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Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

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Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#131

Post by guscost »

henrikschroder wrote: post #127
guscost wrote: post #97

Earlier quoted context omitted.

https://www.nytimes.com/interactive/2020/04/21/world/coronav... http://euromomo.eu There's nothing for the USA as a whole, it will be compiled from states' records and estimates eventually. But it already seems obvious to me that the excess deaths in the next few years from secondary effects (avoiding hospitals, drug overdoses, suicides, stress/panic attacks, less traffic/police on roads, etc) will far outnumber the…

The CDC has all-cause excess mortality tracking and graphs here: https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm As far as I can tell the numbers are statistically computed estimates, based on real reported deaths, so it's not actual counted deaths, and there's still reporting lag skewing the last couple of weeks.

Thanks, yes it looks like recent weeks are weighted for under-reporting (how to figure out the weighting with so much chaos is another question), and they're estimating that a little over 60% of excess deaths in the past few weeks were caused by COVID-19.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#132

Post by axguscbklp »

macintux wrote: post #104
umvi wrote: post #84

Earlier quoted context omitted.

So... you propose just staying on lockdown indefinitely until "adequate testing is in place?" And when will that be? It could be 6 months from now or more so long as the Trump administration is running things. Lockdown isn't "free" like you seem to think. It has a very heavy cost. And some day (if not already), that cost will outweigh the lives saved from doing it in the first place. Because the combined suicides/men…

I have yet to hear anyone explain how we’re going to lose millions of lives due to the lockdown, whereas the risks of opening up without sufficient testing include that as a very real possibility. Yes, it stinks that people are suffering due to the lockdown, but the government could (if it were so inclined) pay people to stay home indefinitely. It clearly can’t manage the virus, however.

>the government could (if it were so inclined) pay people to stay home indefinitely

I'm a bit skeptical, and would be even if instead of "indefinitely" we were just talking about a couple of years. I'm not necessarily disagreeing, but I'm curious about how the math would work out, in your opinion.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#133

Post by stereo »

brianwawok wrote: post #11
aluminussoma wrote: post #3

There is also another opinion: that many people go to the ER who don't really need to go there. I had to visit the ER recently. I did not want to go but my doctor insisted. A family member who is also a doctor also insisted I go. The ER was eerily empty. The ER doctor saw me immediately. There were only a couple of other patients that I could see. This contrasts to prior experiences in the ER where there is a long wa…

A lot of people don’t have insurance. You can’t go to a doctor for a $150 appointment without insurance. But you can go to the ER when it gets really bad for a $2000 appointment (which you don’t pay. May go to court against you but if you are poor, they won’t collect)

Countries where that isn't the case are seeing a big drop too.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#134

Post by brianwawok »

partiallypro wrote: post #52
brianwawok wrote: post #11

Earlier quoted context omitted.

A lot of people don’t have insurance. You can’t go to a doctor for a $150 appointment without insurance. But you can go to the ER when it gets really bad for a $2000 appointment (which you don’t pay. May go to court against you but if you are poor, they won’t collect)

That's what walk-in clinics (Urgent Care) are for. You can visit those often without insurance.

What?

At every one I have been to (not a lot I admit, maybe 4 in my life), I had to both provide insurance card AND pay my copay before a doctor would see me. Without payment, they send you to go to the ER.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#135

Post by AstralStorm »

pmiller2 wrote: post #90
sfj wrote: post #79

Earlier quoted context omitted.

> Opening things back up prematurely, without sufficient testing, is just going to get people killed. But how many will get killed? Allowing people to drive down the street also kills people. What's the limit?

Well, do you have research on how many excess deaths there would be if states started opening up now? California is taking a cautious approach by only opening in stages after cases have stabilized, and only after testing is present. Do you have a better plan than what a group of public health experts have come up with?

One thing I'm not seeing happening is surveys and epidemiology related to impact of various measures undertaken, to keep the ones most effective and lose the others that are superfluous.

This could be done by comparing measures taken in a big random sample of confirmed cases with big random sample of general population.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#136

Post by roca »

6nf wrote: post #32
umvi wrote: post #24

Are just the ERs empty? Or the whole hospital as well? If hospitals are empty, it's time to stop sheltering in place, because it means it's working too well . What's the endgame? We can't just keep the country shut down indefinitely. Life must move on. Even though there's still a lot of fear, I think reopening the country is the best option (while still maintaining social distancing, etc).

To echo your point: In New South Wales, Australia the medical sector had 1000 ICU bed capacity in January. When covid hit, it was rapidly expanded and currently over 2000 ICU beds are available. At the same time all elective surgeries got banned (e.g. hip replacements etc) because some of those would end up in ICU. At the peak of the outbreak NSW used 100 of those 2000 beds. Currently only about two dozen ICU beds ar…

The good news for Australia is that you are probably eliminating the virus and will be able to reopen everything soon, safely. The key point of the comment you are responding to --- "If hospitals are empty, it's time to stop sheltering in place, because it means it's working too well" does not apply to Australia, because it assumes a "flatten the curve until we reach herd immunity" strategy which is not Australia's strategy.

The real problem in the USA and most other Western countries is that there is no clear strategy to defeat the virus. The actions being taken are mostly consistent with "flatten the curve and wait for herd immunity", but that pretty much guarantees crippling economic damage and mass death.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#137

Post by [deleted] »

macintux wrote: post #104
umvi wrote: post #84

Earlier quoted context omitted.

So... you propose just staying on lockdown indefinitely until "adequate testing is in place?" And when will that be? It could be 6 months from now or more so long as the Trump administration is running things. Lockdown isn't "free" like you seem to think. It has a very heavy cost. And some day (if not already), that cost will outweigh the lives saved from doing it in the first place. Because the combined suicides/men…

I have yet to hear anyone explain how we’re going to lose millions of lives due to the lockdown, whereas the risks of opening up without sufficient testing include that as a very real possibility. Yes, it stinks that people are suffering due to the lockdown, but the government could (if it were so inclined) pay people to stay home indefinitely. It clearly can’t manage the virus, however.

[deleted]

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#138

Post by scarmig »

Trasmatta wrote: post #18
scarmig wrote: post #10

It'd be interesting if the quarantine from the coronavirus has also quarantined us from the ravages and stresses of day to day life, leading to improved cardiovascular outcomes. I'd be curious about suicide statistics as well--would they be going up or down right now?

Anecdotally, I feel like stress has gone way up for most people, not down. Not sure it's that's true or not on the larger scale, but it definitely seems true for me and most of the people I know.

Interesting. For me, it's involved a sharp decrease in stress, though that's overlapped with quitting my job and having a substantial financial cushion.

Re: Eerie emptiness of ERs worries doctors: where are the heart attacks and strokes?

#139

Post by grogenaut »

abalone wrote: post #71
SkyPuncher wrote: post #23

Earlier quoted context omitted.

My wife is a doctor. Not an ER doc, but had to do rotations through the ER and frequently interacts with the ER in other rotations. The amount of non-emergencies the ER department sees is astounding.

That would not explain the 40-70% reductions the article cites in actual emergency admissions (strokes etc). Update: whoever downvoted this, I challenge you to state why.

I down voted it because you are arguing about down votes (meta rating) which is against the etiquette / rules.
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