Category Archives: Health Care

COVID-19 Update: All Trends Positive

Over the last few days I almost forgot we’re in the middle of a COVID-19 epidemic. Maybe that’s because thousands of people have been marching down the streets of Richmond and other Virginia cities in defiance of Governor Ralph Northam’s prohibition on gatherings of more than 10 people. But I will give the protesters credit. Many of them — and I’m not just talking about the Antifa wannabes — were wearing masks.

As it turns out, no epidemiological harm is likely to come from the mass gatherings. The spread of COVID-19 is on the downward slide, at least for now.

As can be seen in John Butcher’s chart above, the number of COVID-19 patients treated in Virginia hospitals is the lowest it’s been since late April. Likewise, as can be seen in the graph below, COVID-19-related deaths have declined markedly as well. Continue reading

Northam Relaxes Death Grip

by James A. Bacon

Governor Ralph Northam had a lot to say yesterday, some good and some not-so-good. In this post I’ll focus on the positive: Beginning Friday, most of Virginia will move to “Phase Two” of the rollback of COVID-19 emergency decrees.

Under Northam’s kinder, gentler Vulcan Death Grip, the maximum number of individuals permitted in social gatherings will increase from 10 to 50. Restaurants will offer indoor dining at 50% occupancy. Fitness centers can reopen at 30% occupancy. Other public venues — museums, zoos, aquariums, botanical gardens, and outdoor sporting and performing-arts venues — can reopen without restrictions: Current restrictions will continue for religious services, “non-essential” retail, and personal grooming services. Amusement parks and fairs will stay closed.

“Because of our collective efforts, Virginia has made tremendous progress in fighting this virus and saved lives,” the Governor said. “Please continue to wear a face covering, maintain physical distance, and stay home if you are high-risk or experience COVID-19 symptoms. Virginians have all sacrificed to help contain the spread of this disease, and we must remain vigilant as we take steps to slowly lift restrictions in our Commonwealth.” Continue reading

Government Goons Shut Down Hampton Restaurant

Photos by Bryn Mahan

by Kerry Dougherty

Like many Virginia restaurateurs, The Pepes were relieved when the governor finally allowed outdoor dining to resume earlier this month. The owners of several Peninsula eateries had been surviving on take-out orders since Gov. Ralph Northam’s executive order closed all Virginia restaurants in March.

They reopened The Barking Dog at the Sunset Creek Marina two weeks ago. It’s a casual, open-air burger and dog joint with a roof, picnic tables, benches with backs along the perimeter and zippered sailcloth windows that roll up.

More tent than than restaurant.

But some insufferable busybody reported them to authorities, claiming that The Barking Dog was an indoor restaurant and that the owners were violating the governor’s idiotic ban on indoor dining.

Which raises the question: WHAT THE HELL IS WRONG WITH PEOPLE?

Dissecting the COVID-19 Death Statistics

by Carol J. Bova

If you compare the COVID-19 hospitalization statistics published by the Virginia Department of Health (VDH) and the Virginia Hospital and Healthcare Association (VHHA), you’ll quickly see they don’t add up.

On May 30, the VDH COVID-19 dashboard showed a total of 4,601 hospitalizations. The same day, the VHHA showed that 5,745 patients had been discharged from hospitals, while 1,471 still were being treated in hospitals — a total of 7,216.

The discrepancy, more than 2,600 hospitalizations, is huge. It’s big enough to sway the way Virginians perceive the severity of the epidemic.

The explanation is simple, but hard to understand. VDH says, “The data we share is an underrepresentation of COVID-19 in Virginia….Our data are intended to answer questions about the epidemiology of COVID-19.” VDH is interested only in the severity at the time they learn of a case, not if it later requires hospitalization.

In April, the Virginia Hospital and Healthcare Association stepped up to answer critical questions about the utilization and availability of hospital beds and ventilators. The Association collected the daily numbers from the hospitals and published it along with the number of discharges and the number of hospitals with supply shortages Continue reading

COVID-19 Update: Knowns and Unknowns

Highlights from today’s data dump of Virginia COVID-19 data:

Total number of tests: 303,430
Total number of confirmed COVID-19 cases: 43,611
Percentage of tests that turned out positive: 14.3%

Total hospitalizations: 4,601
Percentage of confirmed cases that require hospitalization: 10.5%
Percentage of COVID-19 cases, known and unknown, requiring hospitalization: no one knows — but smaller than 10.5%.

Total deaths: 1,370
Deaths as percentage of confirmed cases: 1.1%
Percentage of COVID-19 cases, known and unknown, ending in death: No one knows, but smaller than 1.1%.


