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Map of usage of intensive care beds in Germany

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Re: Map of usage of intensive care beds in Germany

#21

Post by a_bonobo »

This may make more sense if it's normalised by the size of each hospital? Small hospitals are immediately at limit and make a red dot for obvious reasons.

For example, there's a red circle next to Bremen, Alle-Weser-Klinik Verden, they have 131 beds [1]. Verden has about 27k inhabitants. There's a large blue circle in Baden-Wuerttenberg, Klinikum am Gesundbrunnen, they have 970 beds [2]. It's in Heilbronn which has 120k inhabitants.

So in a way, this is a population density map https://xkcd.com/1138/

[1] https://de.wikipedia.org/wiki/Aller-Weser-Klinik

[2] https://www.slk-kliniken.de/ueber-uns/daten-fakten/die-slk-k...

Re: Map of usage of intensive care beds in Germany

#22

Post by Someone »

pkaye wrote: post #12
cosmodisk wrote: post #4

Earlier quoted context omitted.

I think western countries have it worse: https://en.m.wikipedia.org/wiki/List_of_countries_by_hospita...

Some countries seem to have high bed utilization rates despite high number of beds. Is it due to more elderly population?

Part of it is cultural. For hospital beds, do you keep patients one extra night ‘just in case’, or do you send them home as soon as possible?

For IC beds, do you give patients the choice between going home to die a week later and a bed in IC that will make them live a bit longer, but with a less comfort and less contact with their loved ones, or do you always go for “all life is sacred”?

Some countries discus this with patients, even if the IC option has a chance of survival. That may sound unethical, but survival, for many patients, will be with much lower quality of life. They may have to move to a care home, stay on medication with severe side effects, may have to train hard for months to even be able to walk again.

Patients that already have a low life expectancy may choose to stay out of IC.

Re: Map of usage of intensive care beds in Germany

#23

Post by cycomanic »

DoreenMichele wrote: post #16
est31 wrote: post #10

Earlier quoted context omitted.

Interesting points, thank you. I previously mostly had the death rate for "ordinary" ICU admissions in mind, which were 50%. Didn't know that once you are you are connected a ventilator, you have a 80% death rate. To compare the effect of ventilators vs none, one needs good studies with randomized groups where one gets ventilators and the other doesn't. But I guess those aren't available and doing them is probably no…

I have a really serious lung condition. I used to use mechanical intervention to treat my condition. I have found other methods and no longer do that, in part because such interventions are hard to keep adequately sterile and are known to increase risk of antibiotic resistant infections because of that element. It's really not good to think of this problem space in terms of finding some group without ventilators at a…

The thing is generally for lung treatment doctors follow a path of escalation, start with less invasive methods like oxygen and progress to ventilators. With covid 19 there have been several reports from doctors that skipping this and putting the patient directly on ventilators directly significantly improves survival. Doesn't that contradict what you are suggesting.

Re: Map of usage of intensive care beds in Germany

#24

Post by [deleted] »

pacificmint wrote: post #7

Translation of the German captions: The number of hospitals that report that their ICU capacities as: Blue: Has Free Capacities (639 currently) Yellow: Some Contention (326 currently) Red: Fully Utilized (41 currently) Covid 19 patients in ICUs: 2453 (76% of which are on ventilators) ICU beds reported by hospitals: 19,663 (58% in use currently)

[deleted]

Re: Map of usage of intensive care beds in Germany

#25

Post by m0zg »

Would be cool to have this for NY as well. I have this nagging suspicion that the press is only showing the small number of hospitals that are overflowing, and not showing the ones that are under capacity, to stoke panic and drive clicks. Similar to the "mass graves" bullshit they wheeled out the other day.

To see why it's bullshit, one has to do some basic arithmetic. Consider that if life expectancy in NY metro area is 75 years and 21 million people live there, 1/75th of the population, or 280K people die per year in NY metro area alone. That's 7671 person per day on average. At the time of this writing 7844 people have died of corona in the entire state, total. I'd bet good money a good chunk (if not most) of these people would die of something else if it wasn't corona, so that's not a "net" increase. If you want to tell me these deaths require mass graves, I have some fine swamp land in Florida that you might want to check out.

Re: Map of usage of intensive care beds in Germany

#26

Post by DoreenMichele »

cycomanic wrote: post #23
DoreenMichele wrote: post #16

Earlier quoted context omitted.

I have a really serious lung condition. I used to use mechanical intervention to treat my condition. I have found other methods and no longer do that, in part because such interventions are hard to keep adequately sterile and are known to increase risk of antibiotic resistant infections because of that element. It's really not good to think of this problem space in terms of finding some group without ventilators at a…

The thing is generally for lung treatment doctors follow a path of escalation, start with less invasive methods like oxygen and progress to ventilators. With covid 19 there have been several reports from doctors that skipping this and putting the patient directly on ventilators directly significantly improves survival. Doesn't that contradict what you are suggesting.

Source?

I cited my source, above. What you're saying is news to me.

Without a source, I can only reply based on general life experience that most doctors are lazy and quick to prescribe drugs and surgery (or similar intervention -- in this case, ventilators) in place of trying to insist on educating patients and taking more low tech, often labor-intensive approaches instead.

