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Medicine The Military United States

US Field Hospitals Stand Down, Most Without Treating Any COVID-19 Patients (npr.org) 240

Posted by BeauHD from the better-safe-than-sorry dept.
An anonymous reader quotes a report from NPR: As hospitals were overrun by coronavirus patients in other parts of the world, the Army Corps of Engineers mobilized in the U.S., hiring private contractors to build emergency field hospitals around the country. The endeavor cost more than $660 million, according to an NPR analysis of federal spending records. But nearly four months into the pandemic, most of these facilities haven't treated a single patient. Public health experts said this episode exposes how ill-prepared the U.S. is for a pandemic. They praised the Army Corps for quickly providing thousands of extra beds, but experts said there wasn't enough planning to make sure these field hospitals could be put to use once they were finished. "It's so painful because what it's showing is that the plans we have in place, they don't work," said Robyn Gershon, a professor at New York University's School of Global Public Health. "We have to go back to the drawing board and redo it."

But the nation's governors -- who requested the Army Corps projects and, in some cases, contributed state funding -- said they're relieved these facilities didn't get more use. They said early models predicted a catastrophic shortage of hospital beds, and no one knew for sure when or if stay-at-home orders would reduce the spread of the coronavirus. "All those field hospitals and available beds sit empty today," Florida Gov. Ron DeSantis, a Republican, said last month. "And that's a very, very good thing." Michigan Gov. Gretchen Whitmer, a Democrat, said: "These 1,000-bed alternate care sites are not necessary; they're not filled. Thank God." Senior military leaders also said the effort was a success -- even if the beds sit empty.
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US Field Hospitals Stand Down, Most Without Treating Any COVID-19 Patients More

US Field Hospitals Stand Down, Most Without Treating Any COVID-19 Patients

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  • I'm just going to say it (Score:5, Insightful)

    by rsilvergun ( 571051 ) on Friday May 08, 2020 @07:34PM (#60038930)
    this isn't just us being unprepared (we were) this is the people in charge not being very good at their jobs even though they told us they were.

    This is what happens when you don't put experts who study in charge. And we know exactly who and what I'm talking about.

    • Re: (Score:3, Informative)

      by b01 ( 6837162 )
      Yeah, hire some "experts" to tell you what you want to hear. Done!

      • Well, you do still have to listen to them (Score:4, Insightful)

        by rsilvergun ( 571051 ) on Friday May 08, 2020 @08:19PM (#60039088)
        and you need to pay attention to their track record, credentials and results. But yeah. Hire experts.

        We had the answer right there [politico.com] and ignored it. Mind you, not without reason [thenation.com]

        • Re: (Score:3, Insightful)

          by Mashiki ( 184564 )

          How do you make it through the day? First you were saying we were all going to die because Trump is an idiot, and his handling of this was terrible and he wasn't listening to the experts. Now you're saying that he didn't hire the "right kind of experts" thus assets went unused.

          • Re: (Score:2)

            by burni2 ( 1643061 )

            How do you make it through the day with seeing words that weren't there and perhaps those that were there.

            He never said Trump was an idiot. He said people in charge (Trump+) were not doing their jobs.

            By comparing the events and numbers to other countries even ones being affected severe like Italy and Spain - which achieved the turn around - in contrast to the actions of Mr. Trump it is obvious that:

            a.) Trump has underestimated the crisis ("just like a flu") this is far from being a single incident as the PO

    • Re: (Score:3, Interesting)

      by alvinrod ( 889928 )
      If you would have read the summary you'd be blaming the governors who were the ones that requested them. Do you honestly believe that Trump is controlling all of this while everyone else just sits on their hands and blindly follows along with what he says?

      Also, just say Trump. Do you think he's Lord Voldemort or something that you can't say his name.

    • this isn't just us being unprepared

      It sounds more like being over-prepared. We ended up have excess emergency capacity that went unused but would have been invaluable if the pandemic had been worse.

