It's a good question, but I don't think it's practical in our "free market"/non-authoritarian economic system. I am not a health science/management expert, but I imagine the issue is how you decide or incentivize what hospitals handle what issues. Barring a government mandate or subsidy, I'm sure every hospital would want to do the high margin or elective procedures and leave the COVID patients for someone else to deal with.

When the normal patient base is told to sit at home or do a teledoc session instead, the hospitals have very little choice.

Read how easily 2 of our posters got infected in a health care setting.

1)baller was just talking to a doctor that is part of his sales calls.
2)the other (sorry can't remember his name) got it when he took an ambulance ride for a heart issue.

Now remember we don't have enough ppe for the medical staff handling KNOWN covid-19 patients.


Now imagine how fast it would run through the medical profession and patients if we were trying to run "covid and non-covid" hospitals without adequate PPE for both patients and staff.

The future likely will include COVID-19 designated hospitals. Doesn't mean the other ones don't have to take precautions.

Duncan Idaho said:

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Read how easily 2 of our posters got infected in a health care setting.

1)baller was just talking to a doctor that is part of his sales calls.
2)the other (sorry can't remember his name) got it when he took an ambulance ride for a heart issue.

Now remember we don't have enough ppe for the medical staff handling KNOWN covid-19 patients.


Now imagine how fast it would run through the medical profession and patients if we were trying to run "covid and non-covid" hospitals without adequate PPE for both patients and staff.

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It is a shame though because people are putting things off routine things they had done to help their current medical issues and/or others will continue to ignore things they may would have addressed otherwise. Even when things do lift back up many will still be too hesitant to go in for certain things unless they are dire. It is catching things early that stops a lot of those bigger issues, but many are less likely to do that now.

Not sure if this is helpful or relevant, but my kids both have braces. The orthodontist office has laid off his entire staff saying he won't likely see anything but bleeders until August for lack of PPE.

jebeka said:

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I learned today a major hospital in our town furloughed 600 healthcare workers. They had 17 Covid cases that they were dealing with so all other operations were shutdown. Why aren't we designating a few hospitals for Covid care and the others for general care? We could take a 300 bed hospital to handle all the regional Covid patients and leave the large hospitals for other illnesses.

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Another question ... if over 90% of all hospitalizations are over age 60 or with underlying health issues .... and 80% of all deaths are over age 70 ... why not protect higher risk groups with stricter quarantine and 'shelter in place' regulations ... and roll back restrictions on low-risk groups?

A couple of possibilities come to mind.

In the larger hospital systems with multiple campuses, clinics, and affiliated urgent care I can see them pushing to a parallel system that funnels all Covid patients through a designated subset of facilities. This allows the profitable activities to potentially go on. There may be a lot of contractual issues to work through but this might be viable. This is obviously dependent on plentiful PPE and accurate and plentiful testing to gate patients and protect the "Covid-Free" zones.

Depending on how several things evolve, we may need to prepare for a tough Fall/Winter surge. A possibility in large cities is to convert convention centers or other buildings into dedicated Covid treatment facilities. As much as possible, all Covid treatment goes on there. One would probably need to begin assessing and planning now if this is to be feasible.

Because this is extremely difficult to do. Old folks homes are staffed by the young. Do we ban anyone over 60 from attending church? No more old ags at football games?

Marcus. How much interaction do you have with Critical Care Pulmonologists? I have some tricky underlying conditions and I normally have a CCP who manages me. Without the CCP having confidence in me I could not work soil remediation/HazMat Cleanup.

We have talked and developed an aggressive plan for me at first sign of any symptoms. Other than a CCP, is there a simple recommendation you might make based on you experience? My CCP is currently managing the group that is managing at least 12.....could be more by now.

I am a pulm/CC/sleep. I'm not sure I understand your question. Clarify please.

That makes total sense. Hospitals are built to make money. If we designate a hospital for Covid it's a financial death sentence for that facility. If a facility is designated Covid it needs to be government compensated.

Hammer meet nail.

I keep thinking we have this backwards, protect the small high risk and let the rest of us work to support them

How many are going to want government compensation under the current scenario?

I'd say one hospital per 400k town or region. Maybe 10 in Houston but 1 in Tyler or Amarillo. If you don't have a Covid hospital then drive to the closest one. Designated hospitals get help.

I know of at least one system in one region that did exactly that and then Governor Abbott banned all elective procedures anyway. So now my hospital is at 5% capacity with no COVID patients.

pocketrockets06 said:

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Because this is extremely difficult to do. Old folks homes are staffed by the young. Do we ban anyone over 60 from attending church? No more old ags at football games?

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Could do more of what grocery stores did during this where they have early hours just for the elderly. At football games could have a section reserved just for elderly (of course they would have to have a way to come in maybe as a group too say right before game starts). Lets face it, they are less likely to get it from each other than they are from the college students or kids, so if gathered in same area would be a little safer. Have a section of church or a service time just for elderly. On an airplane let elderly enter last and have section at front of the plane maybe.

Just give some opportunities to still be able to have places to go so they are not so isolated maybe some would appreciate it. End of the day though, they can still choose to take their chances and go when and where they so choose at their own risks, so they don't have to sit in those places or go at those times, just gives them some safer options.

Marcus Aurelius said:

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I am a pulm/CC/sleep. I'm not sure I understand your question. Clarify please.

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You have the same credentials as my doc then. I was thinking you where Emergency Medicine for some reason.

My question was probably to simple and not asked correctly. I have a wonderful CCP. The question had I asked more clearly would of been " is there another type doctor I should be coordinating with"? Maybe a internal medicine?

I think I am good with just my CCP.....but thought I would pose the question about the possible need for another doc.

Having a good plan brings me comfort. Thanks for all you do. What a time to be a CCP.

Marcus Aurelius said:

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Hospitals are losing millions currently. Critical ICU pts are a loss leader for hospitals. They make money off of large volume elective procedures such as colonoscopies, spinal injections, etc. It wouldn't be fair for one hospital to take on the COVID19 burden while the others continued to profit like normal. Not to mention the health risk to staff of a covid only hospital. And the mitigation efforts would be reduced.

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But what if that one hospital was Ben Taub?

You have the correct doctor. Good luck.

Thanks. Be safe.