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A quick google suggests around 15% of hospital beds are ICU and covid 19 cases that end up in the hospital, only 5% end up in ICU. So that's an interesting lin

by toolz 7y ago

A quick google suggests around 15% of hospital beds are ICU and covid 19 cases that end up in the hospital, only 5% end up in ICU. So that's an interesting line of thinking but it lacks supporting evidence that covid 19 is overwhelming ICU. https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 edit to address your edit: The mortality rate is often wildly inflated with new diseases. That's because most people don't seem to understand real mortality rate vs confirmed cases mortality rate. Obviously when a disease is new the confirmed cases will be confirmed against the people showing serious symptoms. Then when you pretend deaths/confirmed cases == mortality rate you end up with a wildly inflated mortality rate. Until we understand how many people are asymptomatic we won't have a real mortality rate that is reliable.

spac 7y ago
The ICU beds are also taken by all the other sick people. Only a minority is actually free. And people don’t end up in the ICU because they panic: I spoke to several Italian hospital doctors and they are overwhelmed by the troves of patients who can’t breathe.
- toolz 7y ago
  I just read an article that claimed Lombardy has 737 ICU beds available for covid 19. Given Italy has a 3.18 beds per 1000 people that means they have less than 3% of their hospital beds available for covid 19 patients. That's absurd. In relation the USA has roughly 14% of their beds as ICU beds according to a reference from https://www.sccm.org/Communications/Critical-Care-Statistics https://www.sccm.org/Communications/Critical-Care-Statistics
  - creato 7y ago
    You seem to think that for some reason, ICU beds go unused except in a situation like this? ICU capacity is probably built to meet some fraction of demand in normal circumstances. Those beds weren't all unused before this outbreak started. 737 ICU beds available isn't the same as the total number of ICU beds. Normal health problems that need hospital treatment (strokes, heart attacks, car accidents, etc.) are still happening during this outbreak (well, car accidents are probably reduced now with Italy's lockdown protocols).
    - gpderetta 7y ago
      Someone else posted else thread that in UK at any time 80% of all ICU beds are in use. It is likely a similar percentage in Italy.
- kaitai 7y ago
  Right: we do have those ICU beds because people are in them. Toolz, I just don't understand your math. You seem to assume that a neonatal ICU bed is just as good for a 55-year-old man as an adult one, and that no one is going to have any other ICU-needing illnesses for the duration of this epidemic. That's quite puzzling. Can you support these ideas?
kaitai 7y ago
Percentage of ICU beds varies widely. Minnesota, for instance, a state in the US, has about 500 ICU beds [1] and over 10,000 hospital beds total [2]. ICU beds are already heavily used and sometimes there simply are not enough, before COVID-19 has even shown up. Average inpatient stays right now are 4.21 days in Minnesota [3]; I can't find a reliable number for length of stay for COVID-19 patients, but it is longer. There is plenty of evidence that in Italy COVID-19 has overwhelmed ICU beds. They are trying to transport people to ventilators via helicopter. We do have at least twice the ICU bed capacity in the US (compare info from [4], [5]). But many other people need these ICU beds -- it's not like other illnesses will just stop for our convenience. [1] https://minnesota.cbslocal.com/2020/03/08/talking-points-president-of-minnesota-hospital-association-calls-on-state-legislators-to-approve-covid-19-funding/ https://minnesota.cbslocal.com/2020/03/08/talking-points-pre... [2] https://www.ahd.com/states/hospital_MN.html https://www.ahd.com/states/hospital_MN.html [3] https://www.mnhospitals.org/mn-hospitals/quick-facts https://www.mnhospitals.org/mn-hospitals/quick-facts [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351597/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351597/ [5] https://link.springer.com/article/10.1007/s00134-012-2627-8 https://link.springer.com/article/10.1007/s00134-012-2627-8 Edited to add: remember, included in most totals of ICU beds are neonatal and pediatric ICU beds, which won't help much with COVID-19.

by toolz 7y ago

spac 7y ago

The ICU beds are also taken by all the other sick people. Only a minority is actually free. And people don’t end up in the ICU because they panic: I spoke to several Italian hospital doctors and they are overwhelmed by the troves of patients who can’t breathe.

toolz 7y ago
I just read an article that claimed Lombardy has 737 ICU beds available for covid 19. Given Italy has a 3.18 beds per 1000 people that means they have less than 3% of their hospital beds available for covid 19 patients. That's absurd. In relation the USA has roughly 14% of their beds as ICU beds according to a reference from https://www.sccm.org/Communications/Critical-Care-Statistics https://www.sccm.org/Communications/Critical-Care-Statistics
- creato 7y ago
  You seem to think that for some reason, ICU beds go unused except in a situation like this? ICU capacity is probably built to meet some fraction of demand in normal circumstances. Those beds weren't all unused before this outbreak started. 737 ICU beds available isn't the same as the total number of ICU beds. Normal health problems that need hospital treatment (strokes, heart attacks, car accidents, etc.) are still happening during this outbreak (well, car accidents are probably reduced now with Italy's lockdown protocols).
  - gpderetta 7y ago
    Someone else posted else thread that in UK at any time 80% of all ICU beds are in use. It is likely a similar percentage in Italy.
kaitai 7y ago
Right: we do have those ICU beds because people are in them. Toolz, I just don't understand your math. You seem to assume that a neonatal ICU bed is just as good for a 55-year-old man as an adult one, and that no one is going to have any other ICU-needing illnesses for the duration of this epidemic. That's quite puzzling. Can you support these ideas?

kaitai 7y ago

Percentage of ICU beds varies widely. Minnesota, for instance, a state in the US, has about 500 ICU beds [1] and over 10,000 hospital beds total [2]. ICU beds are already heavily used and sometimes there simply are not enough, before COVID-19 has even shown up. Average inpatient stays right now are 4.21 days in Minnesota [3]; I can't find a reliable number for length of stay for COVID-19 patients, but it is longer. There is plenty of evidence that in Italy COVID-19 has overwhelmed ICU beds. They are trying to transport people to ventilators via helicopter. We do have at least twice the ICU bed capacity in the US (compare info from [4], [5]). But many other people need these ICU beds -- it's not like other illnesses will just stop for our convenience. [1] https://minnesota.cbslocal.com/2020/03/08/talking-points-president-of-minnesota-hospital-association-calls-on-state-legislators-to-approve-covid-19-funding/ https://minnesota.cbslocal.com/2020/03/08/talking-points-pre... [2] https://www.ahd.com/states/hospital_MN.html https://www.ahd.com/states/hospital_MN.html [3] https://www.mnhospitals.org/mn-hospitals/quick-facts https://www.mnhospitals.org/mn-hospitals/quick-facts [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351597/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351597/ [5] https://link.springer.com/article/10.1007/s00134-012-2627-8 https://link.springer.com/article/10.1007/s00134-012-2627-8 Edited to add: remember, included in most totals of ICU beds are neonatal and pediatric ICU beds, which won't help much with COVID-19.