      • Read the "fine" summary.

        They praised the Army Corps for quickly providing thousands of extra beds, but experts said there wasn't enough planning to make sure these field hospitals could be put to use once they were finished.

        "It's so painful because what it's showing is that the plans we have in place, they don't work," said Robyn Gershon, a professor at New York University's School of Global Public Health.

        It wasn't that they weren't needed, it's that we didn't use them because there was no system in p

        • Re:RTFS (Score:5, Insightful)

          by ShanghaiBill ( 739463 ) on Friday May 08, 2020 @08:29PM (#60039132)

          It wasn't that they weren't needed, it's that we didn't use them because there was no system in place to use them.

          That is what the unnamed "experts" supposedly said. But the governors are saying the opposite.

          If they were needed, but unused, then please provide some links to all the stories about patients being turned away from other hospitals.

          The reason, and the only reason, they went unused is because the capacity was not needed.

          Chaos and confusion reigned on the ground because we lacked effective top down leadership.

          Right. Because all American healthcare professionals are trained to just panic and run around in circles unless they receive personal detailed instructions from the president.

          • There is a HUGE variation in cost per bed in that linked article. 250 beds for just under $11 million. Or 1,900 beds for just over $11 million?

    • Re:I'm just going to say it (Score:5, Insightful)

      by phantomfive ( 622387 ) on Friday May 08, 2020 @08:21PM (#60039100) Journal
      The infection rate was doubling every 1 to 3 days before we went into lockdown. Another week of doubling like that, and these field hospitals would have been overflowing.

      Check out the graph of deaths in New York [imgur.com]. It's very obvious where social distancing started to have an effect, and to people who understand exponential growth, it's obvious what would have happened if we did nothing.

    • Neither my seatbelt, not my fire extinguisher, nor even my smoke alarms were necessary this month - they went unused. I don't think it wws a mistake to have them in place in case they were needed.

      As Phantomfive said:
      --
      The infection rate was doubling every 1 to 3 days before we went into lockdown. Another week of doubling like that, and these field hospitals would have been overflowing.
      --

      I haven't double checked the doubling rate, but certainly given the information available at the time, it looked like the

    • These are the things you do when you don't know what is going to happen. You listen to the experts and put things in place to deal with the worst case. As it was, two or three weeks ago, the public listened to the experts, took notice, isolated, and so the worst case didn't happen.

      But in the last week, that seems to have gone to pot, so those field hospitals had better be ready to stand back up again in a week or two's time!

      • The "experts" were catastrophically wrong in their predictions used to convince the public to go along though. We were told the death count would be much higher than it is today even with a lockdown and other precautions.

    • Comment removed based on user account deletion

    • No, actually, I think the fact we didn't need the field hospitals in the end is one small success.

      And getting them set up quickly was a success, the armed forces, both national and of the States, performed their duties well during the crisis. It was a comfort knowing they were at the ready to treat me if I couldn't get into a hospital.

    • This experience should have taught you that experts can be just as self-serving and duplicitous as anyone. I'll listen to them over a guy going with his gut. After all, we all have guts. What makes their ignorance and prejudices any better than mine? But I should have been more careful about spreading the idea that wearing masks was harmful. That turned out to be a well intentioned lie at our expense, but a lie it remains.

  • Isolation works nicely. (Score:5, Interesting)

    by RyanFenton ( 230700 ) on Friday May 08, 2020 @07:44PM (#60038954)

    Outside New York and a couple other places, ~97% of folks were able to avoid obvious infection through their own isolation efforts so far.

    But having 97% of the populace basically still vulnerable means there's also still next to no group immunity - and the virus is still VERY quick to spread when groups gather.

    So - yes, we haven't needed extraordinary amounts of medical facilities yet on average.

    Part of that is that most medical folks also report that many, many people are avoiding medical appointments, and many elective surgeries have been pushed out.

    So - there's extra net capacity for now.

