Coronavirus Sars-CoV-2/Covid-19 Megathread

[merithyn]

The mortality rate seems to be less than 1% and the infection rate is going to be less than 100%. I'm not saying this isn't bad but there isn't a reason to overstate the worst case.

Mortality rate is only around 1% as long as the are ICU beds available. Most first world countries only have a few thousand beds available at any one time. And most of those will be in use.

Italy's health system is collapsing, Spain's will last another week tops. The NHS is notoriously ill-equipped for an outbreak after savage cuts. Germany has a crapload of beds, so they should be good for maybe a month.

Scaling these resources is very difficult, because few nurses are actually qualified to work ICU. The closest thing are maybe surgical, so I expect a lot of surgery cancellations and shadowing of ICU nurses by surgical colleagues.

The reason why the Chinese did what they did in Wuhan is that they saw themselves facing this abyss. So they built prefab hospitals, made equipment to fill them and transferred 40 thousand medical and nursing staff to the city from elsewhere.

And here are where all of my concerns lie.

Yes and no.  A lot of the cases (the young and the older active and healthy) don't need hospitalization.  We have cases here in BC where the symptoms are relatively mild and the people recovered at home.  The ICU is going to be needed for the elderly compromised patients.  But many of those elderly patients are already in medically assisted beds at their care homes.

And when all of those beds are taken, what about the serious accidents that happen? Or the heart attacks that happen? Or or or....

There's a waterfall affect that's going to be a serious concern in a few weeks.

[merithyn]

Heard on NPR that Trump was visiting the CDC and he announced that "anyone who wants to get tested can get tested."

That happened on Friday, I think.

He was wrong, of course.

[crazy canuck]

The mortality rate seems to be less than 1% and the infection rate is going to be less than 100%. I'm not saying this isn't bad but there isn't a reason to overstate the worst case.

Mortality rate is only around 1% as long as the are ICU beds available. Most first world countries only have a few thousand beds available at any one time. And most of those will be in use.

Italy's health system is collapsing, Spain's will last another week tops. The NHS is notoriously ill-equipped for an outbreak after savage cuts. Germany has a crapload of beds, so they should be good for maybe a month.

Scaling these resources is very difficult, because few nurses are actually qualified to work ICU. The closest thing are maybe surgical, so I expect a lot of surgery cancellations and shadowing of ICU nurses by surgical colleagues.

The reason why the Chinese did what they did in Wuhan is that they saw themselves facing this abyss. So they built prefab hospitals, made equipment to fill them and transferred 40 thousand medical and nursing staff to the city from elsewhere.

And here are where all of my concerns lie.

Yes and no.  A lot of the cases (the young and the older active and healthy) don't need hospitalization.  We have cases here in BC where the symptoms are relatively mild and the people recovered at home.  The ICU is going to be needed for the elderly compromised patients.  But many of those elderly patients are already in medically assisted beds at their care homes.

And when all of those beds are taken, what about the serious accidents that happen? Or the heart attacks that happen? Or or or....

There's a waterfall affect that's going to be a serious concern in a few weeks.

I am disagreeing with the proposition that a lot of beds will be needed.  ie not everyone who contracts the virus needs the bed - our experience is that not many do.

[merithyn]

And when all of those beds are taken, what about the serious accidents that happen? Or the heart attacks that happen? Or or or....

There's a waterfall affect that's going to be a serious concern in a few weeks.

I am disagreeing with the proposition that a lot of beds will be needed.  ie not everyone who contracts the virus needs the bed - our experience is that not many do.

South Korea and Italy are already rationing their ICU and hospital beds. Canada will get there.

[Sheilbh]

The clash between Trump's germaphobia and his boosterism is coming.

Rep. Matt Gaetz To Self-Quarantine After Coronavirus Exposure At CPAC
Gaetz is one of multiple Republican lawmakers who have to enter a 14-day self-quarantine amid the COVID-19 outbreak.
    By Lydia O'Connor, HuffPost US

Rep. Matt Gaetz (R-Fla.) announced Monday that he is among the Republicans self-quarantining after learning that he came into contact with someone who tested positive for the coronavirus at last month's Conservative Political Action Conference.

Rep. Matt Gaetz
@RepMattGaetz

Reviewing the coronavirus supplemental appropriation and preparing to go vote.

Last week, Gaetz mocked coronavirus concerns by wearing a gas mask on the House floor just days before an infected man from his Florida district died.

