Coronavirus

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Mormad
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ncsualum05 said:

Mormad said:

We're at 158 in the hospital, 27 in icu, 16 intubated

Update: we're at 175, and current projections are 250 by Christmas, and they feel like our death count over the next 10 wks could match that of the previous 8 months. Ouch.
Why? Why? Why?

I don't get it. We are almost a year into this. We should have the treatments now to help people in the hospital. People shouldn't be dying at increasing rates even if there's more spread right now. That doesn't make any sense. What is happening right now that's causing it to be so much worse than it's been most of the year? I know there's some bad behavior but that does not explain it all... there's been bad behavior this entire time. What county are you in and just what is going on?


I don't know, my friend. I haven't seen a predicted increased death rate, but an avg census of 250 would be 5x normal, and it's based on the current R value trending up in the area. I think they're thinking 5x the census could mean 5x the numbers of deaths projected out over 10 weeks even if the actual death rate is flat.

Hopefully we'll never see that sustained census over 2.5 months, but because of staffing issues they have to prepare for the worst so they're not caught with their pants down. Nobody gets mad at hospital systems for being overly prepared, but they do for being under prepared. Rightly so i guess.
Civilized
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Mormad said:

ncsualum05 said:

Mormad said:

We're at 158 in the hospital, 27 in icu, 16 intubated

Update: we're at 175, and current projections are 250 by Christmas, and they feel like our death count over the next 10 wks could match that of the previous 8 months. Ouch.
Why? Why? Why?

I don't get it. We are almost a year into this. We should have the treatments now to help people in the hospital. People shouldn't be dying at increasing rates even if there's more spread right now. That doesn't make any sense. What is happening right now that's causing it to be so much worse than it's been most of the year? I know there's some bad behavior but that does not explain it all... there's been bad behavior this entire time. What county are you in and just what is going on?


I don't know, my friend. I haven't seen a predicted increased death rate, but an avg census of 250 would be 5x normal, and it's based on the current R value trending up in the area. I think they're thinking 5x the census could mean 5x the numbers of deaths projected out over 10 weeks even if the actual death rate is flat.

Hopefully we'll never see that sustained census over 2.5 months, but because of staffing issues they have to prepare for the worst so they're not caught with their pants down. Nobody gets mad at hospital systems for being overly prepared, but they do for being under prepared. Rightly so i guess.

Thanks for the work you do, and for offering a very valuable first-hand perspective on these boards, Mormad.
Mormad
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I'll tell you honestly that the list of docs I'll let treat my family is short and distinguished. I don't trust many health systems, and the relationship between docs and hospital admin and insurance cos is mostly adversarial. But I'll admit that when it comes to this pandemic, the docs and hospital systems seem to be performing like our football team. They face the multitude of challenges and setbacks with this sht with care, thought, diligence, adaptability, and fortitude. I don't always agree with the decisions made, but I'm really proud of the way the medical community has faced the most challenging community health crisis of my career. I think we're doing our best. Thanks for the kind words, friend.
PackMom
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Thanks, Mormad.

Those numbers you listed - is that for the whole system or just your local hospital? Scary either way.
Pacfanweb
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AlleyPack said:

I wonder what deaths due to traffic accidents look like for 2020 vs. 2019.
Because I would think (total speculation, granted) that there's been less travelling in 2020 (due to Covid) from some people than in years past.

But then again, I could be totally wrong.
In the COVID-19 era, fatal accident percentages are up this year despite the smaller number of vehicles on the roads, NHTSA's latest data shows.

https://www.caranddriver.com/news/a34240145/2019-2020-traffic-deaths-coronavirus/


  • The National Highway Traffic Safety Administration (NHTSA) offers up another reason we need to get rid of COVID-19: reckless driving is up, and causing more deaths.

Mormad
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PackMom said:

Thanks, Mormad.

Those numbers you listed - is that for the whole system or just your local hospital? Scary either way.


