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Hospitals continue to crack under the surge
Hospitals across the country are reaching their breaking point on ICU and bed capacity as COVID surges, forcing many health systems to begin diverting patients from emergency rooms and ration care, Axios’ Orion Rummler reports.
What’s happening:
- Pennsylvania: “Most hospitals in Montgomery County are at or near capacity,” county commissioners’ chair Valerie Arkoosh said in Norristown, Pennsylvania, last Wednesday.
- New Mexico Gov. Lujan Grisham (D) plans to allow hospitals to ration care depending on how likely a patient is to survive, the Washington Post reports. Grisham required residents to wear masks and re-enacted strict mitigation efforts.
- Georgia: Major hospitals, including Grady Memorial and Emory University, have had to turn away patients brought in ambulances, the Atlanta-Journal Constitution reports.
- South Dakota: The Monument Health Rapid City Hospital and Sanford USD Medical Center — some of the biggest in the state — say they have no more ICU beds, the Mitchell Republic reports.
- Colorado: More than a third of hospitals across the state said in a survey they expect staffing shortages this week, Colorado Public Radio reports.
Context: White House coronavirus task force coordinator Deborah Birx noted on Sunday’s “Meet the Press” that U.S. hospitals are usually anywhere from 80 to 90% full in the fall and winter — and “when you add 10, 15, 20% COVID-19 patients on top of that, that’s what puts them at the breaking point.”
U.S. and Europe head in opposite coronavirus directions
https://www.axios.com/us-europe-coronavirus-lockdowns-d2bb7b6c-a1c4-4a30-a4a3-8f564775dd74.html
While the U.S. continues to set records for new coronavirus cases, European countries have managed to turn their own terrifying spikes around.
The big picture: As some states in the U.S. crack down to head off the worst, the debate in countries like the U.K. and France has shifted to whether and how to lighten their own restrictions before the holidays.
- America’s surge lagged two to three weeks behind Europe’s, with a similarly worrying trajectory. However, responses in U.S. states have been uneven and generally less severe than in most European countries.
- Daily case counts are already rising significantly in most U.S. states, and they’re likely to tick up further following Thanksgiving gatherings around the country.
Much of Europe returned to some form of lockdown in the fall, but the restrictions tended to be less restrictive than in the spring. They certainly haven’t been in place as long.
- Many countries closed bars and restaurants, and nearly all at least limited their opening hours. Social gatherings were also limited — in Germany’s case, to groups of up to five from a maximum of two households (children are exempted).
- But schools have remained open across nearly all of the continent, and the disruption to economic activity, while highly significant, hasn’t been quite as severe (though many governments have faced anti-lockdown protests).
The fact that countries like Italy were able to bend the curve so quickly with partial lockdowns is encouraging, says Stephen Kissler, a researcher at Harvard who models the spread of diseases, including COVID-19.
- “The evidence shows that these full lockdowns we underwent in the spring aren’t necessary now,” he says.
- “We have so much more information now that we can respond a lot more quickly and in a more targeted manner — really just shutting down the types of activities that contribute most to the spread.”
Test positivity rates are falling significantly in many EU countries — another sign that the current wave is subsiding.
- In Belgium, for example, the positivity rate fell from 21% to 8% over the past three weeks, with similar trends in France and the Netherlands.
- The outlook is a bit darker in Central Europe. The Czech Republic still has a positivity rate of 21%, while Poland’s 49% rate is higher than every U.S. state but Idaho.
Reality check: Europe is far from out of the woods. Deaths and hospitalizations lag behind spikes in cases, and those numbers are falling much later and less sharply.
- Italy recorded a record-high death toll on Thursday, three weeks after case numbers peaked.
- And while the trajectory on cases is positive, public health experts fear a swift reversal if countries open up too quickly.
Governments in the U.K., France and elsewhere had promised the measures would be temporary and Christmas celebrations would still be possible. They’re now attempting a difficult balancing act with the virus still spreading rampantly.
