5 ms·

"Even if you could perfectly isolate all old people (and ignoring the mental health cost of that) the young people needing medical attention would still vastly

by rsync 7y ago

"Even if you could perfectly isolate all old people (and ignoring the mental health cost of that) the young people needing medical attention would still vastly overwhelm the health system." I am willing to stipulate that this is correct. However, I feel that we've slowly developed (over the past few decades) an underlying assumption that "flu-like symptoms" automatically warrant a trip to the hospital. During normal times, if you went to an emergency room in rich, well-educated American cities, you would see many, many rich, well-educated people who had taken their children to the ER (or urgent care center) for flu-like symptoms and had asked for and been given antibiotics, wastefully, for a condition caused by a virus. This was, of course, irksome and disappointing, but now it is a matter of tremendous import for public health: what would our options look like if we did not assume every person exhibiting flu-like symptoms needed medical services ? What would our options look like if people understood that there is no such thing as cold "medicine" or flu "medicine" and that the doctor can do nothing for your not-critically-sick child other than prescribe rest and good nutrition ? Instead, we desire to be consumers of health-care because it is a modern imperative. I believe these were wrong-headed attitudes and we are now paying the price for them.

cameronh90 7y ago
There are medicines for flu: oseltamivir and zanamivir to name two. None for the cold as far as I'm aware. I don't think the desire for a cure is unreasonable on the part of patients though, but it's the job of public health and experts to temper those expectations. By now any doctor prescribing antibiotics for a virus or to placate a patient should be facing professional sanctions.
DangerousPie 7y ago
Are you implying that the reason the hospitals are overwhelmed is that they are admitting people that could just "ride it out at home"? Because that is certainly not the problem. Many COVID patients need to be on 24/7 ventilation in the ICU to stay alive, including young and healthy ones. Way more than the hospitals can cope with. This is not about people's attitudes towards healthcare, this is about thousands and soon millions of people suddenly requiring emergency medical treatment, way beyond what the health system can cope with.
- rootusrootus 7y ago
  > including young and healthy ones I'd be interested to see the stats on this. I also hear that the success rate for patients who have to be ventilated for COVID19 is pretty low. Given that the vast majority of deaths are 70+, one of these statements isn't correct. Either ventilation is pretty successful after all, or many young and healthy patients who are hospitalized for COVID19 are not vented.
- rafiki6 7y ago
  I haven't seen any young and HEALTHY folks needing ICU care. Can you share any cases? Or any stats indicating this is the case?
  - T-A 7y ago
    https://www.statnews.com/2020/03/18/coronavirus-new-age-analysis-of-risk-confirms-young-adults-not-invincible/ https://www.statnews.com/2020/03/18/coronavirus-new-age-anal... And of course the case everybody should know about: https://en.wikipedia.org/wiki/Li_Wenliang https://en.wikipedia.org/wiki/Li_Wenliang
    - rafiki6 7y ago
      I read that statnews article. Nothing in there actually indicates that young and HEALTHY people are at a high risk. What it does say is that 2-4% of the 20-44 age group needed ICU treatment. No indication is made to the risk profile or previous issues that group has. That being said there is a 0.1-0.2% risk for people within the age range of 20-44. The example of the hero doctor frankly stands out as an outlier. We aren't actually sure he was healthy, and even if we were, what we know is he was exposed to a high viral load very rapidly. Beyond that he was under tremendous stress from being a front line worker, meaning he might have been exposed to multiple infections and under stress from an authoritarian government trying to silence him with questionable means. Stress has a very real effect on our immune systems that has been