Whole system. Burlington and asheboro not as bad, mostly the big 3.
ciscopack
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Mormad said:

ncsualum05 said:

Mormad said:

We're at 158 in the hospital, 27 in icu, 16 intubated

Update: we're at 175, and current projections are 250 by Christmas, and they feel like our death count over the next 10 wks could match that of the previous 8 months. Ouch.
Why? Why? Why?

I don't get it. We are almost a year into this. We should have the treatments now to help people in the hospital. People shouldn't be dying at increasing rates even if there's more spread right now. That doesn't make any sense. What is happening right now that's causing it to be so much worse than it's been most of the year? I know there's some bad behavior but that does not explain it all... there's been bad behavior this entire time. What county are you in and just what is going on?


I don't know, my friend. I haven't seen a predicted increased death rate, but an avg census of 250 would be 5x normal, and it's based on the current R value trending up in the area. I think they're thinking 5x the census could mean 5x the numbers of deaths projected out over 10 weeks even if the actual death rate is flat.

Hopefully we'll never see that sustained census over 2.5 months, but because of staffing issues they have to prepare for the worst so they're not caught with their pants down. Nobody gets mad at hospital systems for being overly prepared, but they do for being under prepared. Rightly so i guess.
Thanks for your work Mormad and tell those around you thanks....pass it on!
caryking
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wilmwolf80 said:

The answer to that question is the answer to the question of why the projected deaths for this year dropped from the previous year, when we had been on an upward trend. That is the source of the excess death numbers that have been reported here. It is excess deaths compared to what was predicted, so what was the scientific reason that the predicted number of deaths was lower this year than last. I'll be interested to know if the answer to that question is out there anywhere.

(And questioning why the projection was lowered doesn't lessen the number of people who are listed as dying from Covid, or mean that I don't think it's real, or any of the other BS counter arguments that are normally made in this thread. I just want to know why the projection was lowered. )
I appreciate your answer; however, my ignorance is not able to unpack what you said. Can you dumb it down for me?
On the illegal or criminal immigrants…

“they built the country, the reason our economy is growing”

Joe Biden
WPNfamily
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My family had a run on positives yesterday. My sister, her 3 kids, and parents all tested positive yesterday. My brother in law and I tested negative. I am surprised we did because We have been around all of them over the last week. My wife is making me quarantine at Marriott so I can't possible share with her and our kids. I figure I will go get tested Monday and that would be a reasonable amount of time with no symptoms or a negative test feel good about not sharing with my family. Strange being in the town I live in but not staying at home or seeing the kids.

I think tomorrow I will do a western NC road trip in the 911 to kill a day in which I can't be around people. Gas stations and drive through a should be safe enough while on quarantine. With a negative test I won't go hang around people but feel I am safe enough for road tripping.

Any good places in western NC worth going to look at that are outside?
Daviewolf83
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Mormad said:

We're at 158 in the hospital, 27 in icu, 16 intubated

Update: we're at 175, and current projections are 250 by Christmas, and they feel like our death count over the next 10 wks could match that of the previous 8 months. Ouch.
Mormad - I spent the day driving to Louisville, Kentucky today for a football game tomorrow, so I have not had a chance to thank you for the update. The ICU numbers seem to be inline with the statewide statistics (approximately 25% of all Covid patients in ICU), so not too surprising. It is helpful to know how many of these are intupated, since this is information NCDHHS does not provide in their hospitalization updates.

Regarding your comments on the vaccine, I know we all hope it works to stop the spread of the virus. If it does not, I am not sure what Plan B would be, so we really have to hope Plan A works.

I do have a question about the people hospitalized who are not in ICU. I have been curious as to the level of care these people are receiving in the hospital. Is it medicines that can only be delivered in a hospital? Is it supplemental oxygen? Can you help provide some insight into these patients? Everyone I have known who has been infected with Covid has not required hospitalization, so I am curious about the conditions that cause the need to hospitalize these patients. Thanks again for all the information you provide to us in this thread. It is very helpful.
PackPA2015
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Daviewolf83 said:

Mormad said:

We're at 158 in the hospital, 27 in icu, 16 intubated

Update: we're at 175, and current projections are 250 by Christmas, and they feel like our death count over the next 10 wks could match that of the previous 8 months. Ouch.
Mormad - I spent the day driving to Louisville, Kentucky today for a football game tomorrow, so I have not had a chance to thank you for the update. The ICU numbers seem to be inline with the statewide statistics (approximately 25% of all Covid patients in ICU), so not too surprising. It is helpful to know how many of these are intupated, since this is information NCDHHS does not provide in their hospitalization updates.

