On the menu today: While hospitals aren’t reaching capacity coast to coast, a lot of states have at least a few hospitals that are scrambling to expand capacity or divert patients. And where you’ll find the grimmest situations, you’ll find some of the hottest weather — raising the prospect that unvaccinated people spending time indoors, in air conditioning, is a key factor in the current wave. Also, a grim indicator of how far away the threshold of “herd immunity” is, and stray observations about Andrew Cuomo.
Delta Might Not Be the Only Reason for the COVID Wave
In the last two weeks, the average number of new COVID-19 infections per day across the United States increased 86 percent, to 118,067. That, by itself, is not a crisis; many of the infected remain asymptomatic, including the breakthrough infections of the vaccinated. But the average number of hospitalized patients per day has increased 85 percent, to 66,429 people, and that is worrisome — as well as the fact that the average daily number of new COVID-19 deaths has doubled in the past two weeks, to 608.
The severity of the pandemic varies significantly from state to state, but the reports of hospitals nearing or reaching capacity are starting to pile up:
- In Texas, Governor Greg Abbott is asking hospitals to postpone elective surgeries to increase hospital capacity and is seeking help from additional medical staff from other states. The city of Austin is down to two open ICU beds. (Note that in Travis County, which includes Austin, 58 percent are fully vaccinated, and almost 68 percent have at least one dose.)
- Oklahoma hospitals are asking state officials to grant them the same flexibility they were given last year to rapidly expand capacity.
- Arkansas governor Asa Hutchison has said his state is down to eight open ICU beds.
- In Mobile, Ala., the hospitals are reaching capacity, and the city is using fire trucks to take patients to the hospital because patients are being kept in the ambulances.
- On Tuesday morning, 50 of the 142 medical centers tracked on the Georgia Coordinating Center’s website were classified as severe, 14 were overcrowded, 24 were busy, and 54 were normal.
- In South Carolina, “We are at or above (bed) capacity,” said David Church, vice president of support services for Spartanburg Regional Healthcare System. “We are heading in the wrong direction.”
- In Missouri, the Federal Emergency Management Agency is sending 30 ambulances and 60 medical personnel across the state to relieve the strain on county and local hospitals.
- In Florida, “COVID-19 patients currently occupy 19 percent of ICU beds in the United States; in Florida, it’s almost 44 percent. And only about 11 percent of the state’s ICU beds are available, for the time being, compared with 26 percent nationwide.”
- In Louisiana, Dr. Jeffrey Elder, the director of emergency management at LCMC Health, said Monday that, “All of our hospitals across the state are at capacity.”
- In Boise, Idaho, chief medical officer of St. Luke’s Health System, Dr. Jim Souza, told a local television station that, “we have 20 units across our organization, and 13 do not have a single open bed.
Some people will look at the list of states above and say, “Ah-ha! Those insufficiently vaccinated red states are getting hit the hardest!” And that’s part of the story, but there’s something more going on here:
- Oregon set new records on Tuesday for daily coronavirus cases, hospitalizations, and the number of people needing intensive care. More than 61 percent of Oregon residents have at least one dose of a COVID vaccine.
- Hawaii has seen its daily average of new cases increase ninefold since last month, and Governor David Ige is requiring restaurants, bars, gyms, and other social establishments to scale back indoor capacity to 50 percent. Keep in mind, 72 percent of Hawaiians have at least one dose of a COVID vaccine.
- In San Diego, Calif., Sharp Chula Medical Center is nearing capacity. (In San Diego County, 53 percent of those over 18 are fully vaccinated.)
- Even in Maine, one of the most highly vaccinated states in the country, hospitalizations for COVID-19 increased by over a third in the past month.
All of the people who are currently unvaccinated were unvaccinated back in May, June, and early July when we weren’t seeing these surges of new patients heading to hospitals. Some of this reflects the spread of the more-contagious Delta variant, but not all of it. By mid June, the Delta strain was 25 percent of all new cases; by July 3, it was 52 percent. In most of these places, cases continued to decline until the second week of July or so.
What do Texas, Oklahoma, Arkansas, Missouri, Georgia, South Carolina, Florida, Louisiana, Hawaii, southern California, and Oregon all have in common? They’re all really hot in July and August. (Yup, Oregon’s having intense heat waves this year, too.) Hot temperatures mean that people who aren’t at the beach, lake, or pool are spending more time indoors in air conditioning. More time indoors means more time in close contact with other people. More time in close contact with a COVID-19 variant that is as contagious as chicken pox means you get a faster and more far-reaching spread of the virus.
In May and June, outdoor temperatures weren’t as hot as they are now across the country — which means people spent less time in air-conditioning. This is indeed a pandemic of the unvaccinated — but it is particularly a pandemic of the unvaccinated in places where people are spending more time indoors.
This isn’t a perfect theory, as just about every corner of the U.S. gets hot in the summer. But there are some odd inconsistencies. Montana has 2,934 hospital beds statewide, and as of Monday, just 154 have COVID-19 patients in them. Montana is 44 percent vaccinated. North Dakota has more than 14 percent of its statewide beds available, even though just 40 percent of the state is fully vaccinated. And Wyoming is currently doing fine in ICU beds, even though just 37.1 percent of the state is fully vaccinated. Maybe these states are doing better because of their low population density. Or maybe people just aren’t gathering together indoors as much in these places.
This is an ominous indicator for northern states, because as autumn advances, outdoor temperatures will get colder, and people will spend more time indoors where it’s warmer.
There is one other grim figure in this latest wave of cases. King County, Wash., which includes Seattle, has almost 76 percent of its residents twelve and older fully vaccinated — one of the highest rates in the country, and a spectacular success story. Yet the county is still considered a “high transmission” area, with 121.7 cases per 100,000 residents — at least, in the week preceding August 2 — and the number of infections and hospitalizations are both increasing, although not really at crisis levels. We don’t know what the threshold for herd immunity is . . . but it apparently is higher than 76 percent.
ADDENDA: A fair joke from Iowahawk: “If you think the New York Jets are horrible at drafting personnel, you should see the New York Voters.”
Alexandra DeSanctis is correct that Andrew Cuomo resigned while insisting he didn’t really do anything wrong.
In the middle of yesterday’s Three Martini Lunch, my co-host Greg Corombos dropped a one-liner about New York’s past governors that made me nearly fall out of my chair laughing. (You may be able to hear me still trying to suppress laughter a few minutes later during one of the ad reads.)
Finally, why is it that many of the people who swooned the most for Cuomo were also the same people who swooned the most for Michael Avenatti?