    Even if states 'open' up though - I think most people will quite reasonably keep maximally isolating until a vaccine is present.

    Which is why most economic plans for REALLY re-openning are going to fall very flat for now - that 97+% that haven't had the disease just aren't going to go back to normal - and those folks that do, are going to spread it to their relatives and then you're going to have another wave of shutdowns.

    You're not going to rebuild the 'normal' economy very efficiently that way. You need a plan for doing that safely to meet the real-world psychology of the scenario.

    That, or you need a working vaccine that can be mass-produced in time.

    None of this is news though - but folks don't like the idea of sacrificing stock market numbers, so they'll interpret everything using whatever kind of magical thinking they have to insist that everyone else go back to work, or else be punished.

    Which is exactly why we'll see the most desperate pushed to work or starve before too long - and the many layers of backlash for that.

    I wish we didn't always have to go that route each time- but that's what America is now.

    Ryan Fenton

    • Re:Isolation works nicely. (Score:5, Interesting)

      by alvinrod ( 889928 ) on Friday May 08, 2020 @08:17PM (#60039076)
      If you've been following along with some of the studies that have come out of Italy or Iceland it's pretty obvious that 97% haven't avoided infection. We don't know for sure due to a lack of widespread testing availability, but other studies have found that a lot of people have had COVID-19 (or we have a massive number of false positives) while being completely asymptomatic and never knowing it.

      We do know from the number of cases we've had that the U.S. didn't do a particularly good job of containing the spread of the virus so it's practically impossible for us to simultaneously see a higher rate of serious cases requiring hospitalization as we have while also failing to have at least a similar percentage of the population getting it while remaining asymptomatic. Maybe you could explain part of the U.S. numbers away due to a higher rate of obesity which among other factors has been co-morbid with hospitalization, but we don't have 97% of the population still vulnerable.

      While this is serious, it's not going to bring about the end of the world. Sweden did very little in terms of official response and while they have higher rates of serious cases than neighboring countries, their healthcare system hasn't been overrun or brought to its knees. Maybe if it were some other country like China or North Korea you could accuse them of covering some of it up or trying to hide it, but I think you'd have a much harder time convincing people of the Swedish government doing that.

    • Re: (Score:2)

      by khchung ( 462899 )

      You are only assuming the 3% of people who recovered/would recover from Covid-19 have immunity against it.

      The fact is no one knows yet how effective their immunity is or how long it lasts, or how it would fare against any mutations of the virus. It is possible that 6 months down the road we find out recovered patients no longer have immunity, then what do you do?

      The same with vaccine, what if it is not effective enough or do not last long enough?

      Counting on herd immunity or vaccine to save the country from

    • I would point out that the point of isolation is NOT to prevent people from getting sick.

      Instead, the point is to flatten the curve. You can't avoid this disease forever unless you become bubble boy.

      But if we isolate, then we will spread out the infection, 10% now, 10% next month, 10% the month after, instead of all 30% NOW.

      Once the hospitilazations start going down, we can stop isolating. But until then it is a bad idea to stop the isolation.

      • Did you even read the summary? The gist is, we planned for a huge overflow of patients that never happened. Not even in NYC. Even states that did not have any kind of lockdown, didn't have hospitals overflowing with patients. In fact, hospitals everywhere have been laying off medical staff because they weren't needed!

        https://www.npr.org/2020/05/08... [npr.org]

      • Re: (Score:2)

        by kenh ( 9056 )

        The goal of "shelter at home" was to flatten the curve so that healthcare providers wouldn't be overwhelmed... That was until the President decided we needed to start bringing the economy back, then his critics sensed political points could be scored by moving the goal posts and now declaring that the point of "shelter at home" was to try and protect every American, opening the economy prematurely might cost some lives, and that was unacceptable.

    • If isolation is the thing that prevented these field hospitals from being needed, then we would expect to see them NEEDED in places that did not lock down.