Regarding your comments on the vaccine, I know we all hope it works to stop the spread of the virus. If it does not, I am not sure what Plan B would be, so we really have to hope Plan A works.

I do have a question about the people hospitalized who are not in ICU. I have been curious as to the level of care these people are receiving in the hospital. Is it medicines that can only be delivered in a hospital? Is it supplemental oxygen? Can you help provide some insight into these patients? Everyone I have known who has been infected with Covid has not required hospitalization, so I am curious about the conditions that cause the need to hospitalize these patients. Thanks again for all the information you provide to us in this thread. It is very helpful.


Not Mormad, but our protocol for hospitalization is worsening blood oxygen saturation and inability to take care of oneself within their home on maxed out oral medications.
statefan91
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Official now - I hope we are getting this injected to healthcare workers and nursing home residents next week. Really no excuse to not be.

TheStorm
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wilmwolf80 said:

The answer to that question is the answer to the question of why the projected deaths for this year dropped from the previous year, when we had been on an upward trend. That is the source of the excess death numbers that have been reported here. It is excess deaths compared to what was predicted, so what was the scientific reason that the predicted number of deaths was lower this year than last. I'll be interested to know if the answer to that question is out there anywhere.

(And questioning why the projection was lowered doesn't lessen the number of people who are listed as dying from Covid, or mean that I don't think it's real, or any of the other BS counter arguments that are normally made in this thread. I just want to know why the projection was lowered. )
and when was it lowered? In 2019? (It was a projection, right?)... or after the onset of the pandemic?
TheStorm
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Mormad said:

We're at 158 in the hospital, 27 in icu, 16 intubated

Update: we're at 175, and current projections are 250 by Christmas, and they feel like our death count over the next 10 wks could match that of the previous 8 months. Ouch.
Thanks for the information. How do the age demographics of the a) hospitalizations, b) ICU and c) ventalators compare with the age demographics of statewide deaths?

Do they even bring people in from the nursing homes or not? (They didn't with my mother, so I'm just curious as to what is "normal" in that regard).
Mormad
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Daviewolf83 said:

Mormad said:

We're at 158 in the hospital, 27 in icu, 16 intubated

Update: we're at 175, and current projections are 250 by Christmas, and they feel like our death count over the next 10 wks could match that of the previous 8 months. Ouch.
Mormad - I spent the day driving to Louisville, Kentucky today for a football game tomorrow, so I have not had a chance to thank you for the update. The ICU numbers seem to be inline with the statewide statistics (approximately 25% of all Covid patients in ICU), so not too surprising. It is helpful to know how many of these are intupated, since this is information NCDHHS does not provide in their hospitalization updates.

Regarding your comments on the vaccine, I know we all hope it works to stop the spread of the virus. If it does not, I am not sure what Plan B would be, so we really have to hope Plan A works.

I do have a question about the people hospitalized who are not in ICU. I have been curious as to the level of care these people are receiving in the hospital. Is it medicines that can only be delivered in a hospital? Is it supplemental oxygen? Can you help provide some insight into these patients? Everyone I have known who has been infected with Covid has not required hospitalization, so I am curious about the conditions that cause the need to hospitalize these patients. Thanks again for all the information you provide to us in this thread. It is very helpful.


Typically, it's peeps who need supplemental O2 and meds like antivirals and decadron. This can stop the downward spiral to the need for icu care in those felt to be at risk. Luckily, most infected don't require such care, and it's a judgement call for the ED docs whether some can be discharged from the ED to home or need consultation for admission for higher level care.

