Kevin Roche speaks

Gene Galin interviewed Kevin Roche for Chatham Journal last week. I have posted the video below. Kevin is the proprietor of Healthy Skeptic and the former general counsel of UnitedHealth as well as former CEO of its Ingenix division.

Kevin has tracked the data and the research on Covid-19 from the beginning. He knows what he is talking about and is able lucidly to articulate his knowledge. The video supplements Kevin’s “Where we are now” posts that he has written for us this month. If you have followed Kevin’s work here or at his site, I think you will find this video update of interest.

This weekend’s big Star Tribune story by Jeremy Olson opened another front in the campaign of fear the paper continues to wage. The headline reads “COVID wave overwhelms rural Minnesota hospitals, leaving the sick nowhere to go.” Just in case you didn’t get the point, the subhead reiterates: “Latest wave has overwhelmed rural hospitals, leaving the sick nowhere to go.” This is a Minnesota issue — both the alleged problem and the Star Tribune’s coverage of it. I asked Kevin to comment. His response is below the break.

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Rural areas with their relatively low population and low population density have always had fewer health facilities and resources than metropolitan areas. Hospitals in rural areas never had large numbers of beds. For several decades the United States as a matter of policy has attempted to reduce use of expensive hospital care and this has resulted in a very substantial drop in total hospital beds per capita across the country. Many hospitals closed, others just reduced beds.

This trend hit rural areas particularly hard. As you might imagine, rural hospitals have even fewer specialized beds of any type, including ICU beds, which are featured in the Strib article. Although DOH doesn’t want to talk about it, the vaccine mandates in most health care facilities have caused or exacerbated staffing shortages, particularly again in rural areas. That means that even when a hospital may have beds, they can’t fill them because they don’t have the nursing or other staff to care for patients.

Hospitals typically run at very high occupancy rates, which is what they have to do when you have very expensive, capital intense facilities. There are not a lot of spare beds at any period of time. As noted above, certain actions during the epidemic are making this narrow band of available capacity even narrower.

Covid-19 patients are not a large proportion of any hospital’s daily census. On a given day any hospital has heart attack patients, congestive heart failure patients, patients waiting for or recovering from surgery, patients who need observation for an acute episode of a chronic condition and many other patients. I am not sure why we are treating the Covid-19 patients as the ones who are causing the tightening of available capacity.

A lot of hospital beds are currently filled with patients whose health worsened because they delayed care during earlier stages of the epidemic. People were frightened into avoiding health care facilities and now they have far more serious disease that requires hospitalization. So maybe we should blame the politicians and public health experts who created that fear.

We also know from the Minnesota Department of Health’s own statements that a significant portion of hospitalizations attributed to Covid-19, especially among the vaccinated, are not actually for Covid-19, but admissions for other purposes and Covid-19 is incidentally discovered via routine testing. It is absurd to treat these as Covid-19 admissions. Hospitals, of course, are highly incentivized to call every possible patient a Covid-19 patient because they get paid extra for treating them. So, once more, we see a shortage of capacity blamed on Covid-19 when it probably has little to do with the problem.

The headline for the story is frightening and clearly intended to be so, but what is described in the article actually reveals somewhat typical administrative runarounds and bungling. And it doesn’t appear that there was an issue with hospital beds in general as much as ICU beds in particular. As I noted above, there just aren’t many of those ever in rural parts of the state.

I wonder what the paper will do when it no longer has the epidemic to use to spread anxiety and panic–maybe talk about the very real crime surge which the party in power has created?

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