4 ms·

It already happened. The West will be litigating unpaid rent, etc. for the next decade since there aren't enough court rooms. What we fundamentally got wrong i

It already happened. The West will be litigating unpaid rent, etc. for the next decade since there aren't enough court rooms. What we fundamentally got wrong is that ventilators don't work in 66% - 90% of cases, so "flattening the curve" was largely pointless and distracted leaders from low-tech solutions like quarantine centers and palliative care. We should have learned that in 2002 from SARS-1, but nobody even seems to remember it.

jklein11 7y ago
do you have sources for this >What we fundamentally got wrong is that ventilators don't work in 66% - 90% of cases
- mrep 7y ago
  "The largest study so far to look at mortality among coronavirus patients on ventilators was done by the Intensive Care National Audit & Research Centre in London. It found that among 98 ventilated patients in the U.K., just 33 were discharged alive. The numbers from a study of Wuhan, China, are even grimmer. Only 3 of 22 ventilated patients survived" [0]. [0]: https://www.npr.org/sections/health-shots/2020/04/02/826105278/ventilators-are-no-panacea-for-critically-ill-covid-19-patients https://www.npr.org/sections/health-shots/2020/04/02/8261052...
  - jmcgough 7y ago
    Cuomo has already said this iirc; most people who go on a ventilator don't come off of it alive. That doesn't make it pointless to even have ventilators though, a 40% survival rate is certainly better than a 0% survival rate for those who need a ventilator.
    - lazylizard 7y ago
      Do they die because or inspite of the ventilators?
      - redis_mlc 7y ago
        It's both. You're sedated (comatose) to tolerate the tube and allow the machine to manage the pressure. After a few weeks the air pressure destroys your lungs and the sedation causes you to lose muscle strength. So you get sicker day by day. I'm still waiting for an interview with a ventilator survivor. None so far.
- nradov 7y ago
  Sure here's the source. The 66% - 90% death rate on ventilators appears to be accurate but there's a lot of variance in the data and no rigorous studies yet. https://www.sfgate.com/news/medical/article/Some-doctors-moving-away-from-ventilators-for-15187546.php https://www.sfgate.com/news/medical/article/Some-doctors-mov...
lisper 7y ago
Quarantine doesn't work unless you know who is potentially contagious. The fact that covid-19 is contagious in asymptomatic people and we don't have good testing makes it impossible to isolate the virus without shutting down the economy.
threeseed 7y ago
Not sure what you're talking about here. In Australia for example we are flattening the curve and the measures are working. And we simply passed laws to protect the interests of landlords and renters so there won't be some explosion in litigation. And just letting hundreds of thousands of people die alone, on the streets or in the homes and with no proper burial or funeral is not something people will tolerate. It would be like dropping everyone in the middle of a war zone.
pmoriarty 7y ago
"What we fundamentally got wrong is that ventilators don't work in 66% - 90% of cases, so "flattening the curve" was largely pointless and distracted leaders from low-tech solutions like quarantine centers and palliative care." It's far from pointless. Flattening the curve means a lot fewer people get sick all at once. That buys time for treatments and vaccines to be developed. It's also not nearly as overwhelming to the health care system.
- jackcosgrove 7y ago
  Flattening the curve is justified to not overwhelm medical facilities, but the new coronavirus is so infectious I doubt we'll develop a vaccine before we achieve herd immunity. A lockdown until we develop a vaccine is economically impossible, as it's estimated to take at least a year. A vaccine will be useful for next year's coronavirus. Thankfully the actual death rate is lower than what the models projected. Antibody testing will do a lot to dispel the fog of war surrounding this issue.
  - ddingus 7y ago
    It is entirely possible. Econo locally, we will be revisiting how we handle risks and what acceptable margins are.
  - pmoriarty 7y ago
    At the very least, you're going to be buying people months, possibly years of life for millions of people by having a lockdown. If we were to end the lockdown now there would be way more infections and deaths in the short-term then there would be otherwise. Some deaths may happen anyway due to economic hardship, or social unrest, but the deaths from infections in the short-term are going to be greatly reduced, and even in the long term, the longer the lockdown can be sustained the fewer deaths from infection there are going to be. In the meantime, the government really has to step up to the plate and come up with solutions to the economic problems, which (unlike the pandemic) are under human control.
slg 7y ago
Flattening the curve isn't just about ventilators. It is about keeping the entire system functioning. The simplest example is testing. How are you going to quarantine carriers if we don't flatten the curve, can't keep up with testing, and have no idea who has the virus?
corpMaverick 7y ago
Flattening the curve provides valuable time to figure out the best strategies. Like the ones you mention and more.
pengaru 7y ago
> What we fundamentally got wrong is that ventilators don't work in 66% - 90% of cases, so "flattening the curve" was largely pointless. Use of ventilators coincides with severe cases, and up until this point we haven't learned enough about curing those infected with this virus to recover all such cases. Why are you assuming the ventilator recovery rate is static? We should assume that by "flattening the curve", we've bought valuable time to learn more about this virus, getting closer to better methods of recovery. Ventilators will always play a role in keeping patients alive who've deteriorated to the point of requiring them. I don't think anyone had the impression that ventilators cured anything, which your phrasing of "ventilators don't work" seems to imply.
- redis_mlc 7y ago
  > Ventilators will always play a role in keeping patients alive No they don't. After a few weeks your lungs turn to mush, among other problems.

