At What Point Are We Allowed To Ask Whether JBE Likes This Shutdown?

That might seem an overly provocative headline, but bear with us here, because this week has not been by any means a good one for the prospect that John Bel Edwards is committed to getting Louisiana back to business as usual and ending his economic shutdown, which has put more than a quarter-million Louisianans out of work and has businesses shuttered, many likely for good, from Shongaloo to Grand Isle.

First of all, two things became fairly clear this week in Louisiana.

Thing Number One is that the state has finally appeared to crest the wave along the infection curve you’ve heard so much about since this Wuhan virus disaster began. The numbers of new infections reported daily by the state’s health department have slowed, hospitalizations and ventilator use have begun to level off, and while the death rate hasn’t really dropped off (and we’ve been very dubious about the methods and motivations behind how it’s calculated in any event) everyone seems to agree that’s a lagging indicator of the progression of the outbreak. Even then, if we’re to believe those numbers they do appear to be slowing down. If you want to credit the shutdown for having produced that good news, you can – we aren’t going to address that question here. The numbers are slowing down, whether due to the shutdown or something else.

The numbers should slow down, because Louisiana has received a pair of sizable donations of hydroxychloroquine pills, and all over the country it looks obvious that’s a very viable treatment for this infection. Louisiana’s death rate, which as of yesterday is still an abnormally-high 3.6 percent, should start to come down as the medical system starts applying what works in order to heal patients. Anecdotally, the hydroxychloroquine-and-Z-Pak cocktail docs are administering has already begun generating success stories in the state.

All of which is very positive.

Thing Number Two is that it’s fairly obvious Louisiana’s health-care system is not going to be overwhelmed by the Wuhan virus.

We’ll give you an example of that. A little less than two weeks ago, Edwards and New Orleans mayor LaToya Cantrell, to much fanfare, debuted the newly-christened hospital they’d set up at the New Orleans Convention Center, where a cool $76 million had been spent to set up a 1,000-bed recovery center for coronavirus patients not needing ventilators or an ICU unit.

As of yesterday there are 40 patients at that makeshift hospital. Louisiana is spending just under $2 million per patient.

The state also dragooned three state parks into duty as shelters for homeless people with the coronavirus. As of a few days ago one was empty, while two others had a grand total of 38 people.

There are a couple of hospitals in New Orleans which are full. From the doctors and nurses we’ve talked to, most hospitals elsewhere in the state still have space available. We’ve not heard stories here like the ones in Texas, Florida and Southern California of hospitals being empty and doctors and nurses being furloughed or laid off, but while the state’s numbers say 2,014 people are hospitalized with the virus, that’s not a number which challenges the state’s capacity.

In fact, in none of the three categories of healthcare resource use that Louisiana is tabulating is the virus particularly threatening to overwhelm Louisiana’s capacity. These numbers are from the Louisiana Department of Health’s website – you can find them yourself here.

Edwards has made a big deal about ventilators, grandstanding by ordering some 14,000 of them at a time when the federal stockpile was all of 12,000. At present, there are 473 Wuhan virus patients on ventilators, which is down significantly from a high near 600.

But a ventilator doesn’t care if it’s ventilating someone with coronavirus, COPD or something else. And the state has, as of yesterday, precisely 2,000 ventilators available for use. Of those, as of yesterday 849 were in use by all patients, which is down from 941 on April 3.

Here’s a chart of statewide ventilator use between April 3 and April 9…

   Hospital Ventilators
Date In Use Total Available Total Total Percent In Use
4/3/2020 941 991 1932 48.71%
4/4/2020 917 1054 1971 46.52%
4/5/2020 908 1045 1953 46.49%
4/6/2020 934 1080 2014 46.38%
4/7/2020 885 1109 1994 44.38%
4/8/2020 894 1141 2035 43.93%
4/9/2020 849 1151 2000 42.45%

As you can see, at no point in the last six days, as this event has become most serious, has Louisiana even reached half of its ventilator capacity.

In the New Orleans area, which according to LDH parlance is Region 1, the ventilator numbers are as follows…

          Region 1
In Use Available
376 252
339 293
326 299
182 234
304 326
282 353
282 352

Another category being tabulated as part of the state’s numbers is intensive care unit beds. There Louisiana is a bit closer to capacity. Here are the statewide numbers on ICU usage, coming from all causes…

                  Available ICU Beds & Deaths per ICU Beds In Use *
Date In Use Total Available Total Total Percent In Use Total Deaths Rate
4/3/2020 1675 565 2240 74.78% 60 27.9
4/4/2020 1569 638 2207 71.09% 39 40.2
4/5/2020 1596 602 2198 72.61% 68 23.5
4/6/2020 1551 659 2210 70.18% 35 44.3
4/7/2020 1699 595 2294 74.06% 70 24.27
4/8/2020 1564 648 2212 70.71% 70 22.34
4/9/2020 1580 637 2217 71.27% 50 31.60

As you can see, the state hasn’t gotten above 75 percent of ICU bed usage throughout this outbreak. Nor has the New Orleans area gone critical…

          Region 1
In Use Available
577 136
562 177
595 144
547 175
600 158
548 180
549 191

We should point out that there’s nothing particularly magical about an ICU bed. You can make a hospital bed into an ICU bed if you have to. There is something of a challenge when you reach a staffing capacity, and perhaps that’s an issue – but proper management can deal with it. If New York isn’t overwhelmed, Louisiana can handle this.

And then there’s hospital beds overall. As we said above, LDH’s numbers yesterday indicated 2,014 virus patients were hospitalized.

