4 ms·

This is madness. You can’t scale up ICU based ventilatory support to keep up with a pandemic. All resources should be going towards infection control measures,

by Gatsky 7y ago

This is madness. You can’t scale up ICU based ventilatory support to keep up with a pandemic. All resources should be going towards infection control measures, a quick and highly scalable diagnostic test, and antiviral therapy. In that order.

throwanem 7y ago
You can scale ventilator support faster than you can develop a largely untried branch of medicine. Antiviral drugs barely even exist. Hoping they come along fast enough to help with what's likely to happen in the next four weeks is a pipe dream. I think it's blue sky, too, what they're doing. But what the hell, maybe it'll help. It's not as if that Slack channel would be synthesizing remdesivir by the ton if it weren't doing this, after all.
klipt 7y ago
Exactly, you can't fix an exponential problem with a linear solution. If the caseload doubles every two days, shutting down cities two days earlier is better than doubling the number of ventilators (because even with ventilators, more infected means more deaths). Note that Wuhan shut down when they saw 400 new cases in a day, and their hospitals were still overwhelmed. The USA is over 400 new cases daily already. That's comparing a country to a huge city, but in exponential terms that only buys you days at most. See https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...
- Gatsky 7y ago
  Also people don't seem to realise, a patient on a ventilator is extremely unwell. They are the most unwell people in the entire hospital. They have 24 hour 1 on 1 nursing, constant invasive monitoring of vital signs, blood tests, X-rays, CT scans, antibiotics. They are managed by a team of extremely well trained and highly experienced senior medical professionals. And this goes on for a week or more. Then they leave ICU and proceed to be the most unwell people in the hospital except for those still in ICU. They might have various other complications, and need several more weeks to recover, often needing inpatient rehabilitation. This does not scale.
ericb 7y ago
> You can’t scale up ICU based ventilatory support to keep up with a pandemic. It's almost like people think individual lives matter and don't have control over the larger response?

by Gatsky 7y ago

throwanem 7y ago

You can scale ventilator support faster than you can develop a largely untried branch of medicine. Antiviral drugs barely even exist. Hoping they come along fast enough to help with what's likely to happen in the next four weeks is a pipe dream. I think it's blue sky, too, what they're doing. But what the hell, maybe it'll help. It's not as if that Slack channel would be synthesizing remdesivir by the ton if it weren't doing this, after all.

klipt 7y ago

Exactly, you can't fix an exponential problem with a linear solution. If the caseload doubles every two days, shutting down cities two days earlier is better than doubling the number of ventilators (because even with ventilators, more infected means more deaths). Note that Wuhan shut down when they saw 400 new cases in a day, and their hospitals were still overwhelmed. The USA is over 400 new cases daily already. That's comparing a country to a huge city, but in exponential terms that only buys you days at most. See https://medium.com/@tomaspueyo/coronavirus-act-today-or-people-will-die-f4d3d9cd99ca https://medium.com/@tomaspueyo/coronavirus-act-today-or-peop...

Gatsky 7y ago
Also people don't seem to realise, a patient on a ventilator is extremely unwell. They are the most unwell people in the entire hospital. They have 24 hour 1 on 1 nursing, constant invasive monitoring of vital signs, blood tests, X-rays, CT scans, antibiotics. They are managed by a team of extremely well trained and highly experienced senior medical professionals. And this goes on for a week or more. Then they leave ICU and proceed to be the most unwell people in the hospital except for those still in ICU. They might have various other complications, and need several more weeks to recover, often needing inpatient rehabilitation. This does not scale.

ericb 7y ago

> You can’t scale up ICU based ventilatory support to keep up with a pandemic. It's almost like people think individual lives matter and don't have control over the larger response?