Well played.

It would be like adding a 100 doors to every building on the off chance everyone wants to leave at once on any given day. — Cheshire

Again, this is why we look at actual numbers rather than guess what the numbers might be based on the strength of media interest.

Beds occupied by Covid-19 patients currently stand at about 2,500 out of 115,000 beds (source https://www.england.nhs.uk/statistics/statistical-work-areas/covid-19-hospital-activity/), about 2% of activity. About 20% of those 115,000 beds are occupied by those with avoidable illness (source https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/avoidablemortalityinenglandandwales/latest). — Isaac

A building normally has two doors, right? We'll call that the 115,000 beds normally occupied. Covid has required an extra 2,500. So your analogy is miles off - emotive hyperbole. It's not like adding a hundred extra doors (which obviously sounds ridiculous), it's adding an extra one twentieth of a door. Barely even a catflap.

So we take your absurd example derived from your hysterical guesswork, add some real figures from, you know, actually checking the fucking facts, and we find you're off by a factor of two thousand.

Your real example is the suggestion we add a catflap to every building to add a little extra escape capacity. Does that still sound so ridiculous now we've bothered to check?

There's no way to be constantly ready for a pandemic. Last year hospitals stopped doing elective surgeries to devote all the ICUs to covid19. Most hospitals are heavily dependent in the income from surgery, so ironically, hospitals suffered financially through the crisis.

Hope it goes well for you. I had a sore arm for a few days and some lethargy.

So we take your absurd example derived from your hysterical guesswork, add some real figures from, you know, actually checking the fucking facts, and we find you're off by a factor of two thousand. — Isaac

You just extrapolated from the hospital conditions on your island to support an argument that spans the globe. Make that make sense. I'll wait.

My house is on fire! Can't be because mine isn't.

There's no way to be constantly ready for a pandemic. — frank

I disagree. For a start, emerging pathogen monitoring was cut to the bone, it should never have been. Emergency measures were drafted but not acted on. Both would have dramatically reduced infection rates, as can be seen in the countries which acted more quickly than others.

That done, there should be no need for the crisis-level ICU occupation.

Secondly, still over 90% of ICU admissions have pre-existing comorbidities. We know from the preventable disease study I've already cited that better community healthcare can more than half ICU occupation. So half the existing occupation and nearly half the Covid occupation (half the comorbidities, halves the hospitalisations) and your ICU has bags of capacity.

Thirdly, I'm not, nor ever would be, advocating not using other forms if intervention - lockdowns, masks, sanitation, vaccines... I've never advocated just letting it rip. What I'm opposed to is the narrative which hides all of the massive societal failings which brought this crisis about under the blanket of vaccine hesitancy.

Vaccine hesitancy is a nothing issue, trivially unimportant compared to the practically genocidal strategies adopted by governments and corporations which are the root cause of this.

Thirdly, I'm not, nor ever would be, advocating not using other forms if intervention - lockdowns, masks, sanitation, vaccines... I've never advocated just letting it rip. What I'm opposed to is the narrative which hides all of the massive societal failings which brought this crisis about under the blanket of vaccine hesitancy. — Isaac

No one, literally no one, blames the crisis on hesitancy for a vaccine that didn't exist. You must wear very high boots in order to safely walk around in this much bullshit.

You just extrapolated from the hospital conditions on your island to support an argument that spans the globe. Make that make sense. I'll wait.

My house is on fire! Can't be because mine isn't. — Cheshire

Really? You're still persisting? Did you even check the figures, or did you , again, just presume I must be wrong because the telly says so?

https://scdhec.gov/covid19/hospital-bed-capacity-covid-19

Covid occupancy in the US 1,800 out of 13,000 beds, obesity the most common comorbidity in covid https://www.nature.com/articles/s41366-020-0640-5, over 90% of covid cases in hospitals have comorbidities https://pubmed.ncbi.nlm.nih.gov/32578683/.

Even without taking any other public health action your 100 extra doors example is out by a thousand fold. In the US, it's half a door extra.

Even assuming no other strategies at all (why we would assume that, I don't know) your building example is a hundred times too extreme. Maximum occupancy with no vaccine was about a quarter of available beds, so a normal two door building would need an extra half a door. Your hyperbole is absurd.