      Can you point to a single place like this? Sweden perhaps?

      Several states never locked down. Even they did not need the field hospitals.

    • You're not going to rebuild the 'normal' economy very efficiently that way. You need a plan for doing that safely to meet the real-world psychology of the scenario.

      Not psychology, epidemiology. Specifically, to do it you need to move from general quarantine to targeted quarantine. Massive, widespread testing plus an army of contact tracers who identify and test the contacts of everyone who tested positive. Then quarantine all of the positives. Diseases spread via infection clusters. If you can find and test and isolate contacts quickly enough you might be able to kill clusters, but at the very least you'll be able to dramatically slow the rate of the spread. Very

  • Maybe local governments shouldn't be forcing hospitals to get on bended knee as in a communist nation to beg for permission to expand the numbers of beds.

    It wouldn't solve the whole problem but certainly exposes the dangers and arrogancy of central planning, which is to say, planning by highly fallible mortals with an eye towards politics.

  • > "It's so painful because what it's showing is that the plans we have in place, they don't work,"

    The only thing painful is the thought that a professor of health believes one could come up with a plan to defeat all pandemics... These field hospitals may well have helped under other circumstances, but there sure is no god-given guarantee that even the best planning always leads to success. That these field hospitals didn't work out now doesn't make it bad. It only shows one simply cannot prepare for all

    • Re: (Score:2)

      by cusco ( 717999 )

      Indeed, thank all the gods above, below and non-existent that they weren't needed because even though there were beds there wasn't the equipment necessary to handle that many additional critically ill.

    • Because of how exponential growth works, another week or two without lockdown and the beds would have been completely filled. It sounds impressive to say "50% of our beds are empty" until you realize that's only one doubling away from overflowing.

  • The field hospitals were specifically intended to treat OTHER patients - not infected with COVID-19 - to free up beds and wards at local hospitals so they could better deal with COVID-19 patients.

    • Re: (Score:2)

      by kenh ( 9056 )

      But sadly potential patients weighed their options and choose to not go to the hospital if at all possible - they didn't want to go to the Covid-19 center of their city and risk contracting the virus. How many cancer patients missed their treatments because of such fears? On statistic I heard was that one Big Pharma company saw orders of their cancer treatments drop by 20-25% since the "shelter in home" orders went out - that is bad, cancer patients refusing needed treatments...

  • The predicted need for hospital beds probably came from the experience in other countries. Who knows what happened in China -- but I'm assuming it wasn't a total disaster because they have much greater control over their population than we do and could very severely crack down where needed. Europe seems to have been unlucky and had a few very active sources of infection that really kicked things off, combined with not shutting things down soon enough. The US could have been in much worse shape by now had no

  • Let the army do its job and get the fuck out of it (Score:3, Insightful)

    by Opportunist ( 166417 ) on Friday May 08, 2020 @08:15PM (#60039064)

    Here's how you can fix it:

    1. Get every politician involved.
    2. Put him to a firing squad and let them go to work.

    Now that every disruptive element is out of the picture, you can do some serious business.

    If you let the military do politics, it's called a junta. If you let politicians run military operations, it's called the Vietnam War. We're allowed to learn from history, ya know?

  • These hospitals were built based on bad models that were obviously not based on realistic or feasible inputs.

    When the pandemic is settled out we need to perform a root cause on why the models failed as badly as they did. Pretty much every model got things wrong anywhere from significantly to an order of magnitude. None of the models even got things in the same ballpark as our real world results.

    Public policy decisions that significantly impacted society as a whole were made based on bad models. Businesses w

    • When the pandemic is settled out we need to perform a root cause on why the models failed as badly as they did.

      It's because there were too many unknowns (or measurements with large error) in the inputs. Even today, we don't know how many people have actually been infected. 5:38 did a good analysis of the situation [fivethirtyeight.com].

      • Interesting article on 538. I really have to wonder why all of the models came in much higher than real world results? This bothers me greatly. If the models were done in a neutral manner some of them should have come in lower. I am not aware of a single model that came in lower than real world results.

