Hoosier

As far as knowing more now than in spring, one thing that comes to mind is ventilators and how the harm outdoes the benefit sometimes. Out of curiosity, I went back through the hospital data archives for Indiana and you can see the downward trend in ventilator use. I am assuming that being on a ventilator for covid-19 means that a person is also in the ICU. Looking at the ICU and ventilator numbers, the percentage of patients on ventilator in the ICU was around or even sometimes well over 50% back in April. On October 20, it was about 34% (141 out of 412 on a ventilator in ICU).

Nationwide hospitalizations are closing in on 40k, which is what they were in Aug.

You know what's going to happen, right? Some of those people are just going to go to Cook county, which for now is still going to have indoor dining/bars. Interesting article here. Pritzker and Lightfoot are saying different things about the bars. Chicago is saying there isn't much spread coming from bars, while Pritzker says it is a significant source of spread in Illinois, and they are generally regarded as one of the highest risk places. https://blockclubchicago.org/2020/10/20/bars-linked-to-coronavirus-spread-across-illinois-state-officials-say-after-city-defends-indoor-service/

Fellow Hoosiers... Here was Gov Holcomb response when asked about the surging cases/hospitalizations... We asked Governor Eric Holcomb what it would take to reverse Phase 5, but the response wasn’t exactly clear. “We have the capacity to care. So, when that starts to become threatened, that capacity to care, then we’ll look at additional measures,” said Governor Holcomb (R). https://fox59.com/news/experts-say-indianas-surge-in-covid-19-cases-positivity-rates-and-hospitalizations-concerns-us/amp/ .......... So the question with that is what are the trigger points? How low would hospital bed availability have to get? Also, some areas of the state will run into trouble faster than others, so is it up to the local/county leaders to be on top of it and pull the trigger on restrictions?

Partly the weekend lag but 48 new deaths reported in IN. We were getting numbers like that in the spring.

Deaths have been just about flatlined for the past 5-6 weeks, but it is only a matter of time. The only hope is that the rise comes in under projections. Because of how this goes with incubation period and illness progression, we have already largely sealed our fate for at least the next 1-2 weeks. But we have the ability to control the trajectory beyond that (not that we will).

As far as the partial lockdowns/stay at home orders, I don't think there was much of an alternative in the beginning... especially in the more populated states. Testing was very hard to come by and masks were not being encouraged for the general public. It could have gotten completely out of control if business had carried on as normal. More is known now about the virus and testing has gotten a lot better, so more targeted approaches can be taken.

We'll see. I think at least 75k. The 57k today hasn't happened on a Monday since sunmertime.

57,000 cases today... that is large for a Monday.

Sweden... yes, Sweden, is talking about cracking down https://news.yahoo.com/amphtml/months-minimal-covid-19-containment-163425168.html

Notre Dame got control of the big outbreak that happened right after school started, but things have increased a bit again. In the past 2 months, there have been over 900 cases among students and staff, which is about 7% of the students and staff. Some pockets of the US may not have had 7% of the population exposed yet about 8 months into the pandemic, so it just goes to show how quickly it can spread in a clustered college environment.

The Wisconsin order on limiting gatherings has been reinstated https://www.reuters.com/article/us-health-coronavirus-usa-idUSKBN2742LG

Let's hear from Lori Lightfoot MAYOR LORI LIGHTFOOT SAYS CHICAGO COULD RETURN TO PHASE 3 RULES WITH SHARP RISE IN COVID-19 CASES CHICAGO (WLS) -- Mayor Lori Lightfoot has issued a warning about a sharp increase in COVID-19 cases in Chicago Monday and said the city could return to Phase 3 rules with more restrictions on businesses In the press conference with Chicago Department of Public Health Commissioner Dr. Allison Arwady, Mayor Lightfoot said the number of cases over the past two weeks has risen 50%, with more than 500 new cases per day. https://abc7chicago.com/covid-19-chicago-illinois-mayor-lori-lightfoot/7154268/

I am not 100% sure but I think children haven't really been in the vaccine trials thus far, or at least not adequately represented. Maybe somebody else can comment on that.

Barring eradication of covid-19, hopefully the IFR gets to flu levels or like some of the more benign coronaviruses over time. I've wondered what the IFR was of the other types of coronaviruses when they first showed up.

That estimated IFR is actually higher than I thought.

At least it's not a defecation example.

I think it depends. A long passage of time between events breeds complacency. If we are waiting 20 or 30 years for the next pandemic, I could see us ("us" not just meaning the US, but other nations as well) not being as prepared as we should be. But there's probably a decent chance that it won't be that long until another novel virus pandemic. I think the 9/11 comparison has relevance as to where we are going. Most of life is how it was prior to 9/11, but there are some things that just aren't the same even almost 20 years later. Masks are here to stay for quite a while and even after the mask "mandates" end (I put that in quotes since enforcement is not uniform), I think some people will choose to wear them for years to come. Then there is the way that business is likely to change, with sort of a work from home revolution among other things. Interesting time to be alive.