jklein11 7y ago

do you have sources for this >What we fundamentally got wrong is that ventilators don't work in 66% - 90% of cases

mrep 7y ago
"The largest study so far to look at mortality among coronavirus patients on ventilators was done by the Intensive Care National Audit & Research Centre in London. It found that among 98 ventilated patients in the U.K., just 33 were discharged alive. The numbers from a study of Wuhan, China, are even grimmer. Only 3 of 22 ventilated patients survived" [0]. [0]: https://www.npr.org/sections/health-shots/2020/04/02/826105278/ventilators-are-no-panacea-for-critically-ill-covid-19-patients https://www.npr.org/sections/health-shots/2020/04/02/8261052...
- jmcgough 7y ago
  Cuomo has already said this iirc; most people who go on a ventilator don't come off of it alive. That doesn't make it pointless to even have ventilators though, a 40% survival rate is certainly better than a 0% survival rate for those who need a ventilator.
  - lazylizard 7y ago
    Do they die because or inspite of the ventilators?
    - redis_mlc 7y ago
      It's both. You're sedated (comatose) to tolerate the tube and allow the machine to manage the pressure. After a few weeks the air pressure destroys your lungs and the sedation causes you to lose muscle strength. So you get sicker day by day. I'm still waiting for an interview with a ventilator survivor. None so far.
nradov 7y ago
Sure here's the source. The 66% - 90% death rate on ventilators appears to be accurate but there's a lot of variance in the data and no rigorous studies yet. https://www.sfgate.com/news/medical/article/Some-doctors-moving-away-from-ventilators-for-15187546.php https://www.sfgate.com/news/medical/article/Some-doctors-mov...

lisper 7y ago

Quarantine doesn't work unless you know who is potentially contagious. The fact that covid-19 is contagious in asymptomatic people and we don't have good testing makes it impossible to isolate the virus without shutting down the economy.

threeseed 7y ago

Not sure what you're talking about here. In Australia for example we are flattening the curve and the measures are working. And we simply passed laws to protect the interests of landlords and renters so there won't be some explosion in litigation. And just letting hundreds of thousands of people die alone, on the streets or in the homes and with no proper burial or funeral is not something people will tolerate. It would be like dropping everyone in the middle of a war zone.

pmoriarty 7y ago

"What we fundamentally got wrong is that ventilators don't work in 66% - 90% of cases, so "flattening the curve" was largely pointless and distracted leaders from low-tech solutions like quarantine centers and palliative care." It's far from pointless. Flattening the curve means a lot fewer people get sick all at once. That buys time for treatments and vaccines to be developed. It's also not nearly as overwhelming to the health care system.

jackcosgrove 7y ago
Flattening the curve is justified to not overwhelm medical facilities, but the new coronavirus is so infectious I doubt we'll develop a vaccine before we achieve herd immunity. A lockdown until we develop a vaccine is economically impossible, as it's estimated to take at least a year. A vaccine will be useful for next year's coronavirus. Thankfully the actual death rate is lower than what the models projected. Antibody testing will do a lot to dispel the fog of war surrounding this issue.
- ddingus 7y ago
  It is entirely possible. Econo locally, we will be revisiting how we handle risks and what acceptable margins are.
- pmoriarty 7y ago
  At the very least, you're going to be buying people months, possibly years of life for millions of people by having a lockdown. If we were to end the lockdown now there would be way more infections and deaths in the short-term then there would be otherwise. Some deaths may happen anyway due to economic hardship, or social unrest, but the deaths from infections in the short-term are going to be greatly reduced, and even in the long term, the longer the lockdown can be sustained the fewer deaths from infection there are going to be. In the meantime, the government really has to step up to the plate and come up with solutions to the economic problems, which (unlike the pandemic) are under human control.

slg 7y ago

Flattening the curve isn't just about ventilators. It is about keeping the entire system functioning. The simplest example is testing. How are you going to quarantine carriers if we don't flatten the curve, can't keep up with testing, and have no idea who has the virus?

corpMaverick 7y ago

Flattening the curve provides valuable time to figure out the best strategies. Like the ones you mention and more.

pengaru 7y ago

> What we fundamentally got wrong is that ventilators don't work in 66% - 90% of cases, so "flattening the curve" was largely pointless. Use of ventilators coincides with severe cases, and up until this point we haven't learned enough about curing those infected with this virus to recover all such cases. Why are you assuming the ventilator recovery rate is static? We should assume that by "flattening the curve", we've bought valuable time to learn more about this virus, getting closer to better methods of recovery. Ventilators will always play a role in keeping patients alive who've deteriorated to the point of requiring them. I don't think anyone had the impression that ventilators cured anything, which your phrasing of "ventilators don't work" seems to imply.

redis_mlc 7y ago
> Ventilators will always play a role in keeping patients alive No they don't. After a few weeks your lungs turn to mush, among other problems.