cover… Hospitals in many places are simply being inundated with patients (mostly unvaxxed).

Beyond Covid, this is a very scary situation that will only get worse as the numbers continue to climb in the region. You do NOT want to need medical care of any kind right now in NE Ohio.

We just canceled our trip to see family in Cleveland as a result. My youngest has a bad cold (PCR negative) but if that were to get passed to my elderly parents or asthmatic nephews, things could escalate quickly.

It almost doesn’t matter how severe Omicron cases are if the net result is hospital overload.

https://www.cleveland19.com/2021/12/17/cleveland-clinic-post...

Considering that these hospitals are already full, this will get worse before it gets better.

It has been two years at this point, it is a shame on those in charge that the hospitals aren't up to handling the issue now.

I wish it was a criminal matter, but unfortunately it isn't the case.

Clearly fault lies in many areas but how could admins avoid this?

Their staff is exhausted and quitting far beyond normal attrition levels. The public continues to get sick and now another surge is upon them.

What knob do you turn that they haven’t?

If we cared about up front treatment as much as we cared about vaccinations and stopped seeing one as preventing the uptake of the other we'd see a lot less hospitalizations.

> What knob do you turn that they haven’t?

Higher pay.

Training of COVID-only staff, separation of COVID patients into dedicated hospitals, etc. It's all been done before. Many COVID patients just need basic attention and oxygen, the ones with really complex needs tended to have other serious illnesses anyway.

I don't consider the admins to be in charge, I am thinking the head of health departments: they should have massively upped beds, machines and so forth and improved working conditions, including a massive pay boost.

I am a little skeptical about the claims in the article that Ohio COVID deaths are higher in 2021 than in 2020. I have been building tooling around the CDC excess deaths reports [0]. Ohio looks like it did not have the same peaks in 2021 as it did in 2020 [1]. There would have to be 11,778 more deaths recorded at this point to catch up to 2020.

Certainly the situation is unacceptable and terrible. But I am not convinced that it is much worse in 2021 than in 2020.

[0]: https://mcculley.github.io/VisualizingObservedDeaths/

[1]: https://mcculley.github.io/VisualizingObservedDeaths/Ohio.pn...

[2]: Ohio deaths:

2018: 124,296

2019: 123,359

2020: 142,210

2021: 130,432

If only being a nurse paid as much as attending virtual scrum meetings

It does if you're willing to be a travel nurse and work on covid floors. I've been hearing $6000/week numbers being thrown around (and some nurses are picking up two contracts at a time!). It's insanely shitty work right now (surrounded by people dying left and right and understaffed on top of that, but the pay is good...).

Have to incorporate a premium for the travel nurse job being not in your home office, income being more volatile than a salaried job, and travel nurses are independent contractors so they have to pay for housing/health insurance/taxes.

The $6k per week easily comes down to $3k per week or less of comparable W-2 income, which you can come close to or surpass doing virtual scrum meetings with none of the income volatility of nursing nor the messiness or risk of being infected or attacked. And not seeing your family/friends after work.

The travel job typically has housing built in too and often per diems. So probably closer to 4-5k equivalent! But quality of life isn't great to your point. Software is the objectively better job there unless you're really passionate about nursing!

I would appreciate any help in squaring things like this story with seeing 50k plus in (indoor) sports events with no masking or other remediation measures. And they’re in the same or adjacent states. Is it merely that they’re tolerating the deaths and sickness as less important that their inconvenience?

Because 65% of Ohio's adult population has chosen to receive vaccines and want to live normal lives because of it?

So they think that covid is over for them so they can go on? What about the unvaxed amongst them?

Why should a person who is vaxxed worry about being around unvaxxed, unmasked people in public indoor settings that they’ve chosen to be in?

Uhh, delta and omicron are contagious to doubly vaxxed. And spreadable by these people as well. You’re gambling to some degree that you won’t have a problem or you won’t be around those who are at higher risk. I hope it’s a good gamble with omicron as this will greatly facilitate switching to endemic but nobody’s sure yet.

