Tag Archives: James A. Bacon

COVID-19 Update: Edvard Munch Edition

The latest data from the Virginia Department of Health indicates that Monday saw the biggest single-day increase in the number of new confirmed COVID-19 cases yet in Virginia – 239 cases, bringing the total to 1,250.

The 29 new hospitalizations were the biggest one-day increase yet, bringing the total to 165.

Total deaths increased by two to 27. The number of new tests increased by 1,263 to 13,401 total.

The number of reported new tests has declined three days running from when it peaked at 1,929. Far from administering more tests, Virginia’s hospitals, doctors, and public health authorities appear to be administering fewer. Hopefully, this apparent decline is an artifact of the statistical reporting system, not reflective of real-world shortages in testing equipment or bottlenecks in administering the tests.

Here are John Butcher’s latest calculations of doubling times:

Case count: 3.21 days
Hospitalizations: 3.72 days
Deaths: 2.77 days Continue reading

Some Perspective

I have appended the number of COVID-19-related deaths to a ranking of the leading causes of mortality in Virginia, based on 2017 data, the most recently available from the Centers for Disease Control.

The number of COVID-19 deaths will increase, of course. For purposes of comparison, the Institute for Health Metrics and Evaluation forecasts that Virginia could experience 1,543 deaths — roughly equivalent to the number of drug overdoses.

(Hat tip: Sheila Gunst)

— JAB

Virginia Should Issue Immunity Certificates

Yesterday I argued that Virginia should allocate a chunk of its COVID-19 helicopter dollars from the federal government to conduct widespread testing for the presence of coronavirus antibodies. If the antibodies are present, the person presumably is immune to the sickness and should be free to re-enter society and the workforce.

Turns out, the Germans are planning to do just that. The Telegraph reports that Germany plans to introduce coronavirus “immunity certificates.” Researchers plan to test 100,000 members of the public at a time and issue documentation to those who have overcome the virus.

Explains Gerard Krause, the epidemiologist leading the project: “Those who are immune can then be given a vaccination certificate that would, for example, allow them to be exempt from any (lockdown-related) restrictions on their work.”

After saving lives, the No. 1 priority of the Northam administration must be to expedite a return to economic normalcy. Public health authorities in Virginia should bend every effort to make immunity certificates a reality.

— JAB

COVID-19: Up, Up, and Away

The latest data from the Virginia Department of Health:

Total confirmed COVID-19 cases Sunday: 1,020, up 130 from Saturday.
Total hospitalizations: 136, up 24 from the previous day.
Total deaths: 25, up three.
Total tests: 12,038, up 1,429.

Doubling times: John Butcher has updated his calculations of how long it takes for these epidemic metrics to double. Based on the latest data, the doubling time has lengthened a tad, a tentatively positive sign.

Case count: 3,18 days
Hospitalizations: 3.71 days
Deaths: 2.65 days

Beds, Ventilators, and Epidemiological Models

by James A. Bacon

The Richmond Times-Dispatch is getting frustrated with the lack of hard information about the COVID-19 epidemic forthcoming from the Northam administration. Reporter Bridget Balch has been trying to track down data on the number of ventilators in the state to treat patients stricken with respiratory afflictions. Frustration with the Northam administration’s lack of responsiveness is leaking into her news coverage.

Virginia, with a population of 8.6 million, has 2,000 ventilators on hand, Balch quotes Cotton Puryear, spokesman for the Virginia COVID-19 Unified Command Joint Information Center, as saying Friday. That’s the first time I’ve seen that number. Balch’s article pointedly says that the newspaper had been asking for the number since March 16.

Virginia public health authorities have not released any own internal forecasts of expected demand for ventilators, But the state has requested an additional 350 ventilators from the national stockpile, Puryear said.

