Business as usual in our hospitals (6 BC-Cancer hospitals serving 6 million residents ), its no where near to the dramas other's expressing
The USA is 11.5 days behind Italy in terms of having too many cases for its healthcare infrastructure to handle. At that point, hospitals will have to make tough decisions about rationing out lifesaving interventions to the patients who are more likely to make a recovery from their illness. This will universally be the younger and less comorbid demographic. Additionally, because so much of the ability of a hospital to perform its usual duties will be hijacked into the care of COVID-19 patients with "bilateral interstitial pneumonia", patients coming in with heart attacks and strokes might die at much higher rates. Spoiler Factors that may make the USA fare better than Italy: 1. Inherently we are a more isolated, less communitarian society than Italy's. Americans practice social distancing on their own without any instruction to do so. 2. On a personal level, we have had some time to watch Italy's example and behave in a different manner in terms of going out to socialize, dine, and gather for other reasons. Factors that may make the USA fare worse: 1. We have less per capita hospital beds and ICU equipment (ventilators, CPAP/BiPAP machines). 2. There are still people out there that are parroting the narrative that this is just an overblown panic move with a political motivation behind it. To rebut one argument I've seen so far on this thread, that "It's not even as bad as the flu": Yes, the flu probably kills somewhere between 20-50k people on an annual basis. It's very hard to get accurate numbers on this because a lot of times we physicians are left deciding between the flu or the underlying risk factor such as cirrhosis, end stage renal disease, heart failure, or COPD that had the patient on a slow but sure collision course with their maker. The flu was merely the straw that broke the camel's back. Overall, epidemiologists estimate that the flu has a 0.1% mortality rate amongst the broad population, which means that if we have 20-50k deaths, then somewhere between 20-50 MILLION people are infected with it each year. That is with the flu vaccine which can be variably effective in a given year. That is 10-15% of the population, per year. What people need to understand is, on a given winter depending on the severity of that year's flu strain, any social safety net hospital can be filled to the brink just from flu patients alone! I did residency in Ben Taub, and our ICU had 16 beds. 2014-2015 was a relatively bad year. That winter it was not an infrequent occurrence for our medical ICU team to be covering all 16 ICU beds, 4-8 in the surgical ICU, and rarely 1 in the neurosurgical ICU, where a large proportion of those patients were intubated with severe flu infections. The takehome point I suppose is that the American healthcare infrastructure is designed to accommodate the diseases that it ALREADY sees on a regular basis. Beds are built to be filled, not sit empty. There isn't much room for any additional burden to the system. Our safety factor is much lower than that of engineers. To compare the flu to COVID-19, we do not have enough data yet on how much more or less contagious it is. Some people including the leaders of Germany, UK, and the state of Ohio are already proclaiming that, within the next 24 months, 50-70% of the entire population will have caught it at some point. I'm not sure if that will be the case. What is certain, however, is that its mortality rate is 10-20x HIGHER than that of the flu, and its rate of serious infection is similarly higher. In Italy they are seeing even young people with severe disease who need supplemental oxygen and sometimes temporary placement on a ventilator. Even when such patients recover, there is a possibility of chronic scarring to the lungs from which they will always have a limited respiratory functional reserve. I have to reiterate yet again: you cannot trust medical professionals just on the basis of their credentials. People will say anything if they are paid to do so, or if they just want to follow the crowd that they have decided to identify with. It's perfectly fine to say that, as of right now, the coronavirus has infected many-fold fewer people than the flu has. But, these doctors are not epidemiologists. They are not in the business of predicting the future. Listen to the public health professionals. This is definitely something to be concerned about. We cannot stop the tide, but we can diminish the strength of its initial surge, and over time as people come in with serious illnesses we will be more able to handle them at a slow and steady rate.
