Neurogenes wrote: ↑Fri Mar 20, 2020 3:11 pm
tjcdas wrote: ↑Fri Mar 20, 2020 12:57 pm
Correct but deaths have been verified, most cases are not life threating, we can't shut down the country for months.
The deaths suggest a huge number of undetected cases and portend a really rough next few weeks, as deaths are a lagging indicator of disease. It's not like people get sick, are diagnosed, and die all on the same day. They get infected, hang out for a few days, get sick, hang out for a few more days, get diagnosed, hang out for a few more days, develop severe symptoms, hang out for a few more days, and then in some unfortunate cases die. When you see 17,000 people in the US confirmed as infected, you see 17,000 people who were infected maybe 3 to 14 days ago (please accept that this is extremely rough). When you see 218 people dead in the US, you see 218 people generally infected more than 14 days ago (again, very very roughly). Given the reported rate of death, that means there were probably more people infected two weeks ago than we have yet been able to detect to date. And that means there are far, far more infected today than we have currently identified.
Yes, absolutely all of this. Except I would even argue that currently death as an indicator of disease is even more prolonged than this timeframe above. A huge chunk of the COVID-19 deaths seem to result from ARDS. Sepsis and Multiple Organ Failure as well. These are all ruthless killers but in general, we've gotten better and better at managing these things over the years. Even where the overall survival rates aren't greatly improved, we can often prolong life for extended periods of time.
The average American family has ZERO notion what their critically ill/dying loved one would want done in the event they have very little chance of meaningful recovery. Absent that info, families often opt to do absolutely everything possible to save the life of their family member. Let's say there is a COVID-19 pt with ARDS, sepsis, and multi-organ failure. Sounds like a death sentence, right? It probably is.....eventually. But the family wants to give them a chance, so we do everything. And we've got all kinds of tricks to keep that pt alive in the ICU for weeks sometimes. In addition to all the things you might think of like antibiotics, breathing treatments, etc, we've got vasopressors, paralytics, all kinds of other drips, ventilators w/ fancy modes and settings, beds that turn you upside down, pacemakers, CRRT, nitric oxide, ECMO, etc. My point being that these COVID-19 deaths often come several days to weeks after severe symptoms begin.
That's how it is now anyway. But probably not for much longer. I fully expect this to change soon......quite possibly in the next month or two. I'm fairly certain these critical care doctors aren't gonna play by the old rules anymore. They are going to choose to allocate resources towards those with a chance for meaningful recovery. 2020 will become the worst possible year to need inpatient health care of any kind. Resources will be stretched thin. It doesn't matter if you're in the hospital for something unrelated. Open heart surgery, an emergent craniotomy, some regular old pneumonia, a broken leg.......you will be affected.
This isn't spoken out loud too often, but I think there is this notion among some that we can just forfeit the lives of a large number of our elderly and those with a medical problem. And in exchange for their lives, we can get our old economy and our old life back and things go back to normal. I'm not so sure it's quite that simple and I also don't think it's the precedent we want to set for ourselves.
