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Author Topic: It Just Got Real  (Read 9569 times)

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jdmessner

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Re: It Just Got Real
« Reply #45 on: March 29, 2020, 01:24:34 PM »

sschorr - I am sorry for your loss. Your family will be on my prayer list. The sad thing about this is that in many cases people are dying alone and families don't have a chance to mourn together. It is hard no matter what the circumstances, but this is beyond what we could have ever imagined.

My neighbor is expected to come home today. He had a very rough go of it, but is recovering. This was posted by a doctor at the hospital he was being treated in. I thought it was very insightful. Hope everyone is staying safe and healthy.

Dr Nick Sward a primary care physician at Bronson Hospital: it is not to cause fear just put this in perspective to stay home if you don’t have to work; wash your hands and social distance.

Pandemic Ponderings from Primary Care 3/28/2020
(sorry for length)

Disclaimer: The intent of these posts are NOT to cause panic, but to provide some basic education and help us look at these issues in a different way. Everyone learns differently so hopefully at least one of these posts will resonate with folks.

I've seen quite a few people post: "The recovery rate from this is almost 99%, so stop spreading panic and focus on the positive!" The fact that almost 99% will fully recover is an absolutely TRUE statement. That's great, right?? Slow down a second and just think about that. Sometimes it's hard to work the numbers in your head that our country has 330,000,000 people so if even half of us get infected (lowball estimate), then 1,650,000 of us will die from this. Those kinds of numbers seem hard for people to wrap their heads around so I'm going to focus on where I live, Kalamazoo, Michigan.

Kalamazoo County Population: 263,000
SW Michigan population (7 counties): 874,000
Bronson Methodist Hospital Beds: 434
Borgess Ascension Hospital Beds: 371
Bronson adult ICU beds: approx. 50 (plus 22 O.R beds)
Borgess adult ICU beds: approx. 30

On any given day, both hospitals run at approximately 85-93% capacity (according to American Hospital Directory), so on average, there are 725 patients occupying 805 available beds. This leaves us 80 beds available for anything else that might happen. (If you account for every other hospital in SW Michigan, it adds 77 beds, accounting for utilization)

Current estimates are that between 40-70% of us will become infected with COVID 19 and about 5% of those will need hospitalization (2% requiring ICU care and 1% will need a ventilator). Let's run the numbers!

Population 40% infected 70% infected
263,000 (Kzoo) 105,000 184,000
- 5% hosp 5250 9200
- ICU needs 2100 3680
- Deaths 1050 1840

874,000 (SW Mi) 338,000 593,000
- 5% hosp 16900 26950
- ICU needs 6760 11860
- Deaths 3,380 5,930

So, if you crunch those numbers......

HAVE vs NEED
BEDS: 157 17000-27000
ICU BEDS: 80 6750-12000

Sooooooooooooo even though we already decided that 99% of people will recover from this, you have to remember that 5% will need to be hospitalized. If they CANNOT be hospitalized because WE DON'T HAVE THE ROOM, how many of those people will die? Unknown. But I don't want to find out. That 5% improve because we are able to give them all the care they need. For now. What happens when we cannot? What happens when over half of the nurses, doctors, NP's, PA's, respiratory therapists, Pharmacists and other healthcare people get sick and can't come to work and further drop our ability to care? Even if our hospitals were EMPTY to start, we would fall short of the demand by 50-80% (and we already know both hospitals are 90% full almost all the time). Both hospitals are working 24/7 right now to prepare in any way we can by cancelling elective surgeries and opening up more beds and operating suites which could be used as ICU beds if necessary. But it's only going to make a dent in what is needed and we need YOU to help us.

The picture here is surely one of "Holy****!". But here's where YOU get to make a difference: Research done in China and other countries that have successfully slowed the spread and flattened their curves show consistently that SOCIAL DISTANCING and EFFECTIVE HAND WASHING can lower cases, hospitalizations and deaths dramatically. We CAN make a difference. I know it sucks being home all the time. But if we're going to make a difference, we must do it NOW.
« Last Edit: March 29, 2020, 03:56:24 PM by Bentley »
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hughver

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Re: It Just Got Real
« Reply #46 on: March 29, 2020, 01:33:14 PM »

I got snarled up in all of the numbers but, IMO, the last paragraph says it all.  :2cents:
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Kristin Meredith

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Re: It Just Got Real
« Reply #47 on: March 29, 2020, 02:17:54 PM »

I think most people understand the argument on "flattening the curve" and understand that without it, the loss of life may be greater.  What seems to be missing is an appreciation that there will be, and already has been, a huge cost to that solution.  A cost that might last decades.  We trade things off as a society and I think there is a whole segment who is trying to pretend there will be no trade-offs.

It will be interesting to see what society is saying in 6 months about "flattening the curve" when economics kicks in. 
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okie smokie

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Re: It Just Got Real
« Reply #48 on: March 29, 2020, 09:39:43 PM »

I would expect a gradual flattening and then a respectable drop off of new cases. I believe that the drop off in deaths will be the most reliable curve to follow, since our testing may turn out to be sporadic in numbers.  In Tulsa we went from 7 cases and 1 death a week ago to 61 cases and 3 deaths today. As for how long we will be asked to follow the limited contact rules--I don't care, cause I'm going to stick to those rules until I see clearing from this community.  I think we may have seen the last of the hand shaking and hugging for some time to come. I still love you guys, but that is the way it is for a while.
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Th3Batman86

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Re: It Just Got Real
« Reply #49 on: March 29, 2020, 11:01:47 PM »

Will the "curve" have to be flattened just once?

