Really? We still can't flex hospital capacity?

There is a pathetic effort to catastrophize public health despite the failure of this strategy with Covid-19.  It is self-destructive of trust in government and trust in public health reputation.

There is an active effort underway to catastrophize this winter's flu season by rebranding the common cold as a newly exotic, and threatening, RSV.  What we are experiencing, as far as I can tell from the various numbers, is a routine to slightly harder than normal flu season on top of the residual impacts of Covid-19.  

Nothing to be panicked about other than the claimed hospital under-capacity.  News accounts are laden with stories of young children unable to gain the ICU treatment they need owing to every bed already being utilized.  There are stories of people being rerouted to hospital ten and twenty miles away.

Had to tell whether any of that is meaningfully true.  We had the same propaganda under Covid-19 but every time push came to shove, it turned out to be a scare story.  New York City claimed a public health emergency and the US sent a hospital ship that was barely used at all.  It was all signaling, not a real emergency.

At some point, I had call to research hospital capacities and while they were above average, they were not shockingly so.  Making up the numbers, it was something like normal utilization was 80% and the hospitals were running at 90%.  In other words, heavier than normal but by no means at capacity.

So we went through a two year public health stress test in which hospital capacity was held to be a critical factor in success or failure.

I would have thought that after that, the states would have revisited their emergency capacity plans and probably raised them somewhat.

Consequently, when this year's flu season comes along and the MSM is all ululating over stretched capacity, I am surprised.  We just went through this.  Surely we have greater ability to flex capacity now than we did in 2020?

I haven't investigated hard but have kept my eyes open for any sort of revelation.

This isn't it but it does touch on the topic.  From As RSV Rages, States Intentionally Limit Hospital Beds by Jaimie Cavanaugh and Daryl James.  Regrettably it is written in advocacy speak which reduces the credibility of the argument.  

Bed capacity is a planned condition in each state.  You have the capacity that your state wants (based on authorized Certificates of Need, CON).  It is a fact of economic life that hospitals make the most money when they operate routinely near maximum capacity.  

COVID already provided a wakeup call. California, Texas and 10 other states — covering 40% of the U.S. population — started the pandemic with an edge. They fully eliminated their CON laws years before the emergency, resulting in more hospital beds, surgery centers, dialysis clinics and hospices per capita than the national average at the end of 2019.

Other states had to backtrack. “Conning the Competition,” a report from our public interest law firm, the Institute for Justice, finds that 24 states and Washington, D.C., quickly suspended their CON requirements when COVID infections began to spread, allowing health care providers to respond more quickly to the crisis.

Rather than learn their lesson, most of these states returned to full CON enforcement by 2022 as if nothing happened. Now they are scrambling again.

What they fail to grasp is that putting artificial limits on hospital beds is a dangerous game. Policymakers ignore decades of evidence when they cling to CON laws. Congress found the federal CON law to be a failure in 1987 and repealed it. The Antitrust Division of the U.S. Department of Justice looked at CON laws again in 2008 and found no public benefit. Multiple studies since then show CON costs exceed the benefits.

Repealing CON laws would not end COVID, the flu or RSV. But it would end a rigged system that benefits big hospitals at the expense of entrepreneurs, health care professionals and patients — including the ones crowded out of emergency rooms and pediatric wards this holiday season.

So, based on this article, it would appear that all the federal and state level public health agencies essentially reverted to the pre-Covid-19 norms after 2021.  No lessons learned.  No capacity added.

All through 2020-2022 as I lambasted the government and public health agencies for essentially always making the wrong decision whenever given the opportunity, and always either ignoring or skirting the already available scientific evidence, my refrain was that the one silver lining was that Covid-19 provided a very real world stress-test of our public-health preparedness and our capacity to make good decisions under conditions of uncertainty.  My stated hope was that we would learn from our mistakes and be much better prepared next time.

Because, in the scheme of things, Covid-19 was not nearly as infectious, lethal, or long lived as it might have been.  Had it truly been high transmissibility with high lethality, we would have been facing an existential crisis rather than a crisis of credibility.

If, in 2022, we are still unable to flex hospital capacity to handle the normal surges of winter illnesses, then we have learned nothing.