Also, regional groups comprising the Virginia Healthcare Management Program “have ventilators that can be deployed to hospitals,” said Julian Walker, spokesman for the Virginia Hospitals and Healthcare Association in a statement. But is not clear if those ventilators are included in, or in addition to, Puryear’s 2,000-ventilator number. Continue reading

COVID-19: Doubling Every Three Days

The latest numbers from the Virginia Department of Health, reflecting yesterday’s developments:

Cases: 890, up 151 from previous day.
Hospitalized: 112, up 13 from previous day.
Deaths: 22, up 5 from the previous days.
Tests: 10,609, up 1,443 from the previous day.

Here’s John Butcher’s cheerful little calculation, based on the latest data, of the “doubling time” for key Virginia metrics:

Case count: 3.14 days
Hospitalizations: 3.68 days
Deaths: 2.56 days

And then there’s this: The Institute for Health Metrics and Evaluation has forecast when the virus will start overwhelming hospital capacity in the 50 states. The Institute forecasts that Virginia will encounter “peak resource use” on May 2, 2020. At that point, 3,435 hospital beds will be needed. Virginia has more than enough beds, so there will be an acute-care “bed shortage” of zero. The problem is that Virginia will need 512 ICU beds. Only 329 will be available, creating a shortage of 183 ICU beds. Also, Virginia will have a shortage of 276 ventilators. Continue reading

What Can Northam Do, and Not Do, about COVID-19?

by James A. Bacon

Two days ago, Peter Galuszka posted an interview he conducted with state epidemiologist Lilian Peake, a key functionary in Virginia’s response to the COVID-19 crisis. I found her responses appalling. The degree of passivity cannot be overstated. Her responses to most of Peter’s questions amounted to: “We’re tracking and monitoring the situation.” If the Northam administration was actually doing anything, it wasn’t evident from this interview. (Here’s my snarky summary of what little she had to say.)

One can glean from media accounts that the administration is working behind the scenes on some things, though to what effect it is impossible to tell. The only clearly visible leadership emanating from Richmond has been Governor Ralph Northam’s move to take strong — some might say excessive — action to enforce social distancing (and shut down much of the economy in the process).

Meanwhile, testing kits remain in short supply, making it impossible to accurately track the spread of the coronavirus; the commonwealth still has yet to develop an epidemiological model to help it forecast the spread of the disease; and the healthcare industry is in a state of panic over the looming shortage of hospital beds, personal protective equipment, and ventilators. As for taking measures to put people back to work, I’ve seen nothing. Zippo.

Broadly speaking, there are three main clusters of issues, and we need clarity of thinking about each one: (1) implementing social-distancing measures to slow the spread of the virus; (2) expanding the capacity of hospitals and healthcare practitioners to care for the inevitable surge in COVID-19 patients; and (3) getting people back to work as quickly as possible without undermining measures to counteract the virus. Let’s look at each one. Continue reading

Quantifying the Hospital-Bed Shortage

Source: ProPublica by way of Virginia Business.

by James A. Bacon

Two weeks ago, I raised the alarm: Virginia doesn’t have enough hospital beds to cope with the COVID-19 virus; capacity was most constrained in Northern Virginia. Yesterday, Bacon’s Rebellion contributor Jim Sherlock explained why: Certificate of Public Need (COPN) regulation throttled the addition of hospital beds in the Northern Virginia area. Now Virginia Business magazine — which is really stepping up its news coverage, by the way — explores the repercussions.

If only 20% of Virginia adults contracted COVID-19, hospitals in all metro regions across Virginia would be overwhelmed, according to data from the Harvard Global Health Institute.

The most staggering results from the Harvard study come from the Arlington hospital referral region (HHR) — which encompasses Fairfax County and other Northern Virginia localities. If 60% of adults were to become infected there, hospitals in the region would require an increase of nearly 600% more hospital beds to deal with the crisis. The Newport News region — which includes Williamsburg — takes a close second. Hospitals there would need nearly 500% more beds if 60% of the adult population were to be infected.

So, it is abundantly clear that Virginia does not have enough hospital beds if the COVID-19 virus continues spreading at an exponential rate. The big question is: What are we doing about it? Continue reading

COVID-19 Update: Buckle Your Seatbelts!