The risks of someone my age having serious COVID issues are rather low. I am also fully vaxxed on Pfizer and don't have major underlying health issues. I'm perfectly accepting of the any personal risk because the risks are extremely low. In fact, I had COVID recently (kids caught it at school and brought it home), and my symptoms were very mild and didn't prevent me from working of functioning close to normal. Of course, we all followed proper quarantining guidelines and did not have contact outside of our home with anyone during that period.

If other people who are at higher risk have not chosen to appropriately mitigate their risks with the numerous tactics at their disposal, such as vaccination, masking, social distancing, etc. than I do not feel much of a duty to avoid being around them, if they are going to be at places I want to be.

This is region locked. Why do the Americans need soldiers in hospitals? Are these some kind of special medical unit or something?

insufficient staff, too many patients

Here's a copy of the article from archive.today: https://archive.md/PhD5l

Thanks!

FTA:> “Earlier in the pandemic, our concern in our hospitals was about beds, was about space, today is about personnel,” DeWine said. “22 months. 22 months of this pandemic has taken its toll on our health care workers, and that is certainly, certainly understandable.”

> Of the 1,050 national guard troops being deployed, about 150 are medically trained personnel who can assist in helping patients. DeWine insisted that he and Adjutant General John Harris have worked together to ensure the deployment won’t mean pulling people away from a hospital day job to go work at a different hospital. The remaining 900 troops will be tasked with support services.

> “They will do many things to help the hospitals in this time of great, great crisis,” DeWine said. “It will involve transport within the hospital, food and the environmental work that goes on in hospitals and is so very important every single day.”

This is not unique to the USA, e.g. in the Netherlands the army assists in testing and vaccination campaigns [1]. This is just common sense, those organisations have a large number of people (who in peacetime have not much more to do than exercise and maintain their equipment) who are trained to act in a short times notice and can deploy facilities which are not available to civil authorities.

https://www.defensie.nl/onderwerpen/coronavirus-covid-19

The organizations that employ healthcare workers, and indirectly the organizations that pay for healthcare, do not want to pay sufficient wages to incentivize people to work in the roles needed to provide the level of healthcare expected by the population.

Instead of fixing the remuneration so that people are incentivized to work in healthcare, the easier solution for leaders is to “draft” who chose to be eligible to be drafted in emergencies and have them work. In reality, this is simply displacing healthcare workers from elsewhere.

https://www.reddit.com/r/medicine/comments/rhbri5/comment/ho...

It is leaders of today destroying trust in emergency organizations, protocols, and structure to avoid paying higher wages. Why would anyone sign up for national guard when your role includes having to work because of insufficient wages causing lack of supply of labor?

This really doesn’t have anything to do with wages. Healthcare staff just don’t exist in the quantities we need right now.

It’s a worst case scenario with a bunch declaring early retirement, even more changing professions due to COVID trauma, and lack of proper pipelines of staff.

This has everything to do with wages. Nurse to patient ratios have been getting smaller and smaller for many years now. It is a common topic in medical forums.

It is combined with a worst case scenario, but it is compounded by the fact that a parent or young person is going to look at Mar 2020 and decide to not go into nursing because all they got was a sign saying they were heroes in exchange for working with an infectious disease, while many others got to sit at home on their computers.

The situation for nursing homes is even worse than hospitals and nurses. It actually terrified me, even pre pandemic, to think about the level of care I would get if I had to be in an assisted living facility being taken care of by someone earning $12 per hour also taking care of 19 other people. I would rather opt for suicide.

Wages don't matter. We offer 2-3x market rate and still have x000 vacancies.

People simply do not exist right now. It's very tough.

>Nurse to patient ratios have been getting smaller and smaller for many years now. It is a common topic in medical forums.

Again...this doesn't matter right now because the supply of nurses is just nonexistent.

It matters in the grand scheme. The pandemic started 21 months ago, and there is still insignificant movement in wages.

Also, if you offered 20-30x, the people would exist (for your facility). And if you offer 2-3x market rate and cannot attract people, then not only is x not the market rate, but 2-3x is not either.

