5 ms·

In the preparation list, scaling ICU is most needed. A lot of people survived thank to intensive care units. There might not be enough to cope with the peak

by joak 7y ago

jacquesm 7y ago
That 'might' is probably safely replace with 'are'. No country - even the richest - is prepared to deal with this many ICU cases. For instance in the UK (which has a very good healthcare system) there are about 6k ICU beds on a population of ~65 million. And then there is the risk of having ICU personnel become infected themselves. This is not a trivial challenge.
- throwaway5752 7y ago
  In this case, I guess we have to just trust the people that go through the most competitive and intellectually demanding decade of school and professional training on the planet. They have the benefit of being on the front lines themselves, with the lives of themselves and their coworkers at risk. edit: if it helps avoid distractions, let me say it is obviously not a "benefit" and medical professionals are underappreciated heroes. They deal with infections disease every day, sometimes far more dangerous than covid-19. For them, the danger and planning isn't hypothetical like it is for a vast majority of the commenters here. I trust the medical community to plan for this appropriately more that I trust any other group of professionals.
  - jacquesm 7y ago
    That's not a benefit. And given that these people will try to do their jobs even when under=equipped and understaffed they are paid too little to begin with.
    - deleted 7y ago
      [deleted]
- exikyut 7y ago
  Perhaps that's why there's no point declaring a pandemic. If you do, some prepare, some panic, the panicking ones clog the ICU and the virus spreads like wildfire, the ICU can't keep up. If you don't, nobody prepares, everybody's sprung upon and taken by surprise, the stampedes oversubscribe ICU capacity in much the same way as above. At the end of the day I think the two variables all of this boils down to are infrastructure capacity limits and individual survival rates - and that no relevant models exist that can readily catalyze this specific set of circumstances with confidence. IIUC, what models do exist are not precise/disambiguating enough. So it all comes down to unresolvable clique interpretation. Officials can't work with that. :(
  - jacquesm 7y ago
    The difference is that we can recognize that containment has failed and start planning accordingly. I don't think any rational authority is at this point still arguing that this will be contained to within the borders of those countries now affected. So you might as well accept that we do indeed have a pandemic on our hands, which will have substantial economic impact but need not have a substantial toll in terms of lives lost. Waiting with that declaration is the same as what the authorities in Wuhan did initially: they hoped it would blow over. But viruses do not care about our politics. And if we do not take relatively drastic measures to stop community spreading then the impact will be much higher, both economic and in terms of lives.
    - maxerickson 7y ago
      There's a lot of options between "ignoring it" and "declaring a global pandemic".
      - jacquesm 7y ago
        Such as?
        maxerickson 7y ago
        Lots of examples in the news... Or do you somehow think there is currently no response?
Engineering-MD 7y ago
So scaling of ICU is already possible to a degree. In most hospitals in case of a major accident (eg terror isn’t attack with many injured) theatres are used as ICUs and all non emergency surgery is stopped. I suspect this will happen in these cases. The main issue is going to be sufficient nursing staffing (ICU requires 1:1 nurse:patient ratio usually).
- jacquesm 7y ago
  That trick doesn't work when you're talking about infectious diseases. You need to isolate your patients from each other to avoid re-infection and you need to stop rotating your ICU personnel between units or they themselves will become vectors for infection to people who would otherwise recover or may be mis-diagnosed.
  - Engineering-MD 7y ago
    Theatres are isolated from each other and often adjacent to the main ICU for this reason. So the trick should be effective.

In the preparation list, scaling ICU is most needed. A lot of people survived thank to intensive care units. There might not be enough to cope with the peak

by joak 7y ago

In the preparation list, scaling ICU is most needed. A lot of people survived thank to intensive care units. There might not be enough to cope with the peak

jacquesm 7y ago

That 'might' is probably safely replace with 'are'. No country - even the richest - is prepared to deal with this many ICU cases. For instance in the UK (which has a very good healthcare system) there are about 6k ICU beds on a population of ~65 million. And then there is the risk of having ICU personnel become infected themselves. This is not a trivial challenge.

throwaway5752 7y ago
In this case, I guess we have to just trust the people that go through the most competitive and intellectually demanding decade of school and professional training on the planet. They have the benefit of being on the front lines themselves, with the lives of themselves and their coworkers at risk. edit: if it helps avoid distractions, let me say it is obviously not a "benefit" and medical professionals are underappreciated heroes. They deal with infections disease every day, sometimes far more dangerous than covid-19. For them, the danger and planning isn't hypothetical like it is for a vast majority of the commenters here. I trust the medical community to plan for this appropriately more that I trust any other group of professionals.
- jacquesm 7y ago
  That's not a benefit. And given that these people will try to do their jobs even when under=equipped and understaffed they are paid too little to begin with.
  - deleted 7y ago
    [deleted]
exikyut 7y ago
Perhaps that's why there's no point declaring a pandemic. If you do, some prepare, some panic, the panicking ones clog the ICU and the virus spreads like wildfire, the ICU can't keep up. If you don't, nobody prepares, everybody's sprung upon and taken by surprise, the stampedes oversubscribe ICU capacity in much the same way as above. At the end of the day I think the two variables all of this boils down to are infrastructure capacity limits and individual survival rates - and that no relevant models exist that can readily catalyze this specific set of circumstances with confidence. IIUC, what models do exist are not precise/disambiguating enough. So it all comes down to unresolvable clique interpretation. Officials can't work with that. :(
- jacquesm 7y ago
  The difference is that we can recognize that containment has failed and start planning accordingly. I don't think any rational authority is at this point still arguing that this will be contained to within the borders of those countries now affected. So you might as well accept that we do indeed have a pandemic on our hands, which will have substantial economic impact but need not have a substantial toll in terms of lives lost. Waiting with that declaration is the same as what the authorities in Wuhan did initially: they hoped it would blow over. But viruses do not care about our politics. And if we do not take relatively drastic measures to stop community spreading then the impact will be much higher, both economic and in terms of lives.
  - maxerickson 7y ago
    There's a lot of options between "ignoring it" and "declaring a global pandemic".
    - jacquesm 7y ago
      Such as?
      - maxerickson 7y ago
        Lots of examples in the news... Or do you somehow think there is currently no response?

Engineering-MD 7y ago

So scaling of ICU is already possible to a degree. In most hospitals in case of a major accident (eg terror isn’t attack with many injured) theatres are used as ICUs and all non emergency surgery is stopped. I suspect this will happen in these cases. The main issue is going to be sufficient nursing staffing (ICU requires 1:1 nurse:patient ratio usually).

jacquesm 7y ago
That trick doesn't work when you're talking about infectious diseases. You need to isolate your patients from each other to avoid re-infection and you need to stop rotating your ICU personnel between units or they themselves will become vectors for infection to people who would otherwise recover or may be mis-diagnosed.
- Engineering-MD 7y ago
  Theatres are isolated from each other and often adjacent to the main ICU for this reason. So the trick should be effective.