Def Swami wrote:OrlandoNed wrote:EAS Law wrote:Since apparently we have to run all discussion through a couple of posters here to make sure it’s acceptable, I figured I’d ask a question this way...
What do you guys make of the fact that the mortality rate in the US has dropped from approximately 2-3% to about 1.7%? How about the fact that many, many more are likely to be carriers but we cannot verify because of the lack of testing and confirmation?
This virus can sort of “hide” because of the instances of an asymptomatic response, but you can’t hide a death. I doubt everyone that may have died as a result of COVID19 was tested for it unless they presented with specific respiratory distress or something, but logic would hold that there are way more cases than deaths than even our numbers currently show via the CDC, and the mortality rate is declining.
I think the declining mortality rate is just confirming that the only thing special about Corona is just how contagious it is. Other than that, Corona is a normal flu with a overblown reputation. Simple as that.
A lot of you guys know that I work as a physician in the emergency department. I come at this as someone who sees this on a daily basis and has participated in hospital meetings about how we're going to manage the large influx of really sick patients.
The issue with looking at the mortality rate in our country right now is that the onset of symptoms can be delayed by 5-7 days. So you can have several patients test positive with COVID19 who have no symptoms. You can check in on those same patients 5-7 days later and they can exhibit symptoms that reflect a common cold to severe respiratory distress requiring a ventilator. My colleagues have seen this play out over the last week for patients in the emergency department who look okay, but then return a few days later and end up in the ICU.
If you look at the trajectory of the disease in other countries, as the virus continues to spread, the prevalence rises exponentially and fast. For instance, there are some models that show our prevalence will more than double within a week from today. With that, those more vulnerable, the elderly and chronically ill, are going to be affected. And if we take what has happened in other countries, those patients are going to flood our emergency departments and hospitals rapidly and overwhelm the whole system. Italy is actually having to choose whose life to save at the moment because they don't have enough ventilators, resources, or staffing to keep all of their really sick patients alive. That's a really grim reality that we're currently preparing for in hospitals across the country. Our hospitals are already operating at 110% capacity on a daily basis during flu season. To throw a dangerous pandemic on top of it is something the country's health care system isn't really well prepared for. Which is why social isolation is one of the few ways we can all mitigate the spread of this virus and prevent so many people getting sick at once.
I know it
feels "overblown", especially when you see young and healthy people get this virus and simply have no symptoms or just a cold. But, it's actually more pernicious; it's hard to convince younger, healthy people that they are a vector for this virus. A lot of us could be harboring this virus, but if we transmit it to someone older ( >65 y/o, especially 80), it could really affect them in a bad way. Those are the majority of people who are going to flood the hospitals and overwhelm the health care system. It's a real threat that could run rampant kill lots of people if we didn't take the steps we're taking now. This is the projections from the CDC
if we took none of the steps we're taking now.
Between 160 million and 214 million people in the United States could be infected over the course of the epidemic, according to a projection that encompasses the range of the four scenarios. That could last months or even over a year, with infections concentrated in shorter periods, staggered across time in different communities, experts said. As many as 200,000 to 1.7 million people could die.
And, the calculations based on the C.D.C.’s scenarios suggested, 2.4 million to 21 million people in the United States could require hospitalization, potentially crushing the nation’s medical system, which has only about 925,000 staffed hospital beds. Fewer than a tenth of those are for people who are critically ill.
Luckily, we're taking the right steps to mitigate those projections. I know it's hard to feel on a day to day basis, but we really are saving lives by staying home, practicing social distancing, and washing our hands frequently.
EAS Law, with regard to your question,
even if you take 1.7% mortality rate, that's an extremely high mortality rate compared to the flu, which has a mortality rate of 0.1%. It's even worse for people older than 80, which is around 14.8%. I see patients on a daily basis who have this virus. I could be harboring it for all I know without any symptoms. But, it makes me anxious to visit my parents or grandparents. I simply can't do it and put them at risk.
We're just at the beginning of this epidemic in the country. It is certainly going to get worse in terms of its spread. And as more vulnerable people contract the virus, the more morbidity and mortality will come from it. Many of us at the hospital anticipate to see more sick people requiring ICU care over the next 2-4 weeks; this disease took the same course in every country it hit before us. But, if we do the work now, make the sacrifices early, then maybe we can limit the damage done. I'm optimistic about it from that standpoint. I'm glad the president has come around on acknowledging the severity of this pandemic.
But, I get it. It's such a drastic change in our lifestyles. I love coming home and watching sports as much as the next person. I love going out to the park and playing on my off days. I'm bored out of my mind when I get home.
But, this is the right thing to do. I can't overstate it enough.
