> but I don't get why (from what I've seen) hospitalizations don't seem to be all that important when reporting on COVID numbers in general.
To an extent, by the time the hospital numbers are going up sharply, it's too late, and the hospitals will inevitably be overwhelmed, so it's not a good guide of policy. New case count is the only vaguely timely indicator we have.
"inevitably be overwhelmed" now looks less likely than it did in March. There is less use of ventilators and ICU usage has been less than initially anticipated.
To be clear, I mean that hospitals will inevitably be overwhelmed once you see a sharp upswing in hospitalisations; by the time you see that the pipeline is likely already primed and nothing you can do will change the trajectory of the upswing much for days. If you see a sharp upswing in cases, though, swift action can maybe deal with that (assuming you have decent observability). Most the the cases will never see the inside of a hospital, but they provide a somewhat useful proxy for the future of hospitalization.
If you need to pick a metric on which to reinstitute lockdowns, hospitalization isn't really very useful; it's better than nothing but if you use it you're probably going to overshoot.
At one point ventilators had a 90% fatality rate or something like that. I think they found that in a lot of cases they either weren't helping or were hurting.
One difficulty is that while there have been improvements in treatment resulting in less ventilator and ICU usage, and we've substantially increased number of ICU beds in many areas, we're still seeing staff attrition. In my metro, major hospitals have been diverting cases to further-out hospitals not because of equipment shortages but because of staff shortages. Staff are getting sick, and then they're out for a while. Their training can't easily be replaced -- you can train other medical folks to do sort of a half-assed job in an emergency, but you'll see higher mortality in that situation.
The only reason the hospitals aren't overwhelmed is that we kept the total case count low enough. Now that the case count is going up, we're seeing the same problems.
Yes, we don't seem to have quite the same equipment shortages as we had in March. That's good. That was part of the reasoning behind the lockdowns.
Yes, we seem to be doing better at keeping people dying, that's good ... but it's going to take up more hospital resources for longer periods, that's going to exacerbate shortages.
That's because most major metros shut their econmies down in march well ahead of them having significant community spread. We are now starting to see the results of opening back up and the daily incident rate is increasing super linearly again.
To an extent, by the time the hospital numbers are going up sharply, it's too late, and the hospitals will inevitably be overwhelmed, so it's not a good guide of policy. New case count is the only vaguely timely indicator we have.