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I started studying the US news reports of Covid-19 related to ventilators weeks ago when I realized there were no interviews with survivors, and ignored the spe
by redis_mlc 7y ago
I started studying the US news reports of Covid-19 related to ventilators weeks ago when I realized there were no interviews with survivors, and ignored the speculation around partial testing results and R0 calculations because of the lack of hard data, and exponential rate of infection making analysis moot.
Essentially, ICU admission for ventilators, and subsequent deaths, are the most complete and factual data we have.
The solid information we have is that 66% - 90% of ventilator patients die, as reported for both China and the US. Interviews with doctors all report that ventilators are supposed to be used for up to a week, not 3 weeks.
Although the occasional patient makes it off a ventilator, from a public healthcare policy standpoint, ventilators just don't work well enough, so there's no reason to "flatten the curve" now (April 10, 2020) aside from accumulating PPE (masks, gowns, gloves for hospital staff.) (A cure will likely take 18 months to invent and approve, so that's not something to put on a roadmap.)
The plan should be this:
1. have our healthcare policy experts (CDC, etc.) study today's reported data on patient mortality and PPE supplies for a couple days
2. inform seriously ill, high-risk corona hospital patients about the risks of ventilators (ie. you're probably going to die on one anyway, and horribly)
3. have dedicated quarantine and palliative buildings for moderately ill confirmed corona patients with O2 available (like the Javits Center in NY, as an example for discussion, or an anchored cruise ship moored off each major city). Recovered people can work there safely it appears.
4. have dedicated hospitals for corona ICU patients if they choose to try a ventilator (China has dedicated hospitals)
5. lift the US lockdown and treat corona like any other seasonal flu, mainly because it is, and also to avoid destruction of our economy and related uncertainty
6. the exception is passenger airline flights, which should be grounded until further notice. develop a plan to make airliners safer to fly (hepa filters, etc.) Cities shouldn't be under lockdown, but airlines are almost certainly a major disease vector and need to be treated as such.
(FYI: Wuhan has an international airport only 2 hours flying time to Shanghai Pudong International, which is a major hub. So that's likely how it spread world-wide.)
The impediments for the US to implement this plan are:
1. as a society, the US has lost the ability to formulate and execute policy at the highest level, whether healthcare, hurricane response or infrastructure. At this time, we need experts (like the CDC) to lead.
2. Trump should not be involved in any way, since he doesn't care about facts.
(The reasons California Governor Newsom broke contact this week with the federal government are essentially the above.)
I'll add my collection of supporting links later today. They are all consistent with each other, so the facts I outlined above are not in dispute.
Although the information from China was publicized late, it appears overall to be accurate and helpful. They used their previous experience with corona and bird flu infections to move fairly assertively on Covid-19 - a far better response than the US or Europe.
Please leave a comment if you want an area of my outline above to be fleshed out more.
If somebody could look into how Sweden and Germany have fared with less social distancing, that would be helpful. Please leave a comment about that.
AMA.
- makomk 7y agoThe big problem with this plan is that it would require giving up and letting a large number of Americans die, which is a political and social nonstarter given current expectations around life, death and healthcare. (Well, at least amongst the secular parts of America. Some of the more religious communities seem to still hold the view that it's futile and arrogant to think this is something we can fight, much to the anger and bemusement of secular society.)
- redis_mlc 7y agoFor herd immunity, the number discussed is 80% of the population getting Covid-19. Since there are cases world-wide, I don't see containment at this point working. To even consider containment succeeding, we would need a way to test 300 million people a couple times a week. Since we can't do even 1 million tests a day, the math doesn't add up. "Giving up" is a strange way to look at it. We have various flus annually. There will be a time limit to lockdown of several weeks, not 18 months. So it's important to look at the data and make an informed public healthcare policy decision.
- lostmsu 7y agoThis plan is stupid. In U.S. under lockdowns, already 18k people died in just a few weeks, and every day 1k more die, and that number is still growing. The worst estimate for 2018 flu was 56k (e.g. less than a month left under current lockdown regime to surpass it), best is 12k which is long surpassed.
- redis_mlc 7y agoPeople die every year from flu in the tens of thousands, or car accidents, or myriad other causes. Rather than an emotional response, we need healthcare policy experts to look at the data as of today. What has changed in the past month is that we know ventilators don't work 66% - 90% of the time, so they should be taken out of the "flattening the curve" equation. Please see my post with several links to learn more.
- 7y ago