Even without taking any other public health action your 100 extra doors example is out by a thousand fold. In the US, it's half a door extra. — Isaac

An increase of only half the entire capacity? So, just make it 150% of what's available. Did I mention doormen were required. It's the same in regards to how practical it is as an undertaking.

No one, literally no one, blames the crisis on hesitancy for a vaccine that didn't exist. — Cheshire

I'm not talking about pre-vaccine times, I'm talking about right now.

An increase of only half the entire capacity? So, just make it 150% of what's available. — Cheshire

Even without taking any other public health action...why we would assume that, I don't know — Isaac

Read first, comment second.

Oh, and England in the 80s had double the hospital capacity we have now. It's not hard.

disagree. For a start, emerging pathogen monitoring was cut to the bone, it should never have been. Emergency measures were drafted but not acted on. Both would have dramatically reduced infection rates, as can be seen in the countries which acted more quickly than others. — Isaac

Your perspective is afflicted by a disconnection with the real world. Chinese authorities knew about the pathogen and they responded by suppressing communication about it. This is just one of the thousand ways pathogen monitoring can be reduced to reporting on what we already know.

It's called Murphy's Law.

Secondly, still over 90% of ICU admissions have pre-existing comorbidities. We know from the preventable disease study I've already cited that better community healthcare can more than half ICU occupation. — Isaac

That sounds absurd, but let's go with it. We've cut ICU occupation in half. What you're missing is that ICU capacity is not space. It's trained staff. What you're suggesting is that my hospital could pay nurses, therapists, pharmacists, secretaries, central supply employees, intensivists, radiologists, cardiologists, neurologists, surgeons, orderlies, and me to stay at home until the next pandemic.

Seriously?

Really? You're still persisting? Did you even check the figures, or did you , again, just presume I must be wrong because the telly says so? — Isaac

F-that monkey noise. Tell me why your quoting British figures and trying to tell me something.

Oh, and England in the 80s had double the hospital capacity we have now. It's not hard. — Isaac

Seriously? — frank

Good. I thought I was insane.

Your perspective is afflicted by a disconnection with the real world. — frank

Pathogen emergence used to be monitored to a greater degree than it is now, so it did actually happen in the real world. Countries did put swifter emergency measures in place and thereby reduced their case load, that actually happened in the real world too.

That sounds absurd — frank

Really? Why do you think that 'sounds absurd'? Do you think I'm likely to just quote figures I've got no support for, is that something my posting history suggests?

What you're suggesting is that my hospital could pay nurses, therapists, pharmacists, secretaries, central supply employees, intensivists, radiologists, cardiologists, neurologists, surgeons, orderlies, and me to stay at home until the next pandemic. — frank

How are your shifts? Busy? In England 18hrs is not uncommon for a junior. No-one would have to stay at home, just a normal fucking working day would do it.

Besides, as Cheshire was so delighted to pretend I didn't say, I'm not suggesting a need to double normal capacity (though we could), increasing capacity is one of a number of things which need going, including better community healthcare, hygiene, lockdowns and vaccines.

Tell me why your quoting British figures and trying to tell me something. — Cheshire

They're American figures there. Read first, comment second

Besides, as Cheshire was so delighted to pretend I didn't say, I'm not suggesting a need to double normal capacity (though we could), increasing capacity is one of a number of things which need going, including better community healthcare, hygiene, lockdowns and vaccines. — Isaac

It turns out people have to actually take the vaccines.

Tell me why your quoting British figures and trying to tell me something.
— Cheshire
They're American figures there. Read first, comment second — Isaac

They weren't initially; nor is the one posted to support the claim. Which isn't quoted here.

Oh, and England in the 80s had double the hospital capacity we have now. It's not hard. — Isaac

It turns out people have to actually take the vaccines. — Cheshire

That might well be why, several pages back, I said...

I think vaccination is an excellent public policy response in general. — Isaac

I think vaccination is an excellent public policy response in general. — Isaac

To a pandemic? But, that requires quick production of a vaccine. If there's not enough data about something that was produced just recently; people will pretend it's deficient. And we'll have to use a business with access to vast resources. All of them are evil for some reason.

To a pandemic? — Cheshire

Yes.

But, that requires quick production of a vaccine. If there's not enough data about something that was produced just recently; people will pretend it's deficient. — Cheshire

Some will, others clearly won't.