- The U.K. is introducing the “Christmas bubble,” which will allow up to three households to gather together over the Christmas period.
- Spain is increasing the maximum gathering size from 6 to 10.
- Germany plans to tighten restrictions through Dec. 20 and then allow groups of up to 10 to gather.
The bottom line: In Europe, those decisions are being made with cases on the decline and the outlook improving. That’s not the case in the U.S.
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Nashville nurse, two roommates charged in large Halloween house party
Nashville police are criminally charging three women including a registered nurse for violating Metro Health orders after hosting a large house party on Halloween.
Roommates Madilyn Dennington, Bailey Mills and Olivia Noe, all 23, were issued misdemeanor citations in connection with an Oct. 31 football watch party at their East Nashville home on the 1200 block of Boscobel Street south of Fatherland Street.
Police spokesman Don Aaron said the women were served with court summonses on Monday and are slated to appear on the charges Dec. 16.
According to an arrest affidavit, officers responded about 6:30 p.m. to a complaint about a loud party at the home, heard music blaring and saw several people in the yard. In all, police said they found more than 100 people inside and outside the home.
When officers spoke to Dennington, Mills and Noe outside, they told police they had organized a watch party at their home for a football game, the affidavit states. The officers told the women that at that time, no more than 25 people were permitted to gather in Davidson County unless the gathering was approved by the city.
The women then went inside and told everyone to leave, police reported.
Police then alerted Metro Health officials about the party. Hugh Atkins, Metro Health’s environmental health services director, confirmed the Health Department did not receive an event application for the gathering.
Early last week, Nashville instituted a “rule of eight,” limiting both public and private events to eight people as the holidays approached — down from the previous 25-person cap. Tighter capacity restrictions on restaurants and bars went into effect in the city on Monday.
On Tuesday, Davidson County reportedan increase of 851 cases in 24 hours — the second-highest ever daily increase. So far 369 people in Nashville have died from the virus.
Meanwhile, Monday’s statewide numbers marked a record high increase in cases. The Tennessee Department of Health announced an increase of 7,975 cases and 48 deaths over the previous 24 hours. So far the virus had caused 4,602 deaths statewide.
A nurse and her roommates
Dennington is a registered nurse at TriStar Skyline Medical Center, authorities said.
It was not immediately known whether the hospital had taken any disciplinary action against Dennington. She did not return an immediate request for comment and blocked her Facebook page from a Tennessean reporter shortly after being contacted.
“Properly following pandemic regulations is extremely important to help reduce the spread of COVID-19,” Anna-Lee Cockrill, a spokeswoman for TriStar, said regarding the party. “We are looking into this further.”
According to their social media pages, all three roommates formerly attended the University of Mississippi before moving to Nashville, and Dennington and Noe both graduated from the University of Mississippi Medical Center.
Noe and Mills also could not immediately be reached for comment.
More than 50 arrests, 315 citations
Police data shows at least 50 people have been arrested and more than 315 have been cited under local emergency health orders that went into effect earlier this year.
Just this weekend, Nashville police issued nine citations and made one arrest after people refused to wear face masks in public, a mandated action in Davidson County.
As of late November at least dozen people had been arrested on Class A misdemeanor charges after police said they held large house parties and events. Some of them entertained as many as 600 people at a time, police reported. If convicted, they face up to a year in jail and a $2,500 fine.
As of Tuesday, only one of the arrested defendants had pleaded guilty: Jeffrey Mathews, a 36-year-old Goodlettsville dentist arrested for throwing an Aug. 1 house party on Fern Avenue in East Nashville. He was one of two men criminally charged for the party that drew hundreds.
Mathews, who apologized for his actions, was sentenced to three months of probation and eight hours of community service. His co-defendant, Christopher “Shi” Eubank, 40, remained at large Tuesday after failing to appear in court in October for a hearing on three counts of violating emergency health orders.