But here’s the overall hospitalization rate in Louisiana…

        Available Beds
Date In Use Total Available Total Total Percent In Use
4/3/2020 10679 7675 18354 58.18%
4/4/2020 10307 7910 18217 56.58%
4/5/2020 10488 7824 18312 57.27%
4/6/2020 10417 8117 18534 56.20%
4/7/2020 10731 7508 18239 58.84%
4/8/2020 10611 7531 18142 58.49%
4/9/2020 10617 7493 18110 58.63%

Louisiana has never risen above 60 percent of hospital capacity throughout this outbreak. And they’re not in danger of running out of hospital beds in New Orleans, either…

          Region 1
In Use Available
2709 905
2648 981
2672 977
2460 1392
2599 954
2572 989
2520 1029

Louisiana’s health-care system is not, has not been and is in no danger of being, overwhelmed.

Lest we forget, the entire specific, stated purpose of John Bel Edwards’ economic shutdown, and those of other states and localities, is to prevent the healthcare system from being overwhelmed so that you don’t end up with more patients than you can treat.

That will not happen. It’s clear it won’t happen. Truth be told, it’s also relatively clear it was never going to happen. Edwards relied on data models which spat out apocalyptic numbers which from the beginning were fantasy.

And no, the idea that if you end the shutdown you invite a mass spread of the virus which would then overwhelm healthcare capacity is not valid.

What’s the event everyone blames the current levels of viral spread on? Mardi Gras. So much so that Cantrell has beclowned herself on cable news blaming President Trump for not ordering her to shut Mardi Gras down. We’re told that’s a super-spreader event which is both the reason for the crisis in New Orleans and the reason the shutdown is necessary.

Well, there isn’t anything on the calendar in Louisiana which equates to Mardi Gras. Not anytime soon. Probably the closest you’ll get is when Texas comes to Tiger Stadium to play LSU in September, but even that is nothing like Mardi Gras. Jazz Fest isn’t, the Essence Festival isn’t, the Fourth of July isn’t – nothing is.

Furthermore, opening the economy back up doesn’t mean everybody runs out trying to shake hands, kiss and exchange droplets with each other. The public has been frightened half into oblivion over this virus, and it’s entirely likely you’ll see people wearing masks and gloves everywhere for far longer than could even remotely be considered reasonable. It is simply invalid to equate the new normal Edwards has crafted in Louisiana with Mardi Gras.

And if Mardi Gras didn’t overwhelm the Louisiana healthcare system before the state has spent some $600 million of mostly federal dollars (though 25 percent of that is the state share; the state share drops to 10 percent when Louisiana hits $660 million in expenditures, which is why Edwards and his Commissioner of Administration Jay Dardenne are doing everything they can to spend more money on the virus), then you returning to some semblance your of daily life will have zero chance of overwhelming it.

Again, if it’s no longer reasonable to expect the health care system to be overwhelmed, there is no further justification for the shutdown. By any reasonable interpretation, the prudent thing for John Bel Edwards to be doing should be to signal that it’s going to come to an end at a date in the foreseeable future, whether that’s in a week, two weeks or at the end of the month.

Is he doing that? Absolutely not.

Louisiana Gov. John Bel Edwards said Thursday that he expects measures ordered to slow the spread of the coronavirus to remain in place through the end of May, although he is not ready to officially say yet whether he will extend his stay at home order when it expires on April 30.

Edwards said that expectation is based upon models that show virus infection rates declining in the U.S. are premised upon mitigation measures being in place until the end of May.

Again, he says he’s relying on mitigation models when the state now has a month’s worth of its own data to base its response on, and that data shows Louisiana will not run out of medical capacity.

Edwards also said this earlier this week…

Did you pick up on that? He essentially said there’s no effective treatment. Which means hydroxychloroquine and azithromycin, or Z-Pak, isn’t effective in John Bel Edwards’ world – if you get the virus there’s nothing the state’s healthcare system, with $600 million and counting in taxpayer dollars being thrown at the problem, can do to help.

And so you can’t go back to your life. You also can’t go back to work in John Bel Edwards’ Louisiana, not until he tells you and he doesn’t know when that will be.

Finally, from a transcript we received of the Unified Command Group briefing yesterday. Here was Edwards, in his closing remarks…

Thank you, please stay safe, and please stay well.

As the data becomes more promising, this presents greater challenges for our communications to stay on-message about slowing the spread.  All of the good data is a result of our mitigation efforts.  My office is being consistent, Washington is being consistent, so I need y’all’s help in staying consistent.  I know everybody’s natural inclination is to go back out and go back to work, but we still need to keep slowing the spread.

The audience for that briefing is a host of bureaucrats working in various state agencies. In other words, they’re mostly, if not all, John Bel Edwards’ employees. And he’s preaching to them about message discipline in order to keep his economic shutdown going in the face of what he acknowledges is a “natural inclination” to end it.

And why would there be a natural inclination to end the shutdown? Because the entire purpose of the shutdown was to keep the healthcare system from collapsing under the weight of virus patients. We now know that won’t happen, and so Edwards is ordering his people to “keep slowing the spread.”

This isn’t encouraging. This is an indication Edwards is protecting the shutdown in order to prolong it, more or less for its own sake.

You would hope that a man who purports to lead a state would respect its people enough to feel a responsibility to get them back about their daily lives. Instead, Edwards seems more interested in maintaining his current level of control over the people of Louisiana, and doling out government contracts to his friends, as long as he can regardless of whether the justification for doing so has passed.

Not acceptable. The time to go back to work is fast approaching, as is the time for John Bel Edwards to step down off his power trip and get out of the way.



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