The number of confirmed COVID-19 cases is surging, according to the latest data from the Virginia Department of Health. Confirmed cases reached 604 yesterday, a one-day increase of 164, the biggest yet. Meanwhile, the number of COVID-19 victims hospitalized increased to 83, also the biggest one-day increase yet seen in Virginia.

It is difficult to gauge how much the increase in the number of confirmed patients is due to actual spread of the disease and how much to increased availability of testing kits. The number of Virginians tested yesterday, 1,148, also set a record. The evidence I’ve seen suggests that the identified cases represent just the tip of the iceberg. Hundreds, if not thousands, of patients with COVID-19 symptoms are not being tested, due to a shortage of tests. In all likelihood, the epidemic has sunk much deeper roots in the population than indicated by the official numbers.

As the production and distribution of testing kits accelerates, a new bottleneck may emerge: a shortage of medical practitioners to administer the tests. Health professionals require training to give the test and they must wear personal protective gear when doing so. The training issue may be a short-lived problem, but the chronic shortage of protective clothing and equipment may be more difficult to solve as scarce supplies are allocated disproportionately to “hot spots” such as New York.

— JAB

COVID-19: More Everyday Heroes…

Beech Tree Elementary to the rescue! When Beech Tree mother Van Nguyen heard about the shortage of medical face masks, she put her sewing skills into action and produced 20 masks. Local medical professional pleaded for more. Then Beech Tree 5th grader Caroline joined the effort. Learning how to sew from her mother and YouTube tutorials, she has completed three face masks and has 30 more in production, reports the Fairfax County Public School community relations staff.

Scanning for fevers, donating masks. Based on its experiences dealing with the COVID-19 situation in China and Singapore, Micron Technology, which operates a semiconductor manufacturing plant in Manassas, is using noninvasive thermal scanners to determine if entering employees have a fever.  Sick employees can be told to return home. The company responded early to the epidemic, increasing site-cleaning rotations, making changes to cafeteria serving, and restricting large gatherings. The company is sharing its experience with other major employers across Virginia — and joining other firms, such as Huntington Ingalls, the Newport News shipbuilder, in donating personal protective gear to healthcare workers, reports Stephen Moret, CEO of the Virginia Economic Development in a recent communication to economic development partners.

Another $1 million for tests. The Charlottesville-based Quantitative Foundation has donated $1 million to UVA Health to accelerate the number of tests performed by the health system from 200 daily to more than 500. The grant provides for putting aside a portion for inpatients at other Virginia hospitals and for clinical providers and first responders with symptoms. Prior to the deployment of UVA Health’s in-house testing, patients were waiting five to nine days for results. Thanks to the UVA Health’s ability to produce its own tests, local turnaround time has been cut to 24 hours.

A limited number of trained personnel has constrained the ability of UVA Health to administer tests. The hospital system’s lab is using the grant to add a new lab tech position. That, in addition to the current cross-training of existing laboratory personnel, reports UVAToday, will allow testing in a second shift. The funds will also be used to order a second robotic instrument which, when installed, will further increase capacity.

— JAB

COVID-19 Update: The Epidemic Intensifies

The Virginia Department of Health has published yesterday’s COVID-19 numbers, and they continue to show a rapidly spreading epidemic.

Total confirmed cases (the tip of the iceberg) have risen to 460, an increase of 69 from the previous day.

The number of hospitalizations has risen to 65, an increase of six from the day before.

The number of deaths has leaped to 13, up from nine.

The number of tests has surged to 6,189, up 819.

— JAB

Cancel Your Print Subscription, Save a Bundle, and Support Intellectual Diversity in Journalism

Newspapers with breakfast. End of an era.

I cut the cord today — I stopped subscribing to the print edition of the Richmond Times-Dispatch. I’d been delaying the inevitable for a long time, but a 50-year habit of reading the newspaper over breakfast and coffee was hard to break.