It has nothing to do with attracting people...they just don't exist.

Our best shot is targeting nursing school/other technical school grads, but that still doesn't help fill senior roles.

Basic economics:

"Market rate" is what clears the market - no extra supply or demand.

If you have vacancies at your asking price, you are below the market rate.

In the long run, sure, but it takes years to train a nurse. It’s not hard to imagine that there are simply too few with the training able to do it.

I don't think you understand what "does not exist" means.

The article says that about 150 of the 1050 troops deployed are medically trained. Most will be providing support services where needed.

The national guard exists to answer the call of the state governor for all sorts of things. You’ll also see them deployed for state emergencies like a hurricane or tornado.

Think of it as a quick to mobilize population of volunteers that are trained to do various things.

Yes this is one of the main benefits of having military type orgs available even if not in conflict - you have a group of proven competent people, trained to execute orders that you can deploy into a variety if situations where people power is useful/important. The British Army were used for the 2012 Olympic as marshals etc as G4S messed up the preparations.

Not everything in a hospital requires medical training. Some stuff is purely logistical.

Because our hospitals are over capacity - specifically well over 100% nurse to patient capacity - the guard members will likely be helping with all of the non-medical work nurses would normally do in non pandemic times. Stuff like cleanup, re-supply of rooms and supply closets, maybe some check in work that sort of thing.

This is caused by staffing shortages. Our hospitals thought it was a good idea to fire nurses and staff over the summer.

why did they get fired?

It's a secret we will never know the answer to. Maybe historians from the far future will find some clues.

Some got fired. Some quit and found different, better paying jobs. The reality is that being on staff, working at the bedside in a hospital is a hard job with mediocre pay. But hospitals will give docs huge bonuses and pay travel nurses 2-3x what they pay nurses already on payroll. My wife was an RN at a major pediatric hospital and took a job at a private practice. Much easier job, closer to home, better pay. The hospital called her a month after she left and offered a 5k rehire bonus. Thank you, but no.

They would not take the covid vaccine. These vaccine mandates have consequences.

Nurses and doctors already get pumped full of vaccines as part of their job requirement, so what makes this particular vaccine so special?

It has a more dangerous risk profile than the previously accepted vaccines. Our medical system should be guided by informed consent not coercion.

> It has a more dangerous risk profile than the previously accepted vaccines

Is there compelling research that shows this is actually true? There is elevated risk of heart inflammation, but in my understanding that is not an unprecedented vaccine side effect. I haven’t seen an in depth comparison to established vaccines though

As for neurological side effects, I just read this a morning this large study from uk comparing risks between the conventional platform ChadOx, the BioNTech mRNA platform, and actual coronavirus infection. The two vaccine platforms seen at least on par with each other, and both favorable to infection

https://doi.org/10.1038/s41591-021-01556-7

This one came with political side effects.

Insignificant consequences. https://www.fiercehealthcare.com/hospitals/how-many-employee...

Scanning for 20 seconds showed some of those numbers are 5% of the workforce, that's not insignificant.

I'm near Dayton, Ohio. We had lots of protesting back in August by self-proclaimed medical personnel who were unhappy with vaccine mandates. How many of these people were actually medical personnel, and how many actually quit due to their opposition to the mandate isn't clear, but the feeling I was left with was that a significant number of local medical personnel were unhappy with the mandate.

Mandates and threats are counter productive. Lotteries are associated with waste and make government seem desperate. If the government was really wanted to encourage vaccinations it would provide a fixed compensation.

Probably because procedure volume was down, so they canned people who they could. And then got caught off guard when demand increased again suddenly. Same thing happens over and over in manufacturing.

I haven't seen many "a truly free market would fix this" comments lately. Seen a whole lot of "we need more regulation" comments though.

I wonder if the race to the bottom is inherent in free market or if there's a truly free market solution to this issue with hospital staffing.

> if there's a truly free market solution to this issue with hospital staffing.