I have seen all the handouts saying if you have allergies and respiratory problems, your first line of defense should be things like having wood floors at home instead of carpeting. Not once has a doctor ever sat me down and had a meaty discussion with me about my decor choices or similar. It's always been, at best, "Which drug is your favorite?"

Re: Map of usage of intensive care beds in Germany

#27

Post by woodruffw »

m0zg wrote: post #25

Would be cool to have this for NY as well. I have this nagging suspicion that the press is only showing the small number of hospitals that are overflowing, and not showing the ones that are under capacity, to stoke panic and drive clicks. Similar to the "mass graves" bullshit they wheeled out the other day. To see why it's bullshit, one has to do some basic arithmetic. Consider that if life expectancy in NY metro are…

The New York Times put out an article just yesterday[1] that directly addresses most of your doubts.

In summary:

* Substantially more people have died in both NYC and NY state than is demographically expected, suggesting a significant effect from the virus.

* Virus deaths are probably still under-counted, as bodies retrieved from homes aren't being tested. Patients with significant comorbidities may also be being mis- or under-counted.

I live in NYC, and all of my local hospitals are at the limits of their normal capacities (many have been able to expand their capacities, thankfully). The city has been asking for volunteers to come out of retirement.

To my knowledge, none of my friends or family have been able to get non-urgent treatment or tests for coronavirus symptoms; the system is completely focused on (and occupied with) treating those most at need.

Edit: I also forgot to mention: I don't know exactly what you're referring to w/r/t "mass graves," but I'm guessing it has something to do with Hart's Island. The city buries its unclaimed dead there; any uptick in activity probably tracks roughly with death's among the city's general demographics. It wouldn't be surprising for them to need a few more trenches.

[1]: https://www.nytimes.com/2020/04/10/nyregion/new-york-coronav...

Re: Map of usage of intensive care beds in Germany

#28

Post by watwut »

DoreenMichele wrote: post #20
Santosh83 wrote: post #19

Earlier quoted context omitted.

It's not PC. It's the typical frightened backlash from those who have invested their lot with reductionist logic and simply cannot face any other approach to problems. You find this quite commonly in the field for which this forum exists, hence the outraged responses to you.

My understanding of the term "PC" is that we basically try to be as inoffensive as possible in public. Where this encourages people to not use racist, sexist, etc language, it's generally a good thing. To the degree that it encourages people to hem and haw about uncomfortable truths, like "this is killing people," it's often counterproductive. I'm a former military wife. The military is not a culture that tries to po…

Nitpick: Lack of PC is not uncomfortable. Quite often it is about telling things the person finds comfortable and that feel good - the ones that imply speaker is superior or that someone was always right about world.

Re: Map of usage of intensive care beds in Germany

#29

Post by usr1106 »

m0zg wrote: post #25

Would be cool to have this for NY as well. I have this nagging suspicion that the press is only showing the small number of hospitals that are overflowing, and not showing the ones that are under capacity, to stoke panic and drive clicks. Similar to the "mass graves" bullshit they wheeled out the other day. To see why it's bullshit, one has to do some basic arithmetic. Consider that if life expectancy in NY metro are…

Yes, you really need to follow death rates.

According to some claims up to 70% of corona infections could not result in observable symptoms.

However, if you take just dying people, it would not come as a surprise that they are so weak that the additional infection can produce visible symptoms and their death is attributed to COVID.

In some places in Lombardy (Italy) the death rate is clearly higher. You didn't need the army to transport coffins before. No statistical anlysis required here.

The analysis is further complicated that death rates vary a lot over the year even under normal circumstances. I don't doubt that in some countries a corona peak will be seen, but it will still take months to be sure how big it is.

https://www.euromomo.eu/ shows long term death rates in selected European countries.

Re: Map of usage of intensive care beds in Germany

#30

Post by m0zg »

woodruffw wrote: post #27
m0zg wrote: post #25

Would be cool to have this for NY as well. I have this nagging suspicion that the press is only showing the small number of hospitals that are overflowing, and not showing the ones that are under capacity, to stoke panic and drive clicks. Similar to the "mass graves" bullshit they wheeled out the other day. To see why it's bullshit, one has to do some basic arithmetic. Consider that if life expectancy in NY metro are…

The New York Times put out an article just yesterday[1] that directly addresses most of your doubts. In summary: * Substantially more people have died in both NYC and NY state than is demographically expected, suggesting a significant effect from the virus. * Virus deaths are probably still under-counted, as bodies retrieved from homes aren't being tested. Patients with significant comorbidities may also be being mis…

Yes, Hart Island is being sold as "mass graves". Plus this right here clown (of "come to celebrate the Chinese new year, in spite of coronavirus" fame) said the other day there'd be _temporary burials_ in city parks: https://twitter.com/MarkLevineNYC?ref_src=twsrc%5Egoogle%7Ct...

My point is, as bad as the situation on the ground is in NY, the single digit percentage uptick in the overall number of deaths would most definitely not overwhelm anything at all, and given the dis-use of the emergency hospital capacity and reduced hospital and ICU admissions over the past few days, crowding in the hospitals seems like a load balancing problem to me.

And if anything, I would not be surprised if the official figures _overstate_ the death toll. Dr. Birx mentioned in the presser the other day that everyone who died _with_ C19 is counted as a C19 fatality, even if they did not die _of_ C19. Died of cancer but also have C19? You'll be counted as a C19 fatality.

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