Rural Midwest hospitals struggling to handle virus surge WESSINGTON SPRINGS, S.D. (AP) — Rural Jerauld County in South Dakota didn’t see a single case of the coronavirus for more than two months stretching from June to August. But over the last two weeks, its rate of new cases per person soared to one of the highest in the nation. “All of a sudden it hit, and as it does, it just exploded,” said Dr. Tom Dean, one of just three doctors who work in the county. As the brunt of the virus has blown into the Upper Midwest and northern Plains, the severity of outbreaks in rural communities has come into focus. Doctors and health officials in small towns worry that infections may overwhelm communities with limited medical resources. And many say they are still running up against attitudes on wearing masks that have hardened along political lines and a false notion that rural areas are immune to widespread infections. Dean took to writing a column in the local weekly newspaper, the True Dakotan, to offer his guidance. In recent weeks, he’s watched as one in roughly every 37 people in his county has tested positive for the virus. It ripped through the nursing home in Wessington Springs where both his parents lived, killing his father. The community’s six deaths may appear minimal compared with thousands who have died in cities, but they have propelled the county of about 2,000 people to a death rate roughly four times higher than the nationwide rate. Rural counties across Wisconsin, North Dakota, South Dakota and Montana sit among the top in the nation for new cases per capita over the last two weeks, according to Johns Hopkins University researchers. Overall, the nation topped 8 million confirmed coronavirus cases in the university’s count on Friday; the true number of infections is believed to be much higher because many people have not been tested. In counties with just a few thousand people, the number of cases per capita can soar with even a small outbreak — and the toll hits close to home in tight-knit towns. “One or two people with infections can really cause a large impact when you have one grocery store or gas station,” said Misty Rudebusch, the medical director at a network of rural health clinics in South Dakota called Horizon Health Care. “There is such a ripple effect.” Wessington Springs is a hub for the generations of farmers and ranchers that work the surrounding land. Residents send their children to the same schoolhouse they attended and have preserved cultural offerings like a Shakespeare garden and opera house. They trust Dean, who for 42 years has tended to everything from broken bones to high blood pressure. When a patient needs a higher level of care, the family physician usually depends on a transfer to a hospital 130 miles (209 kilometers) away. As cases surge, hospitals in rural communities are having trouble finding beds. A recent request to transfer a “not desperately ill, but pretty” sick COVID-19 patient was denied for several days, until the patient’s condition had worsened, Dean said. “We’re proud of what we got, but it’s been a struggle,” he said of the 16-bed hospital. The outbreak that killed Dean’s dad forced Wessington Springs’ only nursing home to put out a statewide request for nurses. Thin resources and high death rates have plagued other small communities. Blair Tomsheck, interim director of the health department in Toole County, Montana, worried that the region’s small hospitals would need to start caring for serious COVID-19 patients after cases spiked to the nation’s highest per capita. One out of every 28 people in the county has tested positive in the last two weeks, according to Johns Hopkins researchers. “It’s very, very challenging when your resources are poor — living in a small, rural county,” she said. Infections can also spread quickly in places like Toole County, where most everyone shops at the same grocery store, attends the same school or worships at a handful of churches. “The Sunday family dinners are killing us,” Tomsheck said. Even as outbreaks threaten to spiral out of control, doctors and health officials said they are struggling to convince people of the seriousness of a virus that took months to arrive in force. “It’s kind of like getting a blizzard warning and then the blizzard doesn’t hit that week, so then the next time, people say they are not going to worry about it,” said Kathleen Taylor, a 67-year-old author who lives in Redfield, South Dakota. https://www.wishtv.com/news/coronavirus/rural-midwest-hospitals-struggling-to-handle-virus-surge/

I'm ok with people not wearing a mask as long as they never leave the house and go out in public. Otherwise, wear one when you are out and about. The available info suggests that by wearing a mask, you are blocking more outbound than what is coming inbound. Hence, a masked person going into a place where people aren't wearing them can still be at a fairly substantial risk of contracting the virus depending on the situation.

Roller coaster ride in hospitalizations in Indiana. I would say we are on a trajectory to surpass the hospitalization numbers from spring unless something changes like right now.

No doubt that people are tired of all the precautions and what not. This may sound silly, but for motivation, I sort of play a mind trick and think of the virus as an opponent. It helps me to maintain vigilance and keep up with the safety measures. Even if you are young and healthy, most of us here have parents or grandparents to think about. We don't want to be the one to unknowingly pass it on to them, and all it takes is one face to face encounter.

Sone stats for math nerds. The 9 state area of MN, IA, MO, WI, MI, IL, IN, OH, KY accounts for 20% of the US population. As of today, just over 25% of hospitalized covid-19 patients in the country are from those states.

The Wisconsin hospitalization numbers are striking... way worse there than it was back in spring. Courtesy of Covid Tracking

Rural areas can get lost in the shuffle since the numbers aren't big, but something jumped out at me today. Warren county, which is just about the most rural county in Indiana, had an increase of 7 cases since yesterday. Doesn't sound like much, but it sticks out when the total number of cases in the county goes from 65 to 72 in a pandemic that has been around for over 6 months.