Image credit: Clarksville Now
I guess it was about a week or two ago when I first began to entertain the notion that I’d need to be leaving Nashville, Tennessee—my home for the past four years—and decamp for someplace safer during the coming COVID-19 pandemic. Unlike our Glorious Leader, I DID see the shit storm that was blowing up, because I do things like “reading newspapers” and “listening to the news” and “generally keeping up on what’s going on in the world.”
By the time I dropped off my son with his mother in early March—who knows when I’ll see him again, now that the Canadian border is closed for nonessential travel, thanks Donald, thanks Republicans—I was already worried about some of the choices I might need to make. That was hammered home over the past week, as the New York Times (or was it the Washington Post? Pardon my Internet brain, I simply can’t recall) ProPublica published an interactive map in which you could select your metro area and see how coronavirus was expected to hit. Readers were prompted to select varying levels of infection, ranging from 20% on up to 100% 60%, and the map would illustrate how overwhelmed the hospital system would be.
First I clicked on Philly, a city of 1.5 million people, the poorest large city in the United States, a massive heroin and homelessness problem, and—as much as I love it—kind of a clusterfuck. I stuck with 20% infection, which resulted in something like 127% of beds occupied.
Yikes, right?
Well, Nashville is half the size of Philadelphia, just 650,000 people. And although it’s currently cash-poor, it’s the state capitol and pretty well-off. At 20% infection rate, however, 225% of hospital beds were occupied.
That’s on top of the fact that the state is nearly dead last for rural hospital closures. They closed another just last week. This is mainly because Tennessee is run by far right wingnuts who, to this day, hate Obama so much, they have refused to expand Medicaid.
I’m nearly 50 years old, which makes me higher risk for COVID-19 complications. I also have asthma—thankfully, it’s mild but that also jacks up my risk. I lost my job about a week ago, also due to COVID-19. I was already considering these things when the shit began hitting the fan. Lockdowns. Shelter-in-place. Reports from Lombardy. But it was Canada’s first border restriction that really hit me. What if they close down the highways? What if I can’t leave the state? What if I get stuck? The last thing I wanted was to put myself in a position where I needed treatment I couldn’t get. The last thing I wanted was to get news from Philly that my dad or his wife were in hospital, and I couldn’t get there.
Over the past week, I watched the Tennessee legislature—already defying people pleading with them to shut down meetings to prevent the spread of the virus—focus on such important matters as making the Bible the state book and doing away with carry permits. We made the Rachel Maddow Show as one of seven states doing nothing to stop the spread of coronavirus.
So on Wednesday, I decided I wasn’t sticking around to live through a humanitarian disaster in a failed state, which is what Tennessee is, or will be once all of this is done. I packed up the necessities, and prepared for the 13-hour drive for my father’s house in Philadelphia.
But I woke up Thursday morning feeling a little under the weather—which could have been due to sitting up late and drinking beer with my housemate, but could also be… well, you know. So I decided to drop by Vanderbilt Medical’s walk-in clinic, which is one of the few sites where you can get tested in Nashville.
I arrived around 9:45 AM, and added my name to the list. After waiting about 20 minutes to get called, the fellow sitting next to me said he had signed in at 8:30, got his first interview (it’s a two-tiered process, apparently) at 9:30, and was still waiting to be seen. He was upset and irritated. Everyone was wearing masks. A morbidly obese derelict whose personal aroma was like being punched in the face pushed his wheelchair around the room with his foot, coughing and hacking loudly and incessantly, and making everyone more nervous than they already were. He spit in the water fountain. President Trump was on the TV doing a press conference: he was lying as usual. It’s easy to tell when he’s lying, by the way—the tell is when his lips move. It was also making people nervous. The man next to me kept complaining to anyone who would listen.
A few minutes later, a staffer walked to the entrance and posted a new sign. Apparently, they were turning away people who wanted tests, although no one was saying anything. It was nearly 10:30 in the morning, and they were… out of tests? Who’s to say? Neither the governor, nor the legislature, nor the Tennessee Department of Health has been straight with the people they serve: the latter won’t even say how many ventilators they have. [The article also points out Nashville’s big shelter, Room at the Inn, will no longer let people stay overnight. So the city’s homeless population, which is a lot larger than you might imagine, are now stuck out on the streets (or hanging out at McDonald’s until it closes) presumably getting infected and spreading COVID-19. This isn’t meant as a slam on homeless people, just an acknowledgement of the unsafe conditions they are exposed to on a daily basis, and how those unsafe conditions now have much wider public health ramifications.] But yes, continue to address the pressing matter of the Bible, which you obviously have never read, or there wouldn’t be a homelessness crisis to begin with, you damned hypocrites.
Seeing that sign go up at the clinic made me realize I was doing the right thing. I didn’t even stick around for the test: a quick Google search showed me that Philadelphia already had drive-through clinics, and more than one (Nashville has none). I asked the woman behind the desk to take my name off the list, exited the building, started the van and got the Hell out of Dodge.
Some of you may know that Nashville had its ass kicked by a horrible tornado, which cut right across the state. I wasn’t in town for that disaster, and have spent most of my time back in isolation at my house. So I-40 East was an eye-opener. As I traveled through Williamson Wilson County, it was sheer fucking devastation, the likes of which I have never seen in person before. Hundreds of trees torn up from the ground, scattered around like toothpicks. Homes torn in two. Whole stands of pines still bowed over, three weeks after the storm. All I could think of was those closed hospitals, the refusal to expand Medicaid, and the obvious disaster that was going to make that tornado look like a carousel ride.
