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610,303 Views | 2786 Replies | Last: 2 yr ago by AggieUSMC
deadbq03
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Gordo14 said:

AustinCountyAg said:

So people are testing positive, but the #of deaths per day is decreasing daily???? If that's the case who cares if you're catching it or not?


We've been through this before. Deaths are reported up to 6 weeks after they happen. Look at the death rate isn't a useful metric. It's a fact that more people are dying every day as the case count goes up.
Docs are much better at treating, so while you're absolutely correct that it's going to go back up - I'd be shocked if the death spike this time comes close to having the same relative size as last time.

But the two big answers to the question are:

1) Death isn't the only negative outcome for a Covid case.
2) If hospitals are overwhelmed with Covid, then they can't treat normal causes of death such as heart attacks, accidents, etc as well as they could before.

It's a real shame that media on both sides of the political spectrum have made this all about death.
Fitch
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Statewide Trends:





Regional Breakdown:







Texas Trauma Service Area (TSA) Regions, COVID Census:






Houston Area County COVID Hospitalizations:



Source: https://dshs.texas.gov/coronavirus/additionaldata/
plain_o_llama
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Latest Dallas County summary has been released.

https://www.dallascounty.org/Assets/uploads/docs/covid-19/hhs-summary/COVID-19-DCHHS-Summary_112020.pdf





ramblin_ag02
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I wouldn't believe the hospitalization numbers right now. All the big DFW hospitals are capping COVID admissions at 14% of total census. They are refusing all transfers that they would normally take. I've heard stories of them keeping dozens of COVID patients who should be admitted in the ER for days.

Basically, if the COVID census gets over 15% then the state says they have to stop elective procedures. So no hospital is going to go over that for any reason whatsoever.
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Stymied
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If that's the case, where are the cases going? Being sent back home?

Color me skeptical. That either means they are risking lawsuits by sending Ill patients home or they have historically over admitted people that really didn't need to be in the hospital.

I'm not doubting that it may be happening however we are constantly told that hospitals and doctors don't have a profit motive. You can't have both ways.
tysker
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Define ill patients. During a heavy flu season, do ERs keep beds filled with patients complaining about chills and fever or do they send them home with a note and some theraflu? ERs can be full but they send the least problematic patients home as soon as its clear they dont need additional treatment and can be sent home without too much concern. There are still lots of people that use the ER as their PCP.
ramblin_ag02
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AeroAg2003 said:

If that's the case, where are the cases going? Being sent back home?

Color me skeptical. That either means they are risking lawsuits by sending Ill patients home or they have historically over admitted people that really didn't need to be in the hospital.

I'm not doubting that it may be happening however we are constantly told that hospitals and doctors don't have a profit motive. You can't have both ways.


It just relates to COVID specifically. And part of the emergency measures for the pandemic makes lawsuits almost impossible. EMTALA is suspended. For the first time in my career the big hospitals are refusing to take patients that we are literally not equipped to handle. It all relates to the 15% rule and elective procedures. Believe it or not; it's not like I'm directly dealing with the effects of this or anything.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
BiochemAg97
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ramblin_ag02 said:

AeroAg2003 said:

If that's the case, where are the cases going? Being sent back home?

Color me skeptical. That either means they are risking lawsuits by sending Ill patients home or they have historically over admitted people that really didn't need to be in the hospital.

I'm not doubting that it may be happening however we are constantly told that hospitals and doctors don't have a profit motive. You can't have both ways.


It just relates to COVID specifically. And part of the emergency measures for the pandemic makes lawsuits almost impossible. EMTALA is suspended. For the first time in my career the big hospitals are refusing to take patients that we are literally not equipped to handle. It all relates to the 15% rule and elective procedures. Believe it or not; it's not like I'm directly dealing with the effects of this or anything.
To me, there would be a difference in taking a transfer vs admitting a patient that showed up at your ER. I can see them refusing transfers to avoid busting the 15% limit and having to shut down elective. Harder to see refusing a patient that presents at the ER.
PJYoung
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BiochemAg97 said:

ramblin_ag02 said:

AeroAg2003 said:

If that's the case, where are the cases going? Being sent back home?

Color me skeptical. That either means they are risking lawsuits by sending Ill patients home or they have historically over admitted people that really didn't need to be in the hospital.

I'm not doubting that it may be happening however we are constantly told that hospitals and doctors don't have a profit motive. You can't have both ways.


It just relates to COVID specifically. And part of the emergency measures for the pandemic makes lawsuits almost impossible. EMTALA is suspended. For the first time in my career the big hospitals are refusing to take patients that we are literally not equipped to handle. It all relates to the 15% rule and elective procedures. Believe it or not; it's not like I'm directly dealing with the effects of this or anything.
To me, there would be a difference in taking a transfer vs admitting a patient that showed up at your ER. I can see them refusing transfers to avoid busting the 15% limit and having to shut down elective. Harder to see refusing a patient that presents at the ER.

