I live in Seattle now as a doctor (mostly an outpatient gastroenterologist, don't get your hopes up). In speaking with my parents in Houston, and reading comments on this thread, it's still painfully clear that the majority of Americans outside the coastal hot spots have no idea what's coming for them. The stats that we have out there might as well be made up. If we're not testing anyone--and we aren't--then we're not diagnosing anyone. Even the deaths can be downplayed and attributed to a case of the "severe flu", as it was in Seattle for weeks before some basic scientists here at the Fred Hutch and UW started testing samples pro bono and against the rules: https://www.nytimes.com/2020/03/10/us/coronavirus-testing-delays.html Because the official numbers everywhere are being suppressed by an administration that is averse to scientific data, the country will not begin noticing the effect until a.) celebrities start getting infected (which began happening last night); and b.) the entire hospital infrastructure in the country starts to get overwhelmed like it has been in Italy. In Italy right now you have non-internal medicine physicians being trained on the fly to monitor ventilators and oversee intubated patients in makeshift ICU's in the OR's, even the hallways--wherever they can hook up positive pressure ventilation (PPV). Rationing of resources is common, with greater priority being given to patients who have a greater chance of survival. In a situation like that, the mortality rate is going to be way higher than 2-3%. https://www.worldometers.info/coronavirus/ Because the statistics surrounding coronavirus are so muddled by the underdiagnosis of subclinical (with minimal symptom) cases, we have to rely on other statistics including deaths and what they call the "serious infection" rate. These are patients that need to be monitored in the hospital and given supplemental O2 or PPV. Right now the serious infection rate is 10%--and that includes people in the younger age brackets who will ultimately survive, but might need some help along the way to do so! When you take the 10% infection rate and realize that the number of hospital and ICU beds per capita in the USA is actually lower than that of Italy, you will begin to understand why some people are panicking and buying up all the stuff in the grocery store. We don't need a high rate of transmission; we just need enough sick people to overwhelm what paltry resources we already have over a short period of time. Based on the stats we have about a 10-11 day lag behind what is being realized in Italy so far. The sad part of it all, from my parents and from posters here, is that people are still peddling Fox News talking points about this being a political tactic of some sort to make the administration look bad. I can't help with any of that; I just don't want people to die. The best example we have for how to handle this pandemic is in South Korea, where they were proactive about screening even people without symptoms. There, the mortality rate is lowest at 0.7%, not because they had better outcomes within their healthcare system, but rather because they diagnosed the most subclinical young people who were never going to do anything but transmit the infection onto someone else had they not been alerted to their infection status. If we take that 0.7% figure relating deaths to cases in the USA, we have 40 deaths divided by a 0.007 mortality incidence rate which equals 5700 active cases in the country. Once again this is a conservative estimate, because we have not tested many other (mostly old) people whose deaths were attributed to a severe case of the flu, or a sudden deterioration of their otherwise pervasive chronic medical illness (COPD, heart failure, cirrhosis, kidney failure, take your pick). Deaths will continue to rise, even as the case count curve lags sadly behind, since we have so few test kits and so many barriers for patients to be tested, including the cost which is still prohibitive for most people with mild symptoms. So, before it gets bad, and for the sake of spreading the word, please be more like your friendly European Clutchfan and stay away from crowded public places. Be prepared for the storm in a reasonable fashion. Maybe there are not the thousands of cases that there are here, but I have no doubt that in Houston there are over a hundred, with that exponential curve still growing steeper by the day.
This is the scary part. Young people think they will be fine, but if the healthcare system is overwhelmed noone is going to be fine. Any kind of not lifethreatening healthcare problem is going to be shelved and in the backseat , most doctors will be sick themselves and in quarantine or working 20 hours /day shifts while the deaths will pile up. We need to DELAY DELAY DELAY so at least not everyone needs medical attention at the same time. Keep the old people locked in the house and protected.
The wife of one of my employees is a doctor. She treated someone on Sunday without any protective gear (who was in contact with 5 doctors and 20 nurses). Test for that patient came back positive on Tuesday. My employee was in the office on Monday and Tuesday. First, the whole family went into quarantine. But then the wife and all the other 24 healthcare workers got called back to work (after being tested, and being negative for now). The argument is that the hospital will not be able to keep up its operations if they all stay quarantined. I guess they will get re-tested every day.
What a redundant post in a redundant thread. Very informative and not political at all... And FYI kid, I was initially worried about this when it first came out and it is fine to be concerned. But I'm not getting my info from Fox news. I'm getting it from actual medical professionals. This has been vastly overblown, and you do yourself no favors by posting about politics when trying to be "informative."
positive pressure ventilation, it's also not a dumb question. It's basically forcing air into your lungs.
Yeah, I think a lot of us have been on the same page reiterating this (like from our discussions). I mean I know we discussed it, delaying the spread is best so we don't hammer the overall healthcare system...
I'll take this thread over Tinman's racebaiting. The delaying makes it sound like there should be a queue for when people to get infected or else not enough support for people who do have it. 60 million infected Americans for swine flu at its peak year eh?
You do not debate me, you debate the statistics. We will find out either way in the next 4 weeks. By the way, do not trust "medical professionals"; we are not trained well enough in biostats. You need to be getting your information from someone with an MPH. LINK 1 LINK 2 LINK 3 GOOD PODCAST One prominent feature that separates the old guard of doctors from the new is that the young do not take as much pride in our profession. You should not listen to me because I have an M.D. You should listen to me because I know the science behind the guideline that I am disseminating to you. We take the time to answer the daily challenges to our decision making processes, and do not rely solely on our authority as gospel.
Of the friends I pay attention to: One is an X-Ray Tech at Texas Children's One is an Optician The other three are surgeons. When they say this is overblown, I believe them FAR more than a Washington Post article. How about we revisit this in a year, yes? You'll either look like Thanos or Chicken Little. I wonder who most of us would bet on, regardless of political affiliation...
Sorry on answering same time as you, didn't know if you were busy etc. Regardless, thanks for the informational post. I know a lot of us have been trying to relay this but it's nice having this post at the top to detail things. On a side note, I am glad protocols were broken on testing, because I am pretty certain it's been other places too (talking with some medical professionals), but they couldn't directly confirm so they marked it as another underlying issue. I mean if you don't test for it to confirm positive then you can underreport spread. I'm not like some tinfoil type person but with lack of testing it's clear that it's not being reported correctly.
Nice. Somebody just said I was the Debbie Downer of facts on FB, so I shared this post verifying this. They replied: "that’s why we love you. Don’t shy from the facts....or anything for that matter."
China really screwed us this time. Hopefully we can limit this and not get overwhelmed. More travel bans should be issued. Lets just stay still for a month.