I’m safely at my father’s house now. Self-isolation and quarantine are a real issue here—as I said, he and his wife are in their 70s—and the extent we’ve gone to is a whole other level of crazy. It’s a very rational, reasonable, and necessary kind of crazy, but nuts all the same. I’ll write a post about that later.
Could you go back thru your history and find the link to that interactive map? I’ve plowed thru a crapton of them this morning and still can’t find one that projects data the way you describe.
I think this is it: https://projects.propublica.org/graphics/covid-hospitals, and will add to the article.
Thanks for this.
What number(s) in particular gave you pause? I ask because I plugged in for 3 areas: Nashville (in order to see what prompted you to get the hell outta Dodge), Columbia MO (where I would have been hospitalized if I were still living in Central Misery) and Denver (where I currently be).
From the article, I looked at the the part 40% infection vs available beds and then the paragraph below which looks at intensive care unit beds.
Nashville: 6300 beds over 12 months or 2.1 times the available beds required during that time period. ICU: 4.2 times less than what will be needed.
Columbia MO: 1560 beds over 12 months or 1.73 times the available beds required during that time period. ICU: 4.4 times less what what will be needed.
Denver: 6510 beds over 12 months or 2.9 times the available beds required during that time period. ICU: 4.2 times less than what will be needed.
Thus, by your calculus, I should get out of Denver. It appears based on this data that it damn near doesn’t matter where you live short of some island in the South Pacific never visited by wealthy tourons just off the plane from skiing in Vail.
From my article:
“That’s on top of the fact that the state is nearly dead last for rural hospital closures. They closed another just last week. This is mainly because Tennessee is run by far right wingnuts who, to this day, hate Obama so much, they have refused to expand Medicaid.
I’m nearly 50 years old, which makes me higher risk for COVID-19 complications. I also have asthma—thankfully, it’s mild but that also jacks up my risk. I lost my job about a week ago, also due to COVID-19. I was already considering these things when the shit began hitting the fan. Lockdowns. Shelter-in-place. Reports from Lombardy. But it was Canada’s first border restriction that really hit me. What if they close down the highways? What if I can’t leave the state? What if I get stuck? The last thing I wanted was to put myself in a position where I needed treatment I couldn’t get. The last thing I wanted was to get news from Philly that my dad or his wife were in hospital, and I couldn’t get there.
Over the past week, I watched the Tennessee legislature—already defying people pleading with them to shut down meetings to prevent the spread of the virus—focus on such important matters as making the Bible the state book and doing away with carry permits. We made the Rachel Maddow Show as one of seven states doing nothing to stop the spread of coronavirus.”
Ok, math was never my strong suit but I thought I understood % so I’m having a really hard time getting my head around occupancy rates >100%
I’m still looking for that map, but the >100% number demonstrated NOT ENOUGH BEDS. An overhwlemed system that couldn’t deal with the sheer number of patients. Like a restaurant where all the tables are filled,and there’s a line out the door down the block.
To kind of put a spin on it: let’s say you have a thousand bed facility and maybe 2500 severe covid 19 cases. It is not just that there are 1500 beds too few. It’s that a hospital has a mix of diagnoses filling those beds: traumas, pregnancies, surgeries, ad nauseum. So maybe the hosp really is only prepared to handle 200 beds worth of infectious disease cases. And is only equipped with the supplied for maybe that amt (plus 10% buffer for ‘shit happens’). That introduced lack of bed issues, supply issues, staffing issues, legal advisors (re controversial admission decisions), ad nauseum. Plus, treatment of additional clinical and other hosp support personnel due to exposure during treatment. There are just so many layers of complexity with just the service and volume sides even if we had a solitary clue. I am scared shitless as a sepsis survivor because I am immunocompromused enough to be extra susceptible plus most likely to not be worth the resources to save. And I can’t fault them for that.
Keeping fingers crossed that you don’t have COVID-19. Will say getting the hell out of Tennessee was a wise choice. Arkansas, as backward as it is, finally started drive-through testing in a few locations late this week. That said, there are simply not enough tests for the people who need them, and our hospital system would collapse under the weight of the sort of situation New York City is going through.
A friend of mine in Philly just recovered. He said it was awful, but it seems the worst part was the sheer terror that he was going to die. I might interview him for PP if he agrees.
We now have our first presumptive case in my county. Was only a matter of time.
You may have already seen this Brendan, but if not, I think you will find it interesting:
https://m.dailykos.com/stories/1929798
An hour after reading this, my wife and I were on the phone to our daughter in Oak Ridge, where she’s halfway through a 12-month gig at the National Lab (ORNL), which has sent employees to work from home. We’re very concerned for a variety of reasons. I had occasion to go to the ER at the hospital in Oak Ridge last September, and I have never been in such a amateurish medical facility before. If I thought it was safe to fly to Knoxville, I’d do so, but air travel right about now seems like a dubious option.
I’m glad you are out of TN given those circumstances. Thanks for sharing your story.
On a side note, we have friends in the Nashville area, and they are happy to still have a roof over their heads after the tornados if not much else; there are other people who are now homeless in the middle of this pandemic.
But it sounds like TN is just not responding swiftly. Contrast that with neighboring Kentucky’s response. Both states had a couple cases in the beginning. The Kentucky governor took swift action to close down schools and other activities after only a couple cases in the state. They are now apparently much better off than TN where there are now multiple areas of spread, while Kentucky still has only a few cases (although numbers may have changed since I looked). So to reiterate, I’m glad you’re out of there!