I have reservations about the rest of the this Wall Street Journal editorial but I find their conclusion a pretty good summary of where we stand:
April is going to be a brutal month for America, and the next two weeks especially. But as the bad news arrives, it’s important to understand that the worst-case-scenarios that many in the media trumpet are far from a certain fate.
Right now, this minute, the death toll from COVID-19 of those who have contracted the disease is less than 2%. Here in Illinois it’s 1.44%. IMO it’s a pretty good assumption that, as the number of people who’ve been tested and the velocity of testing both increase, that percentage will actually decline since right now the sickest are being tested. A little back-of-the-envelope calculation tells you that a couple of hundred thousand people may well die. That’s awful—a multiple of those who die every year from the seasonal flu. But it’s not the Black Death. It isn’t even the Spanish Flu.
We need to do a lot more testing, especially epidemiological testing and serological testing. Let’s abandon any thoughts of putting the measures the Chinese did into place. According to the reports I’ve heard everybody has received a QR code for their phones that identifies them and tells what the results of their latest COVID-19 test was. They’re only allowed out if they’re negative for COVID-19 (that’s from the wife of a colleague whose family is in Shanghai).
But I’m also skeptical of China’s reports. There are those who are not bat-**** who say that China’s total cases and death toll may be an order of magnitude or more than they’ve acknowledged. I have more faith in South Korea than that.
Some perspective: In October 1918 a reported 195,000 Americans died from the Spanish Flu. The Population then was 103 million or thereabouts. It is currently 328 million. A comparable death rate would be over 600,000 in a month. In a single MONTH. Kung Flu is bad, it’s the worst pandemic we’ve seen in decades. But the Black Death it is not.
And there’s money to be made to create an effective vaccine and to find drugs to combat the disease. Lots of money. Good businessmen and inventors aren’t going to waste time and potential profits proving efficacy and safety to standards seldom equalled. If it is good enough, go with it, and replace it ASAP when something else more effective comes along. That’s the American Way on steroids. Not the cautious careful bureaucratic way that’s the preferred method of those who have job security by being in government no matter how often or how badly they screw up.
Keep seeing reports of immunosuppressant drugs for HIV or Lupus saving patients. Seems sometimes our own immune systems destroy lung tissue by over responding.
“Keep seeing reports of immunosuppressant drugs for HIV”
We are trying moderate dose steroids among other drugs. The problem is the tif someone gets better we wont know what caused it. If more people die we wont know hat caused it. (Non medical people just cant seem to bring themselves to believe that a medication might be harmful.)
Steve
I think one big problem is that this threat does not respond to the quintessential American response:
Violence.
Yes, this is the real deal. Our sense of security is gone. We grab at straws, Reports of Hope.
Steve, thanks from the bottom of my heart for showing up.
Thank you for your kind words, but the people I lead are the real stars so far.. I asked for volunteers to put in extra time to help in the ICU and almost everyone volunteered. We have invented, with the help of the local university engineering department our own sterilizer. They constantly come to me with new ideas on how to do things better. An awesome team. I love these guys. Then there are the nurses I work with. Amazing people. Better stop before I get too maudlin.
(They are actively trying to keep me from doing much clinical because I am old and they worry about me. At this point I really do need to spend a lot of time planning and working with the rest of leadership. We are completely transforming our hospital. We change the schedules of the 150 plus people in our department every couple of days. But once the crunch really hits I cant spend so much time on admin and will be back to my normal full time clinical and full time admin. )
Steve
Steve: How has it been for you so far? I’m seeing and reading reports ranging from everything from it’s not bad at all to bodies piling up in the corridors.
Thanks for all your efforts. Your description of the various efforts you and your staff have done to continue operations under the situation is pure Americanism at its best, hard work and innovation. I’m glad to see that you are not being tied up by red tape or are simply cutting through it to get things done.
Thank you Tars. Our hospitals closest to NYC already have their ICUs full of intubated Covid pts and are sending them out to our other hospitals. The hospitals themselves have about 80% Covid pts. We are creating new ICU wards. Today we are moving anesthesia machines out of the ORs so we can use their ventilators. (The vents on those machines are generally not quite as sophisticated as a real ICU vent, but so far it looks like these pts dont have real compliance issues like some ARDS pts so we dont need real sophistication. However, ICU staff dont know how to use the vents so we ned anesthesia staff to run the vents.)
We have a flat managerial structure. Know each other well. I have known the CEO at our main hospital for 15 years. I negotiate a contract with her every other year. She is probably better at it than I am and if honest she probably gets the better of me more often than I do her. Mind you it is always cordial. It usually takes a month or so to agree on numbers and sort things out, mostly delays while legal looks at stuff. Now my staffing is changing so fast it is hard to keep up. I stopped by her office to talk with her and she said “I trust you. Just do whatever you think you need to do to make our staff and pts safe.” We are doing some unusual stuff to prepare. My ICU guys are free to try most anything they want. The only restrictions are imposed by our own leaders. They just want to know what they are doing and they are trying to track what seems to work and what doesnt. (We are lucky enough to have a couple guys out from recent surgeries who are spread sheet wizards so they are trying to help keep track.) So not much red tape at the lower levels. State and feds have made some promises. Hope they are kept.
Steve
Steve: Thanks for the reply. It’s good to hear from someone who is ACTUALLY intimiately involved with the whole pandemic and how it is affecting you frontliners to the whole thing. The spin on every news and blog site is such that I don’t trust a damned thing any of them say, even the ones that I’m more politically inclined towards. It’s bad that it sounds like your worst fears may be realized regarding Kung Flu, but it also sounds like you and everybody around you are trying to stay on top of it and not allowing blame-avoidance rules get in the way of fixing problems as they come up.
It’s also good to know that you are in an organization that apparently is not big on Central Top-Down control and thus can respond in real time to fast-moving events. Bureaucrats and bureaucracy can kill, people just don’t understand how they do it.
Stay healthy. Stay safe. And I hope that your entire staff and all your patients come out of it well.