As you know, a small percentage of those admitted are actually being admitted for other issues and found to have covid on routine testing. But they're still listed as covid admissions because their infection, whether clinically significant or not, changes everything in order to limit exposure to staff and other patients.

The goal is to keep covid OUT of the hospital. It stresses the system and inhibits the ability to care for the non-infected community. It costs the system so much more than the relatively tiny uptick in payment they get for covid status. One NC hospital has shut down its OR because of 55 infected OR staff. They can't even staff their rooms adequately, and when emergencies are done they have to use cross coverage staff. Not all OR staff are proficient at craniotomies or open hearts, so it puts those patients at some increased risk, for example. Physicians are being asked to manage patients usually managed by hospitalists or critical care docs because those teams are being maxed out by covid. If we have experience running ventilators we're being asked to cross cover and potentially manage the critically ill. My pain management physician, who is originally trained as an anesthesiologist, is cross covering in the icu on the weekend. Every week brings a new challenge.
Mormad
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Give me some time to put some info together what I'll try to answer that sometime today. That's a great question. I think we're gonna find more in the 40-55 range than we'd expect.
TheStorm
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Mormad said:

Give me some time to put some info together what I'll try to answer that sometime today. That's a great question. I think we're gonna find more in the 40-55 range than we'd expect.
Thanks. Look forward to your response since you are on the front lines. I won't be surprised with any of the inforamtion. This surge "seems" different for some reason.
packgrad
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Serious, but likely stupid, question.... Are all people that go to the emergency room for Covid counted as "hospitalizations"?
Mormad
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packgrad said:

Serious, but likely stupid, question.... Are all people that go to the emergency room for Covid counted as "hospitalizations"?


No. It's a hospital encounter, but not a hospitalization
SupplyChainPack
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Where will the new vaccine be administered, and what is the eligibility requirements for the early doses?
Steve Williams
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Staff
Ran across this article about asymptomatic cases. Interestingly these numbers are right in line with institutions I am familiar with. In this particular city in India, 96% of the positive cases were asymptomatic, meaning, the only way they knew they were sick was from having the test. I think the CDC's % of asymptomatic cases is closer to 40%.

Sharing the findings of the survey, conducted among randomly selected districts and population, health secretary Hussan Lal said 4678 participants were interviewed and their blood samples collected.

Of these, 1201 tested IgG reactive, of which only 4.03 per cent were symptomatic and 95.9 per cent were asymptomatic.

https://www.thestatesman.com/india/sero-survey-finds-24-19-percent-covid-positivity-punjab-96-percent-asymptomatic-1502940269.html
packgrad
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Thanks
packgrad
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tuffy1006
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I'm very curious when this year is over if diabetes and heart disease deaths remain the same or plummet with covid
Cthepack
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Just heard from a FedEx pilot that the vaccine has priority over everything else they are shipping. Good news, but also get those Christmas presents ordered early.
caryking
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Cthepack said:

Just heard from a FedEx pilot that the vaccine has priority over everything else they are shipping. Good news, but also get those Christmas presents ordered early.
That's funny!
On the illegal or criminal immigrants…

“they built the country, the reason our economy is growing”

Joe Biden
GuerrillaPack
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Are you brave enough to survive the Rona?

Daviewolf83
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Mormad said:

Daviewolf83 said:

Mormad said:

We're at 158 in the hospital, 27 in icu, 16 intubated

Update: we're at 175, and current projections are 250 by Christmas, and they feel like our death count over the next 10 wks could match that of the previous 8 months. Ouch.
Mormad - I spent the day driving to Louisville, Kentucky today for a football game tomorrow, so I have not had a chance to thank you for the update. The ICU numbers seem to be inline with the statewide statistics (approximately 25% of all Covid patients in ICU), so not too surprising. It is helpful to know how many of these are intupated, since this is information NCDHHS does not provide in their hospitalization updates.

Regarding your comments on the vaccine, I know we all hope it works to stop the spread of the virus. If it does not, I am not sure what Plan B would be, so we really have to hope Plan A works.