Appreciate the information. My only thoughts on mortality rates are the numbers outside of Italy and China. Also that the elderly population rates are skewing the overall mortality rates. Italy and China, specifically the Wuhan province are significantly higher than other regions. Granted it’s early and not sure the information is correct that’s been given. Plus that 40-70% was one of 4 outcomes from the CDC with that estimate being the absolute worst outcome, of course people ran with that one.
We don't have the best hospital bed per capita in the world, but we blow everybody out of the water on critical beds per capita. https://www.forbes.com/sites/niallm...are-beds-per-capita-infographic/#8c2a957f864a Here's what I think I think: -Panic and fear are hysteria are dumb and we're going to look back at the time when we were sold out of TP and think WTF... -Social distancing and limiting our exposure is exactly the right thing to do now...canceling big events, working from home if we can, keeping elderly away from folks...all good. -Bringing the full might of the United States to fight this off the best we can...A+ If we do this right, we're going to look back in 6-9 months and think "What the heck was the big deal" and that'll be the perfect outcome because we did the right things.
People hoarding toilet paper are stupid. Mouthbreathers in Akron or Topeka acting like panicked rats dont make all the prudent precautions of the professionals panicky, too. That seems to be the logic I've seen, be it intentional or not - a bunch of morons going overboard at the bottom of the food chain means the entire enterprise is irrational panic.
Optimism is the way as long as it doesn't become an excuse for resistance and inaction by our leaders
as a moderate at just about everything who frustratingly sees the truth as always being in the middle and everything in shades of gray, I’ve really appreciated your seemingly non-partisan insight into all of this. If you get pulled away to the frontlines (or even if—hopefully—that isn’t necessary), I hope you still find time to share your opinions here.
can someone explain the heat map looking thing they show on the news, that correlates italy pollution with their lockdown? I didn't get it.
This always puzzles me. Would you prefer I not speak about my life? This place has always been a diary. I started here when there were only 400 members and the internet was brand new. I don't mind being insulted; I was one of the original folks to do so; but I would do it to your face as a friend because my friends & I always, to this day, insult each other. Social media and this BBS has changed, and it isn't for the better. Back in the day we were a family. Disfunctional, but we had each other's back. People like Cheetah ruin that dynamic. Don't laud him. He needs to go away.
I'm in Dallas. This is how crazy it's become up here: My daughter works as an epidemiologist for Parkland Hospital. Their warehouse was broken into and all of their N95 masks were stolen. As of 7 PM last night, all entrances to the hospital have been sealed with armed security posted. There are now only two public entrances allowed - Main Entrance and the Emergency Room. Needless to say, the ER is swamped with walk-ins demanding to be tested. All of the big box stores (Sam's, Target, Costco & Walmart) are sold out of meat, poultry, fish, vegtables, fruits, paper products, bottled water, ice and cleaning supplies. By late afternoon, there has also been a run on charcoal (WTF???). The regular grocery stores like Tom Thumb, Kroger's, Aldi's and Walmart Neighborhood have shelves that are virtually empty. The discount stores like Dollar General, Family Dollar, Dollar Tree have likewise been cleaned out. There's also a run on gasoline as many stations have begun rationing the amount that can be purchased. I lived through 4 hurricanes AND was stranded on the East Coast during 9/11 and I've never seem it this crazy. Just imagine how it'd be if the zombies actually showed up.
I was in Montrose HEB this afternoon st around 3PM and people were 10000 times more rational than on Thursday night and Friday. The store was going all out restocking. There were big voids in coverage - still no toilet paper and you would see one section of shelves completely stocked right next to a section that was totally empty, but it seems like that was mostly a function of having enough manpower hours to get it all done. They were constantly wheeling out palates full of goods the entire time I was there. There were whole shelves filled with canned goods and people would walk right by and werent shanking each other to grab every last can. I dont know, maybe the Mad Max mentality still reigns out in the burbs, but in my little narrow slice of the world, things seemed vaguely normal.
Because there are only two types of people in this country, and this is true to every topic in life Mature Americans or Kiddo Libtards Which one are you, Buck?