Chap Petersen and Pete Snyder: Get Virginia Back to Work

By DJ Rippert

Odd bedfellows? In a recent Op-Ed entitled, “Time to get back to business, Virginia” State Senator Chap Petersen, D-Fairfax, and entrepreneur and Republican activist Pete Snyder call for a more aggressive reopening of Virginia. The piece questions why large companies like Home Depot are allowed to thrive while “Mom and Pop” operations are being regulated out of existence. As the duo write, “Unlike the Wal-Marts and Home Depots whose sales have risen, small businesses have been devastated by the “shut down” economy of the past two months.” Their prescription for change is relatively simple: “What is needed is a defined plan for reopening Virginia’s small business economy, one that gets healthy workers back on the job, while still protecting the vulnerable from the spread of COVID-19.”

Continue reading

Uh, Oh, COVID Hospitalization Numbers Creeping Back Up

Here’s the latest from the Excel spreadsheet of John Butcher, publisher of Cranky’s blog: Daily COVID-19 hospitalizations are creeping back up, as can be seen in the graph above. And the total number of COVID-19 patients is rebounding as well as shown in the graph below: Continue reading

One More Time: The COVID Crisis Is Largely a Nursing Home Crisis

Source: Virginia Department of Health COVID-19 dashboard

by James A. Bacon

The daily numbers reported about COVID-19 in Virginia are volatile, and it would be imprudent to read too much into a single day’s statistics. But two numbers published on public dashboards this morning are symbolic of the true nature of the epidemic.

The first data point is the number of new COVID-19 deaths reported: 20.

The second is the number of of new deaths reported for long-term-care facilities: 19.

In other words, 95% of the deaths reported were of people living in long-term-care facilities. That’s just one day, to be sure, and there have been days when nursing homes accounted for only one-third of total deaths. Over the course of the epidemic, the percentage is 57%.

Surely, Governor Ralph Northam is aware of these numbers, even as he mandates the wearing of facial coverings and signs an executive order extending the state of emergency indefinitely. What’s so frustrating is how little he has had to say about the nursing home outbreaks and what he plans to do about them. At the risk of sounding like a broken record, let me repeat: The COVID-19 epidemic is mostly a nursing home epidemic. Continue reading

You Don’t Have to Like the Decree, But Wear Face Masks Anyway

Wise King Ralph keeps a face mask at the ready.

by James A. Bacon

I’m still digesting Governor Ralph Northam’s face-mask mandate, but my initial reaction is that it could be worse. I dislike the coercive aspect of his executive order. But requiring Virginians to wear face masks in public buildings and places of commerce is less intrusive than compelling businesses and workplaces to shut down. If ordering people to wear face masks allows Northam to feel better about loosening other restrictions, then it’s a net gain.

There’s an element to the face mask debate that I find curiously neglected in the conservative/libertarian commentary I’ve seen. Conservatives and libertarians tout the virtue of personal responsibility. Regardless of whether or not face coverings protect you from getting the COVID-19 virus, they do reduce the chances that you will spread the virus. If we believe in personal responsibility as an alternative to government coercion, conservatives and libertarians need to live their values by… acting responsibly.

I would go one step further: If conservatives and libertarians want to see Northam release his Vulcan Death Grip on Virginia’s economy, they should do everything within their power to ensure that the coronavirus does not spread. If Virginia sees a significant uptick in the spread of the virus, that’s all the Governor needs to back peddle on his timid reversal of emergency shutdown measures. Continue reading

Hypothesis: Improving Treatments Are Making COVID-19 Less Deadly

by James A. Bacon

The Wall Street Journal cited a revealing statistical measure of the COVID-19 virus that reflects upon the ability of different health systems to cope with the epidemic: the percentage of confirmed cases that result in fatalities. That number varies widely across countries and states.

The focus of the article was Singapore and Honk Kong, two densely packed cities that have kept the deaths-to-infections deaths ratio extremely low: 0.4% in Hong Kong and less than 0.1% in Singapore. Not only have those cities done a better job than the U.S. of containing the spread of COVID-19, the virus has proved to be less fatal when people get it.

By contrast, the case-fatality rate in the U.S. overall is 5.9%. That’s high, but not as high as the United Kingdom and Italy, where the figure stands at 14.%. In the U.S., New York City the rate is 8%, according to the Journal.

What about Virginia? Our case fatality rate peaked around 3.6% and has since declined to 3.2%, based on data published on public dashboards this morning. As can be seen above, the rate increased steadily from early April to early May, crested May 9 and 10, and has declined fairly steadily since. Continue reading

What Northam’s “Key Measures” Do and Don’t Tell Him

Source: Virginia Department of Health COVID-19 dashboard

by James A. Bacon

Later today Governor Ralph Northam will issue his mask-wearing mandate for Virginians. I’ll reserve comment about the details of the plan for when I see them. In the meantime, it is worth considering what data he might draw upon to justify his measures.