I do have a question about the people hospitalized who are not in ICU. I have been curious as to the level of care these people are receiving in the hospital. Is it medicines that can only be delivered in a hospital? Is it supplemental oxygen? Can you help provide some insight into these patients? Everyone I have known who has been infected with Covid has not required hospitalization, so I am curious about the conditions that cause the need to hospitalize these patients. Thanks again for all the information you provide to us in this thread. It is very helpful.


Typically, it's peeps who need supplemental O2 and meds like antivirals and decadron. This can stop the downward spiral to the need for icu care in those felt to be at risk. Luckily, most infected don't require such care, and it's a judgement call for the ED docs whether some can be discharged from the ED to home or need consultation for admission for higher level care.

As you know, a small percentage of those admitted are actually being admitted for other issues and found to have covid on routine testing. But they're still listed as covid admissions because their infection, whether clinically significant or not, changes everything in order to limit exposure to staff and other patients.

The goal is to keep covid OUT of the hospital. It stresses the system and inhibits the ability to care for the non-infected community. It costs the system so much more than the relatively tiny uptick in payment they get for covid status. One NC hospital has shut down its OR because of 55 infected OR staff. They can't even staff their rooms adequately, and when emergencies are done they have to use cross coverage staff. Not all OR staff are proficient at craniotomies or open hearts, so it puts those patients at some increased risk, for example. Physicians are being asked to manage patients usually managed by hospitalists or critical care docs because those teams are being maxed out by covid. If we have experience running ventilators we're being asked to cross cover and potentially manage the critically ill. My pain management physician, who is originally trained as an anesthesiologist, is cross covering in the icu on the weekend. Every week brings a new challenge.
PackPA2015 and Mormad - Thank you for the information on the types of treatments being provided to those who are hospitalized. I had assumed the percentage was small for those hospitalized for other reasons, but testing positive for Covid-19. With 75-80% of hospitalized Covid patients not being placed in ICU, I wondered about the level of severity for these other cases and the types of treatments being provided. Your information is very helpful in filling in the blanks on this area.

Do either of you have an idea as to the average length of stay for Covid patients not placed in ICU? I have seen some news reports recently, indicating the average length of stay had been declining, but I have not seen any solid numbers. I was curious if this is accurate.

Thanks again for taking the time to respond. I am still traveling back home from my son's football game at Louisville, so I may not respond further until later tonight.
packgrad
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And then the death rates plummet and we can get back to normal.

PackPA2015
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Daviewolf83 said:

Mormad said:

Daviewolf83 said:

Mormad said:

We're at 158 in the hospital, 27 in icu, 16 intubated

Update: we're at 175, and current projections are 250 by Christmas, and they feel like our death count over the next 10 wks could match that of the previous 8 months. Ouch.
Mormad - I spent the day driving to Louisville, Kentucky today for a football game tomorrow, so I have not had a chance to thank you for the update. The ICU numbers seem to be inline with the statewide statistics (approximately 25% of all Covid patients in ICU), so not too surprising. It is helpful to know how many of these are intupated, since this is information NCDHHS does not provide in their hospitalization updates.

Regarding your comments on the vaccine, I know we all hope it works to stop the spread of the virus. If it does not, I am not sure what Plan B would be, so we really have to hope Plan A works.

I do have a question about the people hospitalized who are not in ICU. I have been curious as to the level of care these people are receiving in the hospital. Is it medicines that can only be delivered in a hospital? Is it supplemental oxygen? Can you help provide some insight into these patients? Everyone I have known who has been infected with Covid has not required hospitalization, so I am curious about the conditions that cause the need to hospitalize these patients. Thanks again for all the information you provide to us in this thread. It is very helpful.


Typically, it's peeps who need supplemental O2 and meds like antivirals and decadron. This can stop the downward spiral to the need for icu care in those felt to be at risk. Luckily, most infected don't require such care, and it's a judgement call for the ED docs whether some can be discharged from the ED to home or need consultation for admission for higher level care.

As you know, a small percentage of those admitted are actually being admitted for other issues and found to have covid on routine testing. But they're still listed as covid admissions because their infection, whether clinically significant or not, changes everything in order to limit exposure to staff and other patients.

