My End Of The Stick

1) Orange County declared a health emergency yesterday. I have no wild idea what that means, and I've worked health care here for 20 years, including about 2/3rds of the E.R.s in the county. Best guess, it simply means TPTB in the county have officially freaked the f**k out about the slow roll out of Kung Flu we've been covering here for over a month, and which we warned our own hospital management about, in detail, over two weeks ago was going to put a serious cramp in our ability to treat patients, indefinitely, even if we never had to treat a single case of Kung Flu in person.

2) Observe the picture above this post. That's at the hospital with the largest ED in the county, 50+ beds. It's the second busiest ED in CA, most years, at over 120K visits/yr.
I have some wee experience inside that ER. So what's wrong with that pic?
Look at the sign.
English. Spanish. Nifty.

But.
OC has a yuuuuuuuuuuge Asian population.
Garbage Garden Grove and Westminster were selected to receive Vietnamese refugees and boat people in 1975. There are now miles-long sections of the main boulevards where you can drive for miles and not see a single English sign. There is also a huge Loatian and Cambodian sub-community there and in adjacent cities.
Anaheim has Chinese in small mountains, both Mandarin-speaking from Beijing and the hinterlands, and Cantonese-speaking from the teeming coastal cities like Shanghai and Hong Kong. (What? You didn't know "Chinese" isn't a language? That there are ten major dialect groups , and that they are mutually unintelligible to each other with a hundred miles of distance, all across China? You're as smart as most health administrators.)
Fullerton is literally teeming with Koreans, who have nearly displaced Hispanics as the #2-ranking minority population. This is in no small part because of the state college and university there.
Irvine's student body, like all the UCs, has a huge Asian sub-population, both students and faculty.
Orange has a large population of Gujarati-speaking Indians.
Then there are Filipinos everywhere, as well as Indonesians, Thais, and every other stray cat and dog from Noah's Ark. Many of whom (especially elderly ones) speak about zero English.

You tell me, but it you're trying to get the word out on a potential pandemic, coming from mainland China, you'd think you'd take a stab at the larger ethnic populations, particularly posting signage for Mandarin and Cantonese speakers. So much for Providence Health Care's common sense. And they now own that hospital, and three affiliated large hospitals in the county. For just one example.
Pooch: screwed.

3) As we noted on these pages a few days ago, unless you were in China, or had direct known contact with known lab-tested infectees, the CDCidiots names "no identifiable risk". Problem being, with a 2-14 (and perhaps as much as 24- or 28-) day incubation period, during some amount of which you're contagious but asymptomatic, you could easily be infected, and be third-, fourth-, fifth-, or Nth-level removed from the person who the CDCidiots think is the main hazard. This kind of rank official stupidity is a recipe to grow this to full-blown pandemic in a few weeks.

4) A poster noted in comments to the previous post that there are about 930K hospital beds in the US, and 93K ICU beds. I have no basis to dispute those numbers, so we'll stipulate for the record they're reasonably accurate. But low-end, this is going to create 1.5M deaths nationwide, if it distributes like flu, and maintains a 3% mortality. (That's 30X the annual flu numbers.) And at 3% mortality, it will create up to 15 million hospitalizations, and 30M hospital visits.
And hospitals, IMH experience, run from 80%-100% full most of the time now, from heart attacks, strokes, trauma, and the other rainbow of human frailty that feeds me and keeps a roof over my head, as it has for over 25 years.

So trying to shoehorn another 15M patients into 930K hospital beds, and 93K ICU beds (our ICU, e.g., is frequently full-up most days already) is going to totally collapse health care in this country as you know it. For everything. For everyone.

Suffice it to say we won't be installing bunk beds in the hospital patient rooms.

We'll be on society-wide China-style lockdowns long before then, and IDC if you pop up hospital wards in gymnasiums or sports stadiums, because you aren't going to squat and crap out 1-2M doctors and nurses overnight to treat the patients in those beds.
Not. Going. To. Happen. Ever.

As Rummy famously told you in 2002, "You go to war with the army you have, not with the one you wish you had."

Those people are going to go untreated, or poorly treated, just like in China, and the rest of the Turd World.

Wrap your heads around that reality.

"So what, Aesop?"

So what is, a number of those people are going to die.
Numbers you're not used to seeing, even if it's "only" 3% or so.
(Which is sheer heaven compared to Ebola's 66-90% rate).
In a busy trauma center, 1-2 deaths is a busy day.
Now double that.
For all of this coming year, potentially.

And the people shafted volun-told to care for them are going to fail, miserably, probably get infected themselves due to lack of training, lack of experience, lack of equipment, and simply being overwhelmed. Making the whole problem that much worse.

Ad hoc treatment centers, if this turns into pandemic, are going to look like the MV Death Princess, minus the swimming pool and cocktail lounges.

I repeat:

There will be no ICU care if this goes full pandemic.

None. Nada. Zip. Niente. Bupkus. Zilch. Zero.

We fight for 5 beds/night in a busy trauma center, now, every day.
We routinely hold 1-4 ICU admits and 5 or more telemetry admissions all night long in the ER (making ER care that much harder to get too, for those sitting outside trying to get in - and that includes ambulances - sh*t rolls downhill), hoping that some patients either improve (and get downgraded) or else simply move to the morgue, in order to open up beds after morning shift change.
Sometimes that happens, sometimes it doesn't.

When it's really bad, we go on diversion, dumping all ambulances onto the other hospitals in the area.
Until they choke and close too.
Once everybody closes, everybody's open again. But there's still no beds, so they sit on a gurney, in the hall, for as long as it takes. Hours, even.

Add on 10-20 WuFlu victims/day/all of 2020, at least 1/3 to 1/2 of them needing admission, possibly ICU beds, and ventilator support, times every ER you ever heard of, and you can cancel Christmas.
Literally.

If you're not at least ICU sick (the only thing worse is Forest Lawn sick, btw) when you come in, you're probably never going to get a hospital bed.

The beds we have will be used to try and save those almost dead.
Anything less is going to get re-routed to some half-assed minimally-staffed mega-disaster-plex, someplace like Angel Stadium, the Pond, or some other huge parking lot location closed for the duration because of public infection risks. Staffed by who-knows-who. Retirees and kids, if they're lucky. Maybe military and the Notional Guard, if they're screwed into it. Possibly nobody.
And run with the same management care, expertise, and diligence that gets you the Post Office, the DMV, and the TSA, 24/7/365. Good times.

If this gets that ugly, go long on shroud and bulldozer stocks.
Short sports franchises, theme parks, airlines, and resort hotel chains.
Think the travel industry starting on 9/12/01.

5) Now, therefore, based on what you now know, think on what you might want to be putting aside for yourselves for, say, the rest of 2020. Maybe into Spring 2021.

If you take care of yourself now, before it's a problem, you won't be part of it down the road, and I won't see your happy @$$ in my hospital, nor will any one of my colleagues.

Don't be That Guy. No, REALLY. Just DON'T. M'kay?

And remember this little chat and explanation the next time some official spokeshole starts blowing happygas on you from out between his butt cheeks, and tells you "American health care is first-rate, and we can handle this." Like they told you about Ebola, right before it showed up in Dallas in 2014. And American health care totally blew that right out its @$$. 

And on that cheerful note, I bid you happy thoughts.
Now go shopping.

And if this turns into a nothingburger, with only a mild impact, remember that the stuff doesn't go bad on your shelves. It just means you can eat for next year at last year's prices.
Win-win.

Qwitcherbitchin and get busy.