We aren't Talking Enough about Hospital Beds

This weekend has seemed like it might be a critical one for reducing the transmission of the coronavirus and the incidence of full-blown COVID-19. It has been dismaying to read accounts of St. Patrick's Day weekend revelry, of long brunch lines, and of crowded airports.

Locally, the City still likely deferred too much to the State guidelines, which have seemed tentative and behind the best information from Italy, Spain, and France, even Seattle, and did not recommend or even demand stronger measures. People in Europe are the proverbial "travelers from the future," begging and imploring for us to take stronger measures before it's too late. There is increasing evidence of asymptomatic transmission, and so without large-scale testing, we should be assuming that there are many more cases here than we know about.

At this point the problem is really about community capacity and slowing transmission, since it seems likely many, perhaps even most, of us will come to be infected over the next several months.

The Register-Guard has the right focus today:
We will outrun our capacity real fast in a wave of illness

And key to managing that is hospital capacity for the gravely ill. Salem Reporter noted

Salem Hospital has 48 ICU capable beds & 27 negative air flow rooms, per spokesman

There has been too little public acknowledgment of how quickly these will fill in a wave of illness. Some number of them will be needed by people in car crashes, industrial accidents, cancer, heart attack, other illness. If we overwhelm them with patients in very bad respiratory distress, people suffering other illness and misfortune will be harmed with less attention and fewer beds. Doctors and nurses overwhelmed themselves fall ill, and then they are not available to care for new sick patients. There is the prospect for a cascading chain of catastrophe here. We already saw the Keizer Fire Department members have to self-quarantine after an exposure. We are very vulnerable.

"Cancel Everything" and self-isolate as much as possible
(adapted from a USA Today chart on "flattening the curve")

The reason to practice extreme physical distancing right now is not just to protect oneself. It is to preserve capacity for the whole community and those most in need. Physical distancing, social solidarity.

We really missed the window in the first half of March.

This was the City's main advice from March 2nd to the 12th:
"the risk of getting [ill] is very low"

Even with bans on "large gatherings" and with school closures, the tone on the 13th still is like "we've got this" and not enough of "holy crap, this is an emergency, we have to be serious."

The poster for March 13th still
underplays hazard
and potential for catastrophe

Even after Multnomah County Library closed,
Salem stayed open.
But there are reasons to think the OHA guidance is too weak

And focusing on care facilities is important, but may contribute to the idea that younger people don't have to worry.

Today's front page

I hope on Monday, even in the absence of guidance from the OHA or CDC, the City embraces that "abundance of caution" and gets very serious, more serious than they already are.

Addendum, midday

Here's a distinguished voice on the WP simulator and calls to stay home.

via Twitter