No, we will need to flatten it twice as with Spanish Flu and now with Covid in China there will be a second wave once life normalizes and the virus spreads again among those who did isolate in time and didn’t catch it the first wave. The Spanish Flu memories of lots of people dying are actually from the second wave of said flu

https://www.thoughtco.com/1918-spanish-flu-pandemic-1779224

“While the first wave of the Spanish flu had been extremely contagious, the second wave of the Spanish flu was both contagious and exceedingly deadly.

In late August 1918, the second wave of the Spanish flu struck three port cities at nearly the same time. These cities (Boston, United States; Brest, France; and Freetown, Sierra Leone) all felt the lethalness of this new mutation immediately.”

Right now this (second wave)  is happening in Hong Kong.

https://abc7.com/amp/coronavirus-covid-19-china-hong-kong/6052596/

“Two or three weeks ago things were finally getting back to normal a little bit," resident Tumshie Smillie said. "Offices were opening back up again, civil servants were going back into the office. People just felt like they could get out a little bit more while still feeling like they needed to feel safe and cautious of the situation.

But in a swift reversal -- in just one week -- all of the progress was erased. The number of COVID-19 cases jumped by 50 percent.”

 
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Kristin Meredith

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Re: It Just Got Real
« Reply #50 on: March 30, 2020, 07:51:36 AM »

I also read an expert's interview saying that we probably would have some of the summer off and then about Sept/Oct have to go back in quarantine to "flatten the curve" and, depending on when a vaccine is developed might have to do a 3rd "flattening in Feb- March of 2021.  Of course, by then no one will have any funds for food or housing, so Mother Nature might solve the problem the old fashioned way.
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hughver

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Re: It Just Got Real
« Reply #51 on: March 30, 2020, 11:28:28 AM »

All I know is that economies can recover, but dead people can't.

You nailed it!
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Kristin Meredith

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Re: It Just Got Real
« Reply #52 on: March 30, 2020, 11:34:30 AM »

I just read a story about kids who have aged out of the foster care system, but managed to go on to college.  They have now been thrown out of their dorms and many find themselves homeless overnight at the age of 18, 19, 20 with little prspect of getting a job or housing or maybe being able to adequately feed themselves.  But hey, it's just economics right. 
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hughver

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Re: It Just Got Real
« Reply #53 on: March 30, 2020, 11:42:39 AM »

And then there's New Orleans who decided to go ahead with Mardi Gras in spite of the virus threat. How did that work out for them?
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Kristin Meredith

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Re: It Just Got Real
« Reply #54 on: March 30, 2020, 12:09:49 PM »

My point is that however we deal with this, there are fallouts and consequences.  And somehow pretending that if we just take the path of experts and medical safety everything will be ok is a false narrative. People are going to suffer no matter what path, people are going to feel pain no matter what path, some may die from an overdoe or suicide because of depression because they have no job or money and their kids are hungry. 

The idea that there is not a cost to flattening the curve is a myth.  I sure would not want to be a 19 year old homeless college kid with no money, now living on the streets -- and I sure hope the folks in the food production and distribution and pharna production and distribution don't decide that they just need to stay home to so that they don't get sick.
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jdmessner

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Re: It Just Got Real
« Reply #55 on: March 30, 2020, 12:18:32 PM »

My point is that however we deal with this, there are fallouts and consequences.  And somehow pretending that if we just take the path of experts and medical safety everything will be ok is a false narrative. People are going to suffer no matter what path, people are going to feel pain no matter what path, some may die from an overdoe or suicide because of depression because they have no job or money and their kids are hungry. 

The idea that there is not a cost to flattening the curve is a myth.  I sure would not want to be a 19 year old homeless college kid with no money, now living on the streets -- and I sure hope the folks in the food production and distribution and pharna production and distribution don't decide that they just need to stay home to so that they don't get sick.

Well put, the bottom line is there is no easy way out.
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hughver

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Re: It Just Got Real
« Reply #56 on: March 30, 2020, 01:47:15 PM »

Don't get me wrong, I have the utmost empathy for all who are adversely affected by the virus weakened economy. My only point is that we need to use care if we are to live to fight another day. A quote from one of todays Seattle Times headlines "A Mount Vernon choir went ahead with rehearsal. Now dozens have coronavirus and 2 are dead".
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Darwin

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Re: It Just Got Real
« Reply #57 on: March 30, 2020, 07:54:33 PM »


Arizona governor issues 'stay-at-home' order; will take effect close of business Tuesday

Time to reup my Netflix subscription
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Kristin Meredith

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Re: It Just Got Real
« Reply #58 on: March 30, 2020, 09:34:04 PM »


Arizona governor issues 'stay-at-home' order; will take effect close of business Tuesday

Time to reup my Netflix subscription

Oh, that must be the newest thing that all the govenor's are doing because our just did it here in Virginia.  Already hear gunshots all around us every day from folks "practicing".
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pmillen

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Re: It Just Got Real
« Reply #59 on: March 30, 2020, 09:41:26 PM »

Arizona governor issues 'stay-at-home' order; will take effect close of business Tuesday

It has never made sense to me to announce travel restrictions or stay at home orders ahead of time.  It causes people to travel more or go out more to beat the lockdown.
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