The Virginia Department of Health COVID-19 dashboard highlights several “key measures.” One, seen above, tracks the total number of COVID-19 cases. This particular graph strongly suggests that the COVID-19 epidemic is spreading as rapidly as it ever was — indeed it has ticked back up in recent days.

Reinforcing this impression, today’s VDH dashboard reports a record increase of new confirmed COVID-19 cases — 1,615. Data compiled over the weekend is subject to jinky behavior due to reporting delays, but that number follows 1,483 cases the day before. So, if the Governor wants to make the case that the coronavirus is still spreading, there is data to support him. The Washington Post, which can scarcely keep its pro-shutdown sentiments out of its news articles, picked up on the latter number in its news headline this morning — and we all know that Northam (or his people) pay close attention to the WaPo’s coverage.

However… Continue reading

Virginia Board of Health & the Infrastructure of Influence

by James C. Sherlock

The Virginia Board of Health (the Board) is by law a policy board (§ 2.2-2100) appointed by the Governor with the majority of seats specifically reserved for representatives of interests regulated by the Department of Health.

Virginia law gives the Board broad policy, regulation and enforcement responsibilities and duties to communicate to the General Assembly.

This arrangement puts representatives of regulated businesses in charge of developing and enforcing the regulations that govern their businesses. The Board then assures us they are advocating for the citizens and cites “advocacy concerning health care reform” as one of its core functions.

Really.  I could not make that up.

Continue reading

COVID-19 Counter-Factuals and Trade-Offs

by James A. Bacon

A recent Columbia University study generated headlines after concluding that 55% of deaths reported as of May 3 could have been avoided if stricter social-distancing controls had been implemented nationally just one week earlier.

Responding to that story, President Trump created a mini-furor by engaging in his usual ad hominem attacks. Rather than addressing the underlying facts and logic in the study, he called Columbia a “liberal, disgraceful institution” — as if labeling the institution ideologically did anything to rebut the rigor of the study.

A nuanced critic of the study might have questioned the validity of using epidemiological models to run counter-factual simulations. The outcome of models like the one used by the Columbia authors depends upon an array of critical assumptions — often debatable — about the relationship between different variables. As the old saying goes, Garbage In, Garbage Out.

Whatever the merits of the particular study in question, the flap revealed that the U.S. academic and media establishments now accept counter-factual simulations as legitimate news. Perhaps someone could build a model to answer a different counter-factual question: Given the fact that most COVID-19 deaths have involved elderly patients with one or more coexisting conditions, how many would have died anyway? Continue reading

Two Faces of the Face-Mask Mandate

by Sidney Bostian

Governor Ralph Northam will announce tomorrow the details of a statewide mandate to wear masks in public spaces and businesses. “We are working through the policy. Obviously it’s an equity issue,” Northam said at his Friday news conference, adding that all Virginia residents would need access to face coverings and that he is examining how to enforce such a policy.

“Wearing a mask could literally save someone else’s life,” Northam said. “That is becoming clearer every day as we move further into managing this virus over the long term.”

The justification cited above — “could literally save someone’s life” — is one of the most interesting “definite maybes” uttered by a public official in recent memory. A careful observer would note that Northam failed to cite his scientific sources for that statement.

Mask wearing in the COVID-19 era has become controversial. Proponents suggest that the coronavirus can be managed only if we compel everyone to wear masks. Opponents to mandatory masks flinch as if they are being asked to wear the “mark of the beast.” Virginians seem evenly divided with about half favoring masks and about half opposing (acknowledging that there are some who don’t care and will swing like a barn door).

Given the passions of the partisans on both sides, it is reasonable to ask that the Governor’s decree meet two tests. First, that there is scientific evidence that universal mask wearing will save lives, and second, that there are few if any citizens who will be adversely affected by long-duration, long-term use of masks. One would hope that Northam, a physician, would affirm the “do no harm” principle. Continue reading

Ralph Northam’s Sovereign Immunity

by Kerry Dougherty

Just as we were eagerly looking forward to a glorious Memorial Day weekend in Virginia Beach, Gov. Ralph Northam dropped a stink bomb.

At his Friday press conference, in his cloying, paternalistic way, Northam said he had some homework for the commonwealth. He wanted everyone to get a mask. Details to come on Tuesday.

Can’t wait. Clearly another authoritarian mandate is coming.

And good luck with your next edict, Governor. No one takes you seriously anymore.

Not after Saturday, anyway, when the whole world saw him frolicking on the Virginia Beach boardwalk, leaning in for selfies with fans and not even pretending to care about social distance.

Northam’s going to have a hard time continuing to whip up COVID-19 panic after this. He demonstrated that he wasn’t worried one bit about the virus. The media made much of the fact that Northam wasn’t wearing a mask on the boardwalk. Of course he wasn’t. Wearing a mask outside is idiotic and unhealthy. Who cares about that? Continue reading