Here’s what did it for me: The print-digital subscription is $70 per month. The digital-only subscription is $12 monthly. What am I getting for the extra $58 a month? Almost nothing. (My wife will miss the puzzles, but she’ll get over it.) When it came time to re-subscribe, I realized I could save almost $700 a year. To me, that’s not chump change.

That got me to thinking…. Bacon’s Rebellion readers, you can do it, too!

If you’re tired of subsidizing a publication whose news articles reflect a steadily constricting view of the world — the liberal/progressive worldview of newsroom editors and writers — stop being a doormat. Speak out in the only way that will make an impression. Cancel your print subscription. Then take half the money you save, donate it to Bacon’s Rebellion, and support intellectual diversity in Virginia media.

— JAB

NoVa Healthcare Adapts to the Epidemic

Alex Krist

by James A. Bacon

The Washington region, including Northern Virginia, is a looming epicenter of the COVID-19 epidemic. Known coronavirus cases in the metropolitan area now exceed 1,000, according to the Washington Post. And it will surprise no one to know that the number of cases confirmed by medical tests represents the proverbial tip of the iceberg.

Of the 25 patients he has seen so far this week, says Dr. Alex Krist, a Fairfax County primary care physician, he would say that five of them carried the COVID-19 virus. They had coughs, shortness of breath, chest pains, and fever — and a week-and-a-half ago they’d been to New York. Given the shortage of test kits, however, they didn’t qualify to be tested. In Northern Virginia, he says, tests are being used not for epidemiological purposes (to track the spread of the disease) but as a screening device to determine if patients are appropriate candidates for ICUs and respirators.

Things will get much worse in Virginia before they get better, says Krist, a Virginia Commonwealth University research professor who chairs the U.S Preventive Service Task Force.

Spurred by emergency conditions, Northern Virginia hospitals and doctors are changing the way they practice medicine, Krist tells Bacon’s Rebellion. “We’re going to run out of hospital beds. We’re going to start trying to treat people at home.” Continue reading

Who’s Got ICU Beds?

ICU beds per 100,000 people aged 60 and older, by hospital referral region

As Virginians try to formulate rational COVID-19 policy, it would be helpful to know how many ICU beds there are in Virginia hospitals. We’ve got a handle on the count of acute-care beds, but the number of ICU beds, reserved for the most critically ill patients, is perhaps an even more critical. Virginia public health authorities have not released that number, as far as I can tell, and I can’t find the data on the Internet. However, the Wall Street Journal did obtain data for ICU beds in Virginia’s hospital referral regions and published the map above showing ICU beds per 100,000 people aged 60 and older.

Here’s a close-up of Virginia:

The Washington Post breaks it down a little differently: ICU beds per 10,000 Americans aged 16 and over. The WaPo provides the following numbers for Virginia HRRs:

Arlington — 2.3
Lynchburg — 2.5
Winchester 2.5
Charlottesville — 3.2
Norfolk — 3.3
Richmond — 3.5
United States average — 3.6
Newport News — 3.6
Roanoke — 4.7

COVID-19 Update: Ignore What I Said Yesterday, the Virus Is Going Exponential

John Butcher was right, and I was wrong. I was hoping, based on the previous two days’ worth of data and a heap of wishful thinking, that Virginia was heading up a less steep slope in the growth in the number of COVID-19 infections than widely feared. John maintained, however, that the data was consistent with an exponential growth curve. Today’s data update by the Virginia Department of Health shows that John, better known as Cranky, as in publisher of Cranky’s Blog, was right.

The number of total cases, new cases, hospitalizations, and fatalities all surged. Total cases in Virginia reached 391 yesterday, a single-day increase of 101. More ominously, hospital admissions rose to a total of 59, a one-day increase of 14. Tragically, the number of deaths leaped from six to nine.

The commonly cited rule of thumb is that the virus doubles in the early stages of the localized spread every three days. The numbers suggest that Virginia is no exception to the rule. Fasten your seatbelts, ladies and gentlemen, it’s going to be a bumpy ride!

Click on “Leave a Comment” below to view John’s updated graphs.

— JAB