You are seeing it happen. People do not accept current labor prices for healthcare work, politicians come under political fire for not providing sufficient level of healthcare, politicians increase funding to healthcare to increase pay, possibly requiring increasing taxes if they cannot figure out how to punt them to future generations.

Or insufficient number of voters want to direct more resources to healthcare to those that cannot afford it out of their own pocket, and they get less or lower quality healthcare. Maybe society decides it is not worth the cost of supporting people past 90, or even 80.

There's plenty of people willing to work at the offered salaries, there is a structural problem in the licensing process preventing them from doing so.

Where is the structural problem?

Total time from high school to nurse can be as low as 16 months, plus however long to get government paperwork.

https://bestaccreditedcolleges.org/articles/how-long-does-it...

A case can be made for doctors who have limited residency spots effectively capping new yearly supply, but what possible argument could there be for nurses other than nurse pay is not high enough to attract more people to nursing?

People changing bedpans get paid $10 to $15 per hour in many states, who wants to do that unless they have zero other options?

The number of people accepted is too small.

Hundreds of people applying for dozens of slots. The trainers that are training are not well compensated.

How do you know the people not accepted would have made desirable nurses? Surely one would want some minimum standard for the people poking you with needles and administering your healthcare/medicines.

> The trainers that are training are not well compensated.

This is just another insufficient pay scenario.

I don't know it, but I sort of take it as a given that the marginal rejectees are going to be roughly as capable as the marginal acceptees. It's not really an aggressive assumption.

And it isn't just an insufficient pay scenario. Hospitals just pass on the high cost of nursing to patients instead of subsidizing training programs. Patients don't see the supply as part of the cost problem and don't demand that more money be devoted to education.

Yes, the feedback mechanisms get quite complicated because 80%+ of people cannot not afford the level of healthcare that they receive.

But the root of the problem remains the disparity in people’s expectations of the services they will receive with the amount those service providers are getting paid.

Any kind of efficient resource allocation relies on accurate predictions. No matter what system you use, free market or otherwise, if reality is constantly defying prediction, or changes too quickly, allocation won't be great.

There's a huge bottleneck in training and education of the licensed professionals involved in nursing.

To have a 'truly free market', there wouldn't be government licensing (a similar role would likely be carried out by third party certification).

I don't think that eliminating licensing would improve anything, but the regulation of nurse training absolutely needs to be included in the discussion of the problem.

It's inherent when quarterly numbers trump long term stability. If managers are only incentivized to meet short term numbers, they make decisions that are detrimental to the future to meet present-day goals. Our financial markets reward this (though there's a question about why they do this that's open in my mind, as most of the money in the market is invested long-term!), so it trickles down into managerial metrics.

Health care is so regulated that the word free market doesn't make any sense.

A truely free market solution would be to train people specially to deal with COVID-19 cases and build a specialized hospital to deal with that. It would also bring the cost down.

I came across an amazing resource the other day that provides data driven insights specifically to Ohio's covid situation, and I'm surprised not to see it in this article.

https://coronavirus.ohio.gov/wps/portal/gov/covid-19/dashboa...

This site provides stats that breakdown hospitalizations by age and race and also reports inpatient and ICU capacity.

It seems right now hospitals are at about 80% capacity, and out of total capacity 20% is due to covid cases.

https://archive.md/PhD5l

Why on Earth are people still not getting vaccinated?

Because some people have already had COVID, received natural antibodies as a result, and are relying on time-tested science, logic, and intuition in their personal decision to not also get a set of shots + [x] boosters so they can be “safe”. By the way, do me a favor and solve for x in the above equation! And solve again a year from now. And again 5 years from now.

Influenza, tetanus, TBE and polio vaccinations also require repeat shots from time to time - and there are certainly more as these are only the ones that I can remember off the cuff.

In the case of the flu, the jury has always been out in it’s effectiveness due to the seasonal variation (the flu shot (notice how that’s never been called a vaccine, for good reason) is based on previous year’s strain.

