Nashville Hospital capacity- THREAD

All throughout the winter - Metro Nashville Government's Website: Asafenashville.org, consistently reported single digit % available capacity for ICU beds, and low double digit % capacity for Floor bed. See screenshot from Jan 7th.

1/
Nashville has always only reported % available, and not actual numbers- yet they pull their data from Tennessee's HRTS- the same source that Knox and Shelby use and transparently report from.

@malkusm wrote about this on our site here:

asmartnashville.org/posts/nashvill…

2/
So since August, we have been tracking these numbers manually since Metro doesnt provide time-series or raw numbers.

We even tried to triangulate the total bed capacity from multiple sources and came pretty close when I build my dashboard:

3/
We presented our data to @StacyCase_ who ran a story on this in September. It was difficult to get straight raw numbers and they still never shared as a result of this.

4/

fox17.com/news/digging-o…
Fast forward to the end of the year, and over the last couple months, where I pulled data from HHS.gov that is aggregated from federal reporting requirements from hospitals, so now we can finally answer this question.

5/
According to healthdata.gov/dataset/covid-…

Nashville maintained just over 3100 staffed beds throughout the winter.

6/
Their max inpatients was around Dec 11 at around 2250 (single days could have seen higher) which amounted to about 72% of overall capacity.

That's 28% overhead.

On Dec 11th, asafenashville.org was reporting just 12%.

7/
For ICU Capacity, Nashville maintained ~596 Staffed ICU beds throughout winter.

Covid peaked at ~170 patients, ~28% of those beds.

Total inpatient peak at highest was 424, leaving ~29% staffed ICU capacity overhead.

@MetroNashville was reporting merely 4-10% availability

8/
Why the discrepancy? Why has there been this constant
"Red" Status of these metrics? According to HHS, we've actually been below these goals of 20% for floor beds and 15% of ICU the Entire time.

9/
Data from the Federal Government directly contradicts the @MetroNashville governments data.

Anyone out there want to dig deeper into this?

I suspect a couple reasonable explanations:

1) They are simply just calculating % available in a very different way.

10/
Perhaps it makes sense the way they do it. We would never know because it's never been explained.

2) There is a simple error in their reporting and they've never caught it.

/11
As of right now, from where I'm standing, the simple way to look at it is that data from the Federal Government directly contradicts the @MetroNashville governments data.

I'm sure this could be cleared up.

/END
Anyone can use this tool I created to look at the capacity over time for any area in the country. Just select dropdowns for state/county.

rationalground.com/hospital-and-i…

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More from @ifihadastick

21 Feb
With Good news about how effective just one dose of Pfizers shot is, I'm optimistic about the effects we will see on Covid mortality.

Almost half of Tennessee's Population over 70 have received at least a first dose.

This population is 70% of the deaths from/with Covid in TN
That's over 350,000 vaccinated.

There are 70,000 cases in this Group. Crude true infection rate is likely at least double- likely 140,000 true infections.

Population of 70+ is ~760k people.
For comparative reference- compare the cases on left to the Deaths on the right for ages 70+.

Just 10% of the Cases, and 70% of the deaths.

The fatality rate for this group (per the CDC) is 5.4%. That's 1 in 20.
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16 Feb
THREAD: Are Schools SAFE during Covid? A Collection of Research, Science, and Data on Schools: Risks to children, teachers, and comparisons within the community.

Sources: Academic, institutional or governmental. I will summarize conclusion and cite link.

Let's begin..

1/
European CDC:

"Investigations of cases identified in school settings suggest that child to child transmission in schools is uncommon and not the primary cause of SARS-CoV-2 infection in children ..

2/

ecdc.europa.eu/en/publication…
whose onset of infection coincides with the period during which they are attending school."

3/
Read 18 tweets
16 Feb
Thought Exercise:

Imagine a scenario where a Religious leader was suddenly given executive authority over the medical communities codes of ethics, methods of treatment, and had carte blanche authority to impose value judgements upon their decisions and trade offs.

1/
Treatments, standards of care, and ethics are now dictated by order of the high priest.

What do you think would have happened? Doctors would have revolted and fought like hell to get their rights and protections back.

2/
Image that business leaders & economists were elevated overnight to the de facto authority on epidemiology and infectious disease, despite having no understanding, education, or expertise in this field. Models and risks assessments are now reduced to dollars and cents...

3/
Read 10 tweets
24 Jan
HHS PCR % Positive Trends by Climate Region Update: Data through Jan 19:

Northeast:
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6 Jan
Now that school is back, I think it's a good time to look back at the fall and revisit the big fear everyone had about opening schools causing "spikes" in cases.

Date Range: Mid July-End of September.

Enough time for multiple incubation periods.

1/
In the fall, didn't matter what learning mode the school system chose, the trends were the same. No spikes. Not even close. The idea that a single thing like school open/close could affect the trajectory should be put to bed.

2/
Of course from Europe we knew Schools and Children are not the drivers of the epidemic



But now we also actually have our own data from our own natural experiment in our own state. Will we learn from it?

3/
Read 8 tweets
3 Jan
HHS PCR Testing data shows how the holiday reporting effect screws up almost every single trendline and indicator based on testing (cases, % positive) -rendering recent days data untrustworthy.

I suspect this effect carries at the state level as well as this federal dataset. Image
Specifically with this one you can see the reports of negative tests decrease. Many reasons for this- likely due to holiday lots of mandatory testing regimes were on hiatus. I know many Health Depts took days off.

This will change the pool and skew towards more positives..
As you have less people testing just to test, and keep same pool of people testing because they really need to test likely due to actual symptoms.

This is speculation based on observations of reduced testing locations and hours, less school testing, etc.
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