We've heard stories of hospitals sending patients home with o2 bottles and contracting with 3rd parties to check on them daily.
cone
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that's probably a good practical response
ramblin_ag02
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They are either sending them home with oxygen and home health, or they are putting them under "observation". Observation patients are in the hospital but not admitted. Or just keeping them in the ER for days. Anything to keep "official COVID admissions" down
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culdeus
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One of the issues with this thing is hospitals can't make much money treating people with just piping O2 in and hoping for the best. They have a defined motivation to keep admits low so they can keep doing electives. It probably hurt a lot when they figured out that intubating people was more or less useless, that was going to be a nice cash cow dead or alive.
AggieFactor
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Still no ICU flu admits
Still no flu hospitalizations
Still no positive flu test at hospitals
Not a Bot
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We are well over 15% in terms of hospital admissions if you calculate it by using the formula: Covid Patients / Total Patients. Not sure what the criteria actually is or what counts in the calculation. Same-day surgeries are still happening.
ramblin_ag02
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Cactus Jack said:

We are well over 15% in terms of hospital admissions if you calculate it by using the formula: Covid Patients / Total Patients. Not sure what the criteria actually is or what counts in the calculation. Same-day surgeries are still happening.


https://www.dshs.texas.gov/ga32/

Technically it's a 7 day rolling average of percentage of COVID inpatients for an entire trauma region. So maybe there's a criteria not met in there somewhere yet
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TexasAggie008
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It has to be 7 CONSECUTIVE days at 15%+....the one that matters for North Texas/DFW was 14.4% yesterday and has been 15% 0 days during this run. Hopefully it doesn't happen because there's absolutely no reason to crush businesses during the holiday season (restricting restaurant and retail capacity).
ramblin_ag02
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TexasAggie008 said:

It has to be 7 CONSECUTIVE days at 15%+....the one that matters for North Texas/DFW was 14.4% yesterday and has been 15% 0 days during this run. Hopefully it doesn't happen because there's absolutely no reason to crush businesses during the holiday season (restricting restaurant and retail capacity).


It's never going to get to 15% because it isn't a true assessment. Hospitals are gaming to keep that number down. I don't blame them, but the hospitalization numbers in Texas aren't good data anymore
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
culdeus
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ramblin_ag02 said:

TexasAggie008 said:

It has to be 7 CONSECUTIVE days at 15%+....the one that matters for North Texas/DFW was 14.4% yesterday and has been 15% 0 days during this run. Hopefully it doesn't happen because there's absolutely no reason to crush businesses during the holiday season (restricting restaurant and retail capacity).


It's never going to get to 15% because it isn't a true assessment. Hospitals are gaming to keep that number down. I don't blame them, but the hospitalization numbers in Texas aren't good data anymore


They simply gonna say they are pneumonia beds or what?
Fitch
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Statewide Trends





Regional Trends







Trauma Service Area (TSA) Regional Hospitalizations





Houston Area Hospitalizations

Not a Bot
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TexasAggie008 said:

It has to be 7 CONSECUTIVE days at 15%+....the one that matters for North Texas/DFW was 14.4% yesterday and has been 15% 0 days during this run. Hopefully it doesn't happen because there's absolutely no reason to crush businesses during the holiday season (restricting restaurant and retail capacity).


Looking at the latest data it's trending that direction.
Phat32
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Anecdotal, but I know way more people that have contracted it during this wave than at any other point in the pandemic.
Charpie
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Same
c-jags
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yukmonkey said:

Anecdotal, but I know way more people that have contracted it during this wave than at any other point in the pandemic.
same here. first go round i only had 2 or 3 first hand positive cases from March - July. probably 30 or so since August.

while i know there are people that have passed from it, no immediate acquaintances of mine have.
hoosierAG
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Same, barely knew anyone with it until this recent wave. Now it seems multiple times a day I hear from or about another one
Cyp0111
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Where are yall located ? The wave in Houston over the summer felt like a lot more people I knew got it but different areas going through at different timing.
hoosierAG
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I'm in the Raleigh area in NC. We are having record cases every day (like a lot of places) so not surprised. Exposure quarantines are even more so as you would imagine. Again, like others said, it's anecdotal so nothing more/less. Just what I am experiencing.
c-jags
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Cyp0111 said:

Where are yall located ? The wave in Houston over the summer felt like a lot more people I knew got it but different areas going through at different timing.
Temple/Belton/Killeen for me.

we still haven't had an explosion of any sort. our media has tried to make it look like we have but our hospitals have never near overrun and we have 100 deaths out of 400k people.
Not a Bot
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Houston area is still well below their summer peak. One of the few bright spots in Texas.
cone
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it just got cold this morning

we'll see
Not a Bot
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Saw a news article today that Tyler-area hospitals had a drop in Covid hospitalizations, from 268 to 235. This is in a region that is approaching the 15% for 7 consecutive days. This is either day four or five above the threshold. Curious to see what these reported numbers do to that total.

A lot of restaurants are teetering already and if they are forced to reduce capacity or shut down again in this area it is going to be devastating.
plain_o_llama
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The latest Dallas County Summary has been posted.
Data on these charts is thru 11/21

https://www.dallascounty.org/Assets/uploads/docs/covid-19/hhs-summary/COVID-19-DCHHS-Summary-120120.pdf







plain_o_llama
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And the emergency room symptoms chart


pocketrockets06
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So more people going to the ER for CLI but ICU hospitalizations trended down. This would jibe with what I'm reading where docs have raised the threshold for admission as the hospitals are getting crowded. That's not a positive sign. But we may not see the deaths at home until weeks later. (Same happened in NYC in the spring).
Fitch
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Statewide Trends






Regional Trends







Trauma Service Area COVID Hospitalizations






P.U.T.U
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Interesting to see the more southern regions to have had a bigger spike than what we are seeing now except for a few areas. Line seems to be around San Angelo, Waco, Nacogdoches.
 
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