Lumping that in with the rest of the diseases on your list where a vaccine can and does provide true immunity is a massive case of apples and oranges.

https://en.wikipedia.org/wiki/Influenza_vaccine

I completely agree that having been infected with COVID should excuse one from vaccine mandates, at least within some time frame. However, that isn't why most of the unvaccinated are unvaccinated. Only a few million people had been infected with COVID in the U.S. at the time the vaccine was released, around 1% of the population.

Not everyone goes to the doctor for a scratchy throat (primary symptom of Omicron, by the way), and as a result a huge number of data points are quickly excluded from that “1%” stat.

Right but if you have no diagnosis of Covid then the argument above doesn’t apply since you don’t actually have any evidence of “natural immunity”

We can say with fairly high confidence that the natural immunity rate is fairly low due to the infection rate of the unvaccinated vs. the vaccinated. If any significant portion of the unvaccinated had natural immunity, then the gap between the vaccinated and the unvaccinated would close since natural immunity actually confers more protection.

Of the many people who have told me that they have had COVID already, none have donated blood and received a free antibody test. I donated blood three times between the start of the pandemic and getting the first vaccine. I got three free antibody tests.

Most of the unvaccinated that I talk to who claim to have had COVID but won't give blood say they are scared of needles. So it makes sense they are scared of getting the vaccine.

Wikipedia defines a vaccine as "a biological preparation that provides active acquired immunity to a particular infectious disease."

It's not currently possible to be vaccinated, and calling our current treatment a "vaccine" is incorrect.

I don’t understand your point. It’s a vaccine, you get vaccinated, your body produces antibodies, your risk of catching the disease goes down, your risk of ending up in hospital nearly disappears

Anything is possible when you decide to change the definition of what something means. The CDC used to define “vaccinated” as “the act of introducing a vaccine into the body to produce immunity to a specific disease.” They changed that key word in the definition to “protection”, so sure if you move the goalpost on what something is, you absolutely can call this a “vaccine” and not an MRNA treatment!

Ok sure, it gives 95% resistance, not 100% resistance. So? Do we not mandate seatbelts because they only save your life 95% of the time?

Previous vaccines didn't provide "immunity" in that sense either.

The annual flu vaccine had 60% efficiency. Yet people didn't complain about it being called "vaccine".

From the fine article:

  > The nearly 14,000 Ohioans who have died this year were
  > almost exclusively — about 95% — unvaccinated individuals.

The key here is the words "this year". Most of the deaths this year occurred earlier in the year when vaccination was not available. I've tried finding the data on the state and CDC website a couple of times throughout the year to no avail. I would like to see the trend right now or at least the past couple months data.

When Ohio released it's "breakthrough" dashboard, I thought it was misleading as well since it included all of 2021 and the vaccine wasn't available to all adults until mid-April or so. Because of that, I started recording the weekly snapshots for a few weeks but lost interest. Since I was capturing weekly, you could just look at the new numbers. Here's what my data showed for Ohio:

Between Sep-15 and Oct-27, there were 2899 COVID deaths. Of those, 2625 were unvaxxed or partially vaxxed and 274 were fully vaxxed. So fully vaxxed deaths were about 9.5% of COVID deaths during that period. I stopped capturing weekly data at that point.

I just went and looked at it again with the most updated numbers and from Oct-27 when I stopped recording weekly data and today, 92% of Ohio COVID deaths are unvaxxed.

Given all that, I don't think starting at 2021 is all that misleading at all. Ohio's fully-vaxxed rate for adults is around 65%. Even assuming it was closer to 60% in the fall, you have 40% of the Ohio's population accounting for 90%+ of its COVID deaths.

Here are Ohio's monthly deaths for 2021 [1]. For December I took the deaths from the first through the 18th and extrapolated linearly.

  Jan  3611
  Feb  1324
  Mar   584
  Apr   558
  May   454
  Jun   227
  Jul   165
  Aug   736
  Sep  2174
  Oct  2341
  Nov  1009
  Dec  1752

[1] http://91-divoc.com/pages/covid-visualization/?chart=states&...

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