Wayland said:Regional variation (and in turn variation due to policy of specific hospital groups) is more important than statewide. Of course it is important to see that Meck hospitals have a much higher incidence of non-critical admits than Wake hospitals. When you look statewide all the data blends, so that you can't pick out that one hospital group is pumping cases. When you separate them back out, you can see that clearly.acslater1344 said:Wayland said:It shows as soon as the governor made the order to extend Phase 2 and implement a mask order, Meck hospitals instantly almost doubled their admission rates of Covid patients. We can see from the surveillance that ICU admits didn't follow along with such a sharp increase but that the number of non-critical patients has grown significantly the last two weeks. That growth was initially limited to one hospital group and came immediately AFTER the announcement was made. Hospitalizations had been stable (and ICUs even declining) UNTIL the announcement and somehow trends (especially in Meck) turned on a dime when the governor spoke.acslater1344 said:Wayland said:
So about that hospitalization data. Let's take a look.
Look familiar, it was the same data I was providing (can't get pic to link)
ICUs. First notice they don't go far back, like I said in the past, they didn't start collecting this information until early May. Next, that jump in the Triad (20 ICU patients in one day), looks more like a reclassification (like identifying a Step-Down unit as ICU for tracking purposes)... or maybe that jump is purely organic.
Oddly enough ICUs were actually declining when the order was made to continue Phase 2 and a mask order was put into place. Maybe that is why they didn't want this out at the time.
Lots to dive into.
It looks like all hospitalizations were pretty stable until the extension of Phase 2 and the mask order when they immediately started to climb, especially in Meck (and a week later Triad). Order extension around the 24th, almost immediately Meck hospitals start admitted a whole bunch of non-ICU patients.
Why'd you change the data filter for the last graph? Just curious as I'm not sure I'm following that last point. Thanks!
Announced continuation of Phase 2 -> Hospital admission policy change to allow admit more non-critical patients -> Overall hospitalizations increase lead to impression that things are getting worse when it is a business decision (77k per patient in CARES money + expenses) -> Restrictions stay in place. It is a loop.
Again, let's provide the necessary care to anyone, but when we aren't honest with what the numbers are and we use it to drive fear, that is not good. The business decision for hospitals can be a win-win because they provide additional care, but then we have media (looking at your WRAL) announcing "OMFG RECORD HOSPITALIZATIONS DOOM IS COMING". Not helpful.
Wake is right behind Meck in case growth but CapRAC (inlcudes WakeMed hospitals) and MCRHC (includes Rex/UNC) don't show that same growth.
Gotcha. I still don't quite follow how you filtered the last graph though to illustrate that point. If you look at the confirm 24 hour admittance data statewide, it tells a different story. Phase 2 extension announced 6/24, with 97 new admits that same day. The next 5 days all had LESS admits than the day the order was announced, and it wasn't until 7/8 when 24-hour admits really spiked (131 confirm cased admits). Now if you drill into specific regions/hospital groups, the story may change a bit, but for this discussion i would think the state wise data is more relevant.
Hospitals in different regions are controlled by different entities, so also have different policies.
Regional or local data is much more important than statewide. Outbreaks are localized not evenly distributed over the state. Meck's curve is different from Guilford is different from Wake is different from New Hanover. Each locale experiences the outbreak differently.
I know I am arguing two slightly unrelated points here. One, Meck hospitals were pumping non-critical cases after Cooper's announcement of Phase 2. Two, local or regional data is vastly more important than statewide data when trying to identify outbreak trends.
Okay, I'm following now. I think both points are valid. On point two, though, I think governors all over the country have been making policy decisions based on statewide trends, while knowing that those trends are driven primarily by hot spots (Charleston & Myrtle in SC for instance). I'm not sure asking local officials to make the incredibly important calls around reopening phases & mask mandates is a better option if that's what you're suggesting. A consistent approach at the state level is necessary IMO.
Also, I think you may be onto something with Meck's curve. That said, though, if DHHS asks Meck hospital groups if they've changed their COVID admittance policy and the answer comes back as no (i'm sure that's what they've said or would say) what then? Should the state openly accuse hospitals of changing their policy, which has led to an increase in hospitalizations that aren't indicative of more true virus spread? Should the state bake that unconfirmed assumption into policy decisions?
Now if I've missed where Meck hospitals have publicly said they've changed their admittance policy, please disregard the last paragraph. Love the discussion by the way.