empirically shown to make it very challenging for the body to recover from infections. I want us to be incredibly careful about how we share information and our interpretations of it. I have yet to see anything that clearly indicates that young people age 20-44 are at a high risk if they are HEALTHY. Healthy here means not currently battling any other severe infections, and in a general state of good health. The percentage within this demographic is clearly stated as 0.1-0.2% and this includes immunocomprised people. Please help spread accurate information, as this panic is getting absurd. I was at a grocery store today and people were fighting for supplies that there is not actual shortage of, and being generally rude to each other. People are losing their livelihoods and our economy is crashing. A recent bloomberg article is stating that we should expect a 30% unemployment rate. https://www.bloomberg.com/news/articles/2020-03-22/fed-s-bullard-says-u-s-jobless-rate-may-soar-to-30-in-2q https://www.bloomberg.com/news/articles/2020-03-22/fed-s-bul... This would be a devastating outcome which will be substantially worse than this virus has been, especially in a country like the USA with no universal health care and no clear indication that will ever happen. Have you ever tried being poor in the US? It's not fun or easy. Unfortunately our leadership is not equipped to handle this correctly. Corrupt congresspeople are profiting off of this. The sitting president is showing signs of mental instability. The alternative probably isn't much better. Beyond that, sentiment on social media now seems to have people favoring authoritarian measures enacted to force people to stay home. This virus is serious, but our reaction to it is much more serious. We cannot sustain this type of quarantine for the long run. We may end up finding ourselves under authoritarian rule that won't disappear anytime soon. The only solutions we have are that we accept this virus as a real part of life, we attempt herd immunity through a more targeted type of quarantine, or we wait for the miracle of a vaccine to be developed. Referring back to the statnews article, they come to a similar conclusion and say that the demographics of a country should dictate the measures taken to prevent the most at risk populations from contracting this virus.
IkmoIkmo 7y ago
There's actually evidence that there's tissue damage in the longs (read, potentially permanent damaged lung capacity) even prior to symptoms, and of course, even after recovery, in young people too. This thing is no joke. There's good reason to believe even many young people who get infected will have permanent damage and for given the correlations between lifespan and organ health, it's not unlikely that this damage to the lungs results in years of lifespan cut decades down the line. That's just a little tidbit on people who don't even show any symptoms. Then there's many people hospitalised who're literally in a state of feeling like they can't breath for weeks, it's absolutely agonising. If you want more, just look up the pictures of coffins laid out in Italy and the military trucks transporting out dead bodies. These aren't hoax images or videos (although some do circulate). I don't see how the comparison to flu is apt.
- shadowprofile77 7y ago
  What would be your sources for this, and in reference to the claim that people being hospitalized and feeling like they can't breathe for weeks, are you referring to those who number among the roughly 5% of critical cases?
cstejerean 7y ago
Who goes to the ER for flu like symptoms? Even with insurance the costs would make this a fairly expensive trip, and the wait times can involve hours. I mean I’m sure there are some but it’s hard to imagine that this a choice that lots of people would make. If you want something prescribed the local urgent care center is a much quicker and much cheaper option. For children you can also generally get same day appointments at most pediatric clinics. It would require a pretty severe case to justify a trip to the ER.
nec4b 7y ago
You missed the point entirely. If we could magically isolate everyone over 50 and let everybody else get infected it would still overwhelm hospitals with people that really need ICU care.