And we'll have to use a business with access to vast resources. — Cheshire

Why?

All of them are evil for some reason. — Cheshire

Pretty evil, yes. I'd call restricting access to a life-saving vaccine and thereby leading to thousands of deaths evil. The head of the WHO seems to agree likening it to "apartheid". Why, do you think that's just OK behaviour?

Really? Why do you think that 'sounds absurd'? — Isaac

It just doesn't square with my experience in trauma, neuro, surgical, and medical ICUs that half of the patients on any given day wouldn't be there if they'd had better preventative medicine. Are you sure you weren't looking at hospital admissions vs ICU admissions?

And we'll have to use a business with access to vast resources.
— Cheshire
Why? — Isaac

But, that requires quick production of a vaccine. — Cheshire

To make a lot of something fast requires many something makers.

Pretty evil, yes. I'd call restricting access to a life-saving vaccine and thereby leading to thousands of deaths evil. The head of the WHO seems to agree likening it to "apartheid". Why, do you think that's just OK behaviour? — Isaac

This is a different thread.

To a pandemic?
— Cheshire

Yes. — Isaac

Fin

Are you sure you weren't looking at hospital admissions vs ICU admissions? — frank

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7390529/

...was where I got the figure from. Other studies have given lower figures, but still over half, it seems to depend on what comorbidities are measured (obviously)

https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(21)00074-0/fulltext

Obesity alone gives ten times the likelihood of ending up in ICU, miss that out, your figures are going to be a lot lower. Just a thought (not trying to be disparaging to Americans, but maybe you guys don't even see obesity as a comorbidity? It's so common in the US).

The point would still stand even at the lowest figure I've seen (~60% if I recall).

To make a lot of something fast requires many something makers. — Cheshire

Does it?

This is a different thread. — Cheshire

You brought it up.

To a pandemic?
— Cheshire

Yes. — Isaac


Fin — Cheshire

I wish.

To make a lot of something fast requires many something makers.
— Cheshire
Does it? — Isaac

You asked why a large corporation is necessary for the production of a large quantity of vaccine in a short time frame; by implication of suggesting a vaccine is a proper response to a pandemic.

You brought it up. — Isaac

You did. It's essentially a child asking to mail his vegetables to Africa in regards to how it relates to this discussion.

I wish. — Isaac

Granted.

Discussions, concerns and admonishments have been appreciated. — 180 Proof

Thank you :flower:
It's rather selfish of me to want you to be around for a long, long time, but it is what it is. :flower:

I'd like to call it love but I don't want you to be uncomfortable

...was where I got the figure from. Other studies have given lower figures, but still over half, it seems to depend on what comorbidities are measured (obviously) — Isaac

I don't see how that article supported your claim. Could you point it out specifically?

:kiss:

England with a population of 54,000,000:

Beds occupied by Covid-19 patients currently stand at about 2,500 out of 115,000 beds — Isaac

US with a population of 331,000,000:

Covid occupancy in the US 1,800 out of 13,000 beds — Isaac

So England has almost 10 times as many hospital beds as the US with about one sixth the population? This would mean there is (roughly) 1 bed for every 556 people in England and 1 bed for every 25,460 people in the US. Surely this cannot be right?

I don't see how that article supported your claim. Could you point it out specifically? — frank

Sure. Take the 72.2% figure from the first study (which didn't include obesity) and add to it the OR (as a factor of case admissions) in the Lancet study. I get 91.4%

Other studies I've read since have shown obesity to be a much higher factor in ICU admission - this one https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7262326/ for example has it at 76%, but since it didn't use separate ORs I couldn't add that one (as I'd have no way of knowing how much overlap in comorbidity there was - obese and CVD for example)

Either way, if you're happy with the data from the CDC showing over 90% of hospital admissions have underlying comorbidity, and the data (again CDC) showing over 90% of mortality with underlying comorbidity, then why would you be suspicious of ICU admission rates which match. It'd be odd if the didn't match wouldn't it? A lower ICU rate than admission rate would mean that hospitals were actually increasing the general risk for healthy patients. Possible, I suppose, but seems unlikely.

If you're interested (I can never tell whether you genuinely are interested or whether you're just playing 'catch Isaac out'), anyway - on the off chance you're actually interested from a medical point of view - this article breaks down the ICU requirements in term of ORs https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228874/?report=reader.