This is a developing story.
U.S. exceeds 100,000 COVID-related hospitalizations
More than 100,200 Americans were hospitalized as of Wednesday due to the coronavirus for the first time since the outbreak began in early 2020, per the COVID Tracking Project.
The big picture: The milestone comes as health officials anticipated cases to surge due to holiday travel and gatherings. The impact of the holiday remains notable, as many states across the country are only reporting partial data.
- Meanwhile, more hospitals are running out of beds or turning away new patients, limiting the care available to both coronavirus patients and those with other health care emergencies, Axios Caitlin Owens reports.
Flashback: The daily rate of new coronavirus infections rose by about 10% in week leading up to Thanksgiving, continuing a dismal trend that may get even worse in the weeks to come.
- Before the Thanksgiving holiday, the COVID Tracking Project warned of a “double-weekend pattern.
- “Far fewer people will be tested on Thanksgiving Day, and perhaps on the day after as well, and then the usual weekend pattern will begin,” it said.
- “Death reporting, too, will slow down for an unknown number of days.”
What to watch: That backlog is expected to clear sometime this week, resulting in a potentially confusing surge on all metrics in the meantime.
By the numbers: The U.S. reported 13.7 million cases (confirmed and probable), 1.4 million tests, 196,000 cases and 2,733 deaths on Wednesday.
- To date, 264,522 people in the country have died from the virus.
- California confirmed more than 20,000 COVID-19 infections on Wednesday — the highest daily case count for any state so far during the pandemic.
- Wednesday’s death count is the second highest on record since May 7, and marks the first time deaths have topped 5,000 over a two-day stretch.
Coronavirus hospitalizations top 100,000 for the first time
More than 100,000 Americans are now in the hospital with coronavirus infections — a new record, an indication that the pandemic is continuing to get worse and a reminder that the virus is still very dangerous.
Why it matters: Hospitalizations are a way to measure severe illnesses — and severe illnesses are on the rise across the U.S. In some areas, health systems and health care workers are already overwhelmed, and outbreaks are only getting worse.
By the numbers: For weeks, every available data point has said the same thing — that the pandemic is as bad as it’s ever been in the U.S.
- Yesterday’s grim new milestone represents an 11% increase in hospitalizations over the past week, and a 26% jump over the past two weeks.
- Hospitalizations are rising in 38 states, in some cases reaching unsustainable levels.
A staggering 29% of all the hospital beds in Nevada are occupied by coronavirus patients, the highest rate in the country.
- That represents an enormous influx of new patients, on top of all the other people who are in the hospital for other reasons — which puts a serious strain on hospitals’ overall capacity, and on the doctors and nurses who staff them.
- Fueled by that surge in coronavirus patients, 77% of Nevada’s inpatient beds and 80% of its intensive-care beds are now in use, according to federal data. And coronavirus infections are continuing to rise, so many more beds will soon be full.
Between the lines: Many rural areas already have more patients than they can handle, prompting local hospitals to send their coronavirus patients to the nearest city with some capacity left to spare. But as cases keep rising, everyone’s capacity shrinks.
- In New Mexico, for example, coronavirus patients are using 27% of hospital beds. To put that number in perspective: It’s a surge that has left the entire state with just 16 ICU beds left to spare.
Coronavirus patients are also filling 20% of the hospital beds in Colorado and Arizona. And in 32 more states, at least 10% of all hospital beds have a coronavirus patient in them.
How it works: Each week, Axios has been tracking the change in new coronavirus cases. But the Thanksgiving holiday disrupted states’ reporting of those numbers, and we’re afraid that could paint a distorted picture this week.
- The holiday led to some significant reporting delays, which would make the number of new cases seem artificially low — and then when states report that backlog of data all at once, the spike in cases could be artificially high.
- Hospitalization data is not subject to the same reporting issues, so we’re using that this week as a more reliable measure of where the pandemic stands.
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HENRY KOTULA 