Gaetz was on board Air Force One with President Donald Trump shortly before revealing his situation.

[merithyn]

Couldn't have happened to a better man. 

[Richard Hakluyt]

Not to be rude about the president of the USA, but he is an obese git in his 70s, a brush with the virus could be very unpleasant for him.

[crazy canuck]

And when all of those beds are taken, what about the serious accidents that happen? Or the heart attacks that happen? Or or or....

There's a waterfall affect that's going to be a serious concern in a few weeks.

I am disagreeing with the proposition that a lot of beds will be needed.  ie not everyone who contracts the virus needs the bed - our experience is that not many do.

South Korea and Italy are already rationing their ICU and hospital beds. Canada will get there.

We shall see.  There were thousands of passengers a week disembarking at the Vancouver airport from China up until just recently.  I suspect it is here but most people are not presenting for tests because for most (those who are healthy) the symptoms are going to be fairly minor - much like a cold.  The health authorities have now tested over 2000 people and have tracked down those who were in contact with those who have tested positive.  Very small percentages of those have tested positive.

Now the whole thing could mutate but right now, based on what we are seeing the main risk is to those whose health is compromised of which a large number are the elderly.

[Iormlund]

My ex was sent home today when a coworker tested positive. She's not under quarantine. She's not being tested (hasn't been contacted at all by health services). Her job involves frequent travel all over Spain.

We're so fucked.

[Sheilbh]

Yeah - I think NHS advice if you come into contact with a confirmed case is that you'll get tested and you should self-isolate anyway.

[crazy canuck]

My ex was sent home today when a coworker tested positive. She's not under quarantine. She's not being tested (hasn't been contacted at all by health services). Her job involves frequent travel all over Spain.

We're so fucked.

She may not have had contact.  Simply working in the same building is not going to be a likely route of transmission.

[Josephus]

Not to be rude about the president of the USA, but he is an obese git in his 70s, a brush with the virus could be very unpleasant for him.

There's a silver lining in every cloud.

[Admiral Yi]

Only precautions I've seen around here are: cashiers at the supermercado are wearing plastic gloves, and the chick at Starbucks told me to toss my old cup when I went to get a cheap refill (they usually reuse the cup).  Haven't seen any masks yet.

[viper37]

Trump does have a point though....we don't seem to go into full lock down every year when flu breaks out. Is this THAT much worse?

3x more infected people than seasonal flu.10x more deaths than seasonal flu.20% of the infected need a respirator to survive.
nearly everyone infected is knocked out for at least a month with severe flu like symptoms.

You ever had a nastly flu?  How'd you feel going to work while in that state, with a strong fever?  That's going to last close to one month, assuming you are in good health.
Now, make it like 3x more people like that than with the regular flu that nearly overwhelms our hospitals.  What do you think is going to happen to the 20% who require a respirator when there is none available?  What do you think happens when there's a choice between a 70 year old man with coronavirus and a 30 year old with cardiac problems?

[merithyn]

We shall see.  There were thousands of passengers a week disembarking at the Vancouver airport from China up until just recently.  I suspect it is here but most people are not presenting for tests because for most (those who are healthy) the symptoms are going to be fairly minor - much like a cold.  The health authorities have now tested over 2000 people and have tracked down those who were in contact with those who have tested positive.  Very small percentages of those have tested positive.

Now the whole thing could mutate but right now, based on what we are seeing the main risk is to those whose health is compromised of which a large number are the elderly.

Well, let's look at this by the numbers.

With almost 20% of Vancouver, BC, being 65 and older, that's 125,000 people. Let's say that 25% of that population get the disease, of which 40% are likely to be severely ill (eg needs hospitalization with a ventilator) per the Italian numbers. That puts 50,000 65+ people in the hospital in Vancouver.

Per NCBI, there are only 8000 ventilator beds in hospitals across *all of Canada*. I'm going to guess that roughly a quarter of those are in or near Vancouver by stint of population counts. That's roughly 2000 ventilator beds in Vancouver for an estimate of 50,000 people.

https://vancouver.ca/files/cov/2017-05-04-city-of-vancouver-2016-census-age,-sex-and-type-of-dwelling-data-release.pdf
http://www.protezionecivile.gov.it/documents/20182/1221364/Dati+Riepilogo+Nazionale+2marzo2020/f750bdea-4e89-4747-8d05-72ede9f40f05
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4426537/