Corona virus fatigue

[RWebb]

you may want to avoid certain parts of town...

[tadd]

The big unknown, aside from how large the time window of infection is, is how long will the body keep immunity. SARS and MERS the body will keep antibodies for 2-3 years. Some in the Corona family are only months.

So it may roll thru, then roll thru again till we reach to herd immunity.

Nobody wants critical people being turned away from care. That said, Italy is there.

Even if 0.001% of the population have a very hard time with the virus, out of 360 million, is still a big number all at once. There just aren't that many ICU beds.

Things are just getting warmed up. Exponential growth is a sneaky thing. Sadly, testing is slow, so the numbers will grow quick. Maryland started with three cases two weeks ago in one county. We are now at 43 confirmed as of last night in 11. Doubling every week gets you to big numbers quick... but with a nice slow, 'yea whatever nothing to see here', start.

As has been said, we will all get this till we reach herd immunity levels. Not if, but when. That is what we can control. Thank you social distancing. I wish this had been the message put out, not the image of not enough ventilators.

My prediction is that April will be really climbing the ramp up, we might peak in late may.

[tadd]

Fun facts. From here: https://www.sccm.org/Communications/Critical-Care-Statistics

Added bold... so ~100k ICU beds to cover every critical care need. Elsewhere the paper says those beds stay around 65% capacity. So typical available would be 35K beds.

So assuming JUST 0.1% death rate, those 35K beds translate into 35 million sick at once. Just those dying and not including those very sick needing ICU care, but will recover. So 1/10 of the US population can be sick at any one instant... or 9-10 months to reach herd immunity levels.

AHA data: According to the AHA 2015 annual survey, the United States had 4862 acute care registered hospitals; 2814 of these had at least 10 acute care beds and at least 1 ICU bed. These hospitals had a total of 540,668 staffed beds and 94,837 ICU beds (14.3% ICU beds/total beds) in 5229 ICUs. There were 46,490 medical-surgical beds in 2644 units, 14,731 cardiac beds in 976 units, 6588 other beds in 379 units, 4698 pediatric beds in 307 units, and 22,330 neonatal beds in 920 units. The median number of beds in medical-surgical, cardiac, and other units was 12, with 10 beds in pediatrics and 18 in neonatal. Fifty-two percent of hospitals had 1 unit, 24% had 2 units, and 24% had 3 or more units.

[RWebb]

This is worst case, so don't react too strongly...

https://www.statnews.com/2020/03/10/simple-math-alarming-answers-covid-19/

[sithot]

Listened to the broadcast today. Pretty good.

https://blog.siriusxm.com/get-around-the-clock-updates-expert-advice-about-the-coronavirus-on-sxms-doctor-radio/

[tabs]

Originally Posted by Rawknees'Turbo

^^^

Speaking of madness - my cop brother just told me that many customers in Garland Texas (large city that borders Dallas) are calling 911 to complain about item limits being placed on things like TP at the local grocery stores. You can't make this shiit up!

I make up so much shyte everyday that I plug up the toilette...

[Rawknees'Turbo]

Originally Posted by tabs

I make up so much shyte everyday that I plug up the toilette...

Do you have to use an air hammer with an oversized chisel bit to bust that shiit up, like Island does?!

[Nader]

Everyone has an opinion. So do I. Which I'll try to keep to myself. But I also have experience with this virus, and I can share that. I'm a hospital physician, practicing over 20 years, and in the epicenter of the U.S. pandemic. I've hospitalized multiple suspected and confirmed COVID-19 patients. Some were unsuspected (they came in for unrelated, non-pulmonary medical illnesses, but spiked a fever while in the hospital and tested positive). Most were elderly with mild/moderate disease, one was gasping for breath until he died 2 days later. That's just my experience, in one week of 11 hour shifts. Our group has 20 other physicians, so you can extrapolate.

What scares me, is that we're seeing more young, previously healthy patients get sick. Several ended up in the ICU on the ventilator. And our hospital isn't as hard hit as a neighboring one. I get occasional reports from them, and it sounds like a real crisis situation over there. They have run out of ICU beds for anything other than COVID, so we get their overflow. I could tell you some pretty scary stories about what we're seeing, but I won't.

Bigger picture is that what you've heard is true, the hospitals can't absorb the multitude of critically ill patients that are to come. Care will be rationed, and hard decisions will need to be made; does the demented 85 year old get the last ventilator, or the 35 year old mom with young children? Actually, that decision shouldn't be hard to make. But from what I've dealt with in my career, you'd be surprised at the selfishness of some patients and their families.

Speaking of rationing care, it has already begun; hospitals are already cancelling scheduled elective procedures to save beds. They do this because no hospital has any reasonable amount of built-in vacant capacity to deal with. At baseline, we're already inundated with a large geriatric population in their 80s and 90s that's living longer with chronic disease because modern medicine keeps them alive against their best interest, who are consuming mind-boggling amounts of medical resources. Add to this the massive population of Boomers who are knocking at our healthcare gates with their own burgeoning medical issues, and you have a healthcare system at the breaking point. Throw in a pandemic, and, well, you'll all see soon enough...

