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Comment by zrail | Hacker News Reader

> in terms of covid hospitalisations overwhelming our hospitals: i‘m optimistic as well that this might not happen at scale.

I see no reason for this optimism. Every hospital that I know of in SE Michigan has been over capacity for several weeks. We have gotten regular emails from both hospital systems in Ann Arbor begging everyone to get vaccinated.

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This is inaccurate https://www.michigan.gov/coronavirus/0,9753,7-406-98159-5236...

Most people don’t realize that hospitals typically run at 98%+ capacity in the winter in a pre-COVID environment. This maximizes their profitability and allows them to operate relatively at a loss for the rest of the year.

This varies greatly between countries. In many countries hospitals don't have profits - they operate like courts or army with yearly budgets assigned by the government.

Michigan has certificates of need for hospital beds. Capacity is centrally planned (no doubt the incumbents are good friends with their regulators).

That's in addition to the games CMS plays with Medicare certification and funding.

Pre-covid, if you picked a random hospital at a random point in time in the U.S. there was a 16% chance it would be at max capacity and something like a 30% chance it would be over 80% capacity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840149/

It amazes me that hospitals are shutting down, healthcare worker numbers have barely recovered to 2018 numbers, bed capacity is shrinking in many areas and even still people think we have a healthcare crisis.

We've created 80% of all dollars ever created in the past two years. We have the money. It seems obvious (to me, anyways) our healthcare spending would explode in that sector and solve simple issues like capacity and worker shortage, if in fact that was an issue to begin with.

Healthcare workers take many years to train. When they die of COVID, go on long term disability because of long COVID, or burn out because they can't mentally handle watching another willfully unvaccinated person die, that person is irreplaceable in the short term.

HCW aren't on the decline because of any of those things (at least not primarily). This is made abundantly clear by looking at the steep dropoff in march of 2020 https://fred.stlouisfed.org/series/PAYEMS

HCWs are below where they would otherwise be because of policy.

Aside from that, long covid is psychosomatic. https://jamanetwork.com/journals/jamainternalmedicine/fullar... which means the root cause of long covid is likely misinformation about long covid to begin with (thanks "The Atlantic", for scaring everyone into being sick)

Above 75% is roughly considered to be high occupancy. Efficiency drops at that point for various reasons, such as the difficulty in moving patients between units due to a lack of beds. These numbers are also comprised of large regions of the state with multiple facilities, but the facilities still operate independently.

For adults, those regions of Michigan have the following ICU utilizations:

Region 1: 90%

Region 2N: 82%

Region 2S: 89%

Region 3: 94%

Region 5: 85%

Region 6: 87%

Region 7: 94%

Region 8: 72%

The NYT compiles per-hospital stats at [1], although the data is incomplete.

If Detroit were to not have beds available for patients, one option might be to transport patients as far away as Cleveland. There's a recent article discussing the situation at the Cleveland Clinic's 64 bed MICU [2].

[1] https://www.nytimes.com/interactive/2020/us/covid-hospitals-...

[2] https://fox59.com/news/national-world/not-gonna-make-it-out-...

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