The goal is to keep covid OUT of the hospital. It stresses the system and inhibits the ability to care for the non-infected community. It costs the system so much more than the relatively tiny uptick in payment they get for covid status. One NC hospital has shut down its OR because of 55 infected OR staff. They can't even staff their rooms adequately, and when emergencies are done they have to use cross coverage staff. Not all OR staff are proficient at craniotomies or open hearts, so it puts those patients at some increased risk, for example. Physicians are being asked to manage patients usually managed by hospitalists or critical care docs because those teams are being maxed out by covid. If we have experience running ventilators we're being asked to cross cover and potentially manage the critically ill. My pain management physician, who is originally trained as an anesthesiologist, is cross covering in the icu on the weekend. Every week brings a new challenge.
PackPA2015 and Mormad - Thank you for the information on the types of treatments being provided to those who are hospitalized. I had assumed the percentage was small for those hospitalized for other reasons, but testing positive for Covid-19. With 75-80% of hospitalized Covid patients not being placed in ICU, I wondered about the level of severity for these other cases and the types of treatments being provided. Your information is very helpful in filling in the blanks on this area.

Do either of you have an idea as to the average length of stay for Covid patients not placed in ICU? I have seen some news reports recently, indicating the average length of stay had been declining, but I have not seen any solid numbers. I was curious if this is accurate.

Thanks again for taking the time to respond. I am still traveling back home from my son's football game at Louisville, so I may not respond further until later tonight.


I do not have those numbers. It would make sense that we are getting better at treating less severe cases and getting them home quicker, but I have no concrete data on that.

Thanks for the appreciation. It has been very, very hard for the medical community. We are exhausted and frustrated.

I appreciate your daily numbers posts by the way.
Civilized
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packgrad said:

And then the death rates plummet and we can get back to normal.



Appears to be only around 1.5 million Americans living in nursing homes, which is a smaller number than I would've guessed. Maybe double that number for other similar types of congregate facilities that aren't technically nursing homes and you're still at only 3 million people.

Vaccines available for over 20 million in the next couple of weeks.

Make it happen!
caryking
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Civilized said:

packgrad said:

And then the death rates plummet and we can get back to normal.



Appears to be only around 1.5 million Americans living in nursing homes, which is a smaller number than I would've guessed. Maybe double that number for other similar types of congregate facilities that aren't technically nursing homes and you're still at only 3 million people.

Vaccines available for over 20 million in the next couple of weeks.

Make it happen!
Of the 3M, how many do you think will refuse?
On the illegal or criminal immigrants…

“they built the country, the reason our economy is growing”

Joe Biden
Civilized
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caryking said:

Civilized said:

packgrad said:

And then the death rates plummet and we can get back to normal.



Appears to be only around 1.5 million Americans living in nursing homes, which is a smaller number than I would've guessed. Maybe double that number for other similar types of congregate facilities that aren't technically nursing homes and you're still at only 3 million people.

Vaccines available for over 20 million in the next couple of weeks.

Make it happen!
Of the 3M, how many do you think will refuse?

No idea.

My guess is, far fewer will refuse in that demographic than others because of that demographic's significantly higher mortality from the virus. Kind of a vaccine corollary to "there are no atheists in foxholes."

Why?
Pacfanweb
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Civilized said:

caryking said:

Civilized said:

packgrad said:

And then the death rates plummet and we can get back to normal.



Appears to be only around 1.5 million Americans living in nursing homes, which is a smaller number than I would've guessed. Maybe double that number for other similar types of congregate facilities that aren't technically nursing homes and you're still at only 3 million people.

Vaccines available for over 20 million in the next couple of weeks.

Make it happen!
Of the 3M, how many do you think will refuse?

No idea.

My guess is, far fewer will refuse in that demographic than others because of that demographic's significantly higher mortality from the virus. Kind of a vaccine corollary to "there are no atheists in foxholes."

Why?
Pretty good analogy there. Few older folks are going to refuse the vaccine. They don't want the virus.
statefan91
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