[Rawknees'Turbo]

Originally Posted by island911

Frankly I am stunned by the stories out of TX. I mean here I am in the hood of US case #1 and where the majority of deaths have occurred and the most noticeable change is the lack of traffic. (Costco looks like Costco... plenty of stock. typical business.)

TX has warm weather and sunshine (both are killers of the CV)

It was just announced that Dallas ISD schools are closed indefinitely beginning Monday (currently in Spring break). Wow! Lots of students poised to run loose and go buck wild!

[island911]

Thanks for the post Nader.

My almost 80 y/o at-risk mother (recently out of hospital for weeks) thinks that this reaction to this virus is an over reaction. She points out that she has had a whole life and that taking away the livelihood of so many is the real tragedy. IOW the "cure" (which is not a cure - it is stealing life and opportunity) is worse than death that is already right around the corner.

It is expected that we will have more elderly people die. (surprise) Many of them from CV19. The big concern --and why the massive clamp-down on freedoms-- is only to SLOW the spread such that the elderly don't all die at once.

I have one 80y/o aunt who shut her self in weeks ago. That is her taking responsibility for her own safety. ..rather than relying on the world to shut down around her. THAT is an important distinction. isolate the at-risk population rather than the whole population. Either way the elderly are isolated. Yet here we are, politicians forcing ALL people into isolation. And, again, all that will do is slow the virus. While that is something good, the cost is tremendous.

[island911]

[pavulon]

Originally Posted by RWebb

are you familiar with Newport, Orygun??

A little. Why?

[island911]

Originally Posted by island911

it can't last much longer, can it?

I mean the fear mongering... it is over the top.

I thought I was safe when I checked the weather - even the damn weather sites have CV stories (good news, it dies off faster in warm climate)

Anyway, I'm sick of the hysteria.

I suspect a lot of parents of grade-school kids must be pretty pissed that their daycare went away.

The hysterical reaction to supplies is getting old too.

^ OP 9 days ago ^

feels like weeks.

Today:

Donald J. Trump @realDonaldTrump
WE CANNOT LET THE CURE BE WORSE THAN THE PROBLEM ITSELF. AT THE END OF THE 15 DAY PERIOD, WE WILL MAKE A DECISION AS TO WHICH WAY WE WANT TO GO!

It's about time.

We need to Flatten the ECONOMIC damage curve.

[group911@aol.co]

Originally Posted by island911

^ OP 9 days ago ^

feels like weeks.

Today:It's about time.

We need to Flatten the ECONOMIC damage curve.

Cool. I heard Rand Paul is looking for a new pool boy. Take one for the team.

[Nader]

Glad to no longer be the "epicenter" of the US pandemic (sorry, NY). But our hospital, like everywhere else, is desperately short of supplies; we're reusing N95 masks way beyond their life expectancy, in ways that would make the Cuban owners of American classic cars proud of our efforts.

We're on the verge on Mad Max style foraging for gas masks and materials for makeshift PPE. I kid you not, we have doctors shopping at Harbor Freight for face shields and whatever else isn't already sold out.

[mepstein]

Originally Posted by Nader

Glad to no longer be the "epicenter" of the US pandemic (sorry, NY). But our hospital, like everywhere else, is desperately short of supplies; we're reusing N95 masks way beyond their life expectancy, in ways that would make the Cuban owners of American classic cars proud of our efforts.

We're on the verge on Mad Max style foraging for gas masks and materials for makeshift PPE. I kid you not, we have doctors shopping at Harbor Freight for face shields and whatever else isn't already sold out.

People who think letting it go is the solution are going to be surprised when they don't get care for their loved ones or themselves because all the overworked health care workers are too sick to come to work.

I'd rather deal with my fading 401K than a fading family member.

[island911]

This is not a this OR that scenario.

We can go back to work AND protect those at risk.

Currently we are isolating EVERYONE to protect the few at risk.

IF we focus on isolating /protecting only those at risk the rest of us can go back to business.

[Bob Kontak]

Originally Posted by Nader

we're reusing N95 masks way beyond their life expectancy, in ways that would make the Cuban owners of American classic cars proud of our efforts.

Exactly what I heard from my nurse sister in Charlotte.

[Nader]

Something to clarify; the morbidity vs. mortality. You're hearing about the number of deaths (mortality), which is surely dominated by the geriatric population. What you're not hearing about is the number of critically ill patients (morbidity), more and more of whom we are seeing under the age of 60, who go into respiratory failure and need the the ventilator to stay alive, but aren't dead (yet?).

These patients don't just "ride the vent" for a few days before they recover. No, the lung damage by this infection is severe enough that we're seeing patients stuck on life support for WEEKS. Which is why the limited number of ventilators are tied up and there's such a shortage.

[93nav]

Thank you for your 'boots on the ground' reports.

Best of luck and stay safe.

Originally Posted by Nader

Something to clarify; the morbidity vs. mortality. You're hearing about the number of deaths (mortality), which is surely dominated by the geriatric population. What you're not hearing about is the number of critically ill patients (morbidity), more and more of whom we are seeing under the age of 60, who go into respiratory failure and need the the ventilator to stay alive, but aren't dead (yet?).

These patients don't just "ride the vent" for a few days before they recover. No, the lung damage by this infection is severe enough that we're seeing patients stuck on life support for WEEKS. Which is why the limited number of ventilators are tied up and there's such a shortage.