        Science needs to understand what went wrong with the models before the next pandemic that breaks out. Science also needs to be better at filtering out political influence that may have swayed the results. The

        • Interesting article on 538. I really have to wonder why all of the models came in much higher than real world results?

          What are you citing here? Why do you think that?

    • Utterly impossible for infection prediction, each virus is different. You don't know what you're going to get until pandora's box is opened each time.

      And this thing isn't over yet, we may have only delayed the inevitable 70% of populace infected and the percent dead from that.

    • The Left is more afraid the overwhelming failure of the COVID models might lead people to doubt the climate doom models produced by these same academics and realize there might be a pattern to this incompetence.

  • Large scale Training exercise (Score:5, Insightful)

    by Mspangler ( 770054 ) on Friday May 08, 2020 @08:20PM (#60039096)

    From the military and disaster management point of view, it was a training exercise. And like any training exercise, the review will identify things that worked, and things that didn't.

    For instance, The Navy's hospital ships are nearly useless for epidemics due to the inadequacies in the ventilation system. It might be time to replace them. They were converted from oil tankers. Maybe new ones can be built from cruise ship hulls. There should be surplus capacity in those shipyards for quite awhile.

    • How the US' Hospital Ships Work
      https://www.youtube.com/watch?v=-pNBAxx4IRo [youtube.com]

    • this was an excellent exercise and it may well pay off in huge dividends in some future disaster.

      The corps, confronted with this sudden demand to build temporary hospitals, designed several highly-modular concepts that could be made from interchangeable parts and setup quickly in any of several categories [army.mil] of large buildings, like sports arenas, convention halls, old de-commissioned hospitals, etc. These "hospitals" looked like little more than many curtained cubicles inside large spaces, but actually includ

    • Why are we talking about this like it's over? (Score:5, Interesting)

      by hey! ( 33014 ) on Saturday May 09, 2020 @06:46AM (#60040094) Homepage Journal

      On May 1, the United States had 903714 active cases (total cases minus deaths and recoveries). On May 8, it had 1,019,567 active cases.

      No state has fewer active cases than it did a week ago except Hawaii, Montana and Texas. Texas was a one day reporting blip on May 1; if you take a three day moving average the number of ative cases is showing consistent growth. I expect that New York and New Jersey will show a statistically significant decline in active cases very soon, but nobody should be declaring victory yet.

  • the Army Corps of Engineers mobilized in the U.S., hiring private contractors to build emergency field hospitals around the country.

    .. it looks like stereotypical USA responsiveness in that it was more important to not miss a business opportunity than it was to effectively attempt to save lives.

    • Re: (Score:2)

      by kenh ( 9056 )

      Business opportunity? The miltary and national guard, along with charities built the field hospitals - not private contractors.

  • What use are the WHO (with their 3% to 5% mortality rate reported in march) and the Imperial college of London (reporting 3 million deaths in the USA at one point) if they can't accurately predict what we give them money to predict? I didn't take a braniac to look at the cruse ships and do some simple math and put bounds on the mortality rate. If you don't know what the numbers are then don't advise people or write papers. I'm not sure anyone on the planet at this time even understands what the true spread

    • Please take a break, read more, read deeper, and more than the headlines, please:

      Projections are based on a scenario, if the scenario changes the projection changes. Also the U.S. are currently within the pandemic, meaning the death toll will still rise and those projected numbers are mostly totals.

      Keep in mind media mostly fails to interpret projections correctly, because they have the same understanding on those numbers as you, those are projections and the big, fat, red warning must be "scenario outcome,

  • Pandemic, isn't over, shit heads (Score:4, Interesting)

    by syousef ( 465911 ) on Saturday May 09, 2020 @05:59AM (#60040068) Journal

    Shutting them down now is idiotic. We don't know for a fact what the next wave will look like.

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