by rsync 7y ago

cameronh90 7y ago

There are medicines for flu: oseltamivir and zanamivir to name two. None for the cold as far as I'm aware. I don't think the desire for a cure is unreasonable on the part of patients though, but it's the job of public health and experts to temper those expectations. By now any doctor prescribing antibiotics for a virus or to placate a patient should be facing professional sanctions.

DangerousPie 7y ago

Are you implying that the reason the hospitals are overwhelmed is that they are admitting people that could just "ride it out at home"? Because that is certainly not the problem. Many COVID patients need to be on 24/7 ventilation in the ICU to stay alive, including young and healthy ones. Way more than the hospitals can cope with. This is not about people's attitudes towards healthcare, this is about thousands and soon millions of people suddenly requiring emergency medical treatment, way beyond what the health system can cope with.

rootusrootus 7y ago
> including young and healthy ones I'd be interested to see the stats on this. I also hear that the success rate for patients who have to be ventilated for COVID19 is pretty low. Given that the vast majority of deaths are 70+, one of these statements isn't correct. Either ventilation is pretty successful after all, or many young and healthy patients who are hospitalized for COVID19 are not vented.
rafiki6 7y ago
I haven't seen any young and HEALTHY folks needing ICU care. Can you share any cases? Or any stats indicating this is the case?
- T-A 7y ago
  https://www.statnews.com/2020/03/18/coronavirus-new-age-analysis-of-risk-confirms-young-adults-not-invincible/ https://www.statnews.com/2020/03/18/coronavirus-new-age-anal... And of course the case everybody should know about: https://en.wikipedia.org/wiki/Li_Wenliang https://en.wikipedia.org/wiki/Li_Wenliang
  - rafiki6 7y ago
    I read that statnews article. Nothing in there actually indicates that young and HEALTHY people are at a high risk. What it does say is that 2-4% of the 20-44 age group needed ICU treatment. No indication is made to the risk profile or previous issues that group has. That being said there is a 0.1-0.2% risk for people within the age range of 20-44. The example of the hero doctor frankly stands out as an outlier. We aren't actually sure he was healthy, and even if we were, what we know is he was exposed to a high viral load very rapidly. Beyond that he was under tremendous stress from being a front line worker, meaning he might have been exposed to multiple infections and under stress from an authoritarian government trying to silence him with questionable means. Stress has a very real effect on our immune systems that has been empirically shown to make it very challenging for the body to recover from infections. I want us to be incredibly careful about how we share information and our interpretations of it. I have yet to see anything that clearly indicates that young people age 20-44 are at a high risk if they are HEALTHY. Healthy here means not currently battling any other severe infections, and in a general state of good health. The percentage within this demographic is clearly stated as 0.1-0.2% and this includes immunocomprised people. Please help spread accurate information, as this panic is getting absurd. I was at a grocery store today and people were fighting for supplies that there is not actual shortage of, and being generally rude to each other. People are losing their livelihoods and our economy is crashing. A recent bloomberg article is stating that we should expect a 30% unemployment rate. https://www.bloomberg.com/news/articles/2020-03-22/fed-s-bullard-says-u-s-jobless-rate-may-soar-to-30-in-2q https://www.bloomberg.com/news/articles/2020-03-22/fed-s-bul... This would be a devastating outcome which will be substantially worse than this virus has been, especially in a country like the USA with no universal health care and no clear indication that will ever happen. Have you ever tried being poor in the US? It's not fun or easy. Unfortunately our leadership is not equipped to handle this correctly. Corrupt congresspeople are profiting off of this. The sitting president is showing signs of mental instability. The alternative probably isn't much better. Beyond that, sentiment on social media now seems to have people favoring authoritarian measures enacted to force people to stay home. This virus is serious, but our reaction to it is much more serious. We cannot sustain this type of quarantine for the long run. We may end up finding ourselves under authoritarian rule that won't disappear anytime soon. The only solutions we have are that we accept this virus as a real part of life, we attempt herd immunity through a more targeted type of quarantine, or we wait for the miracle of a vaccine to be developed. Referring back to the statnews article, they come to a similar conclusion and say that the demographics of a country should dictate the measures taken to prevent the most at risk populations from contracting this virus.

IkmoIkmo 7y ago

There's actually evidence that there's tissue damage in the longs (read, potentially permanent damaged lung capacity) even prior to symptoms, and of course, even after recovery, in young people too. This thing is no joke. There's good reason to believe even many young people who get infected will have permanent damage and for given the correlations between lifespan and organ health, it's not unlikely that this damage to the lungs results in years of lifespan cut decades down the line. That's just a little tidbit on people who don't even show any symptoms. Then there's many people hospitalised who're literally in a state of feeling like they can't breath for weeks, it's absolutely agonising. If you want more, just look up the pictures of coffins laid out in Italy and the military trucks transporting out dead bodies. These aren't hoax images or videos (although some do circulate). I don't see how the comparison to flu is apt.

shadowprofile77 7y ago
What would be your sources for this, and in reference to the claim that people being hospitalized and feeling like they can't breathe for weeks, are you referring to those who number among the roughly 5% of critical cases?

cstejerean 7y ago

Who goes to the ER for flu like symptoms? Even with insurance the costs would make this a fairly expensive trip, and the wait times can involve hours. I mean I’m sure there are some but it’s hard to imagine that this a choice that lots of people would make. If you want something prescribed the local urgent care center is a much quicker and much cheaper option. For children you can also generally get same day appointments at most pediatric clinics. It would require a pretty severe case to justify a trip to the ER.

nec4b 7y ago

You missed the point entirely. If we could magically isolate everyone over 50 and let everybody else get infected it would still overwhelm hospitals with people that really need ICU care.