Rafe wrote: ↑Sat Apr 04, 2020 5:12 pm I'm not on the panic train, but I absolutely do not know what the best answer is to balance the economic risks and the medical risks. I posted a couple of days ago about the 1998 PBS episode of American Experience on the 1918 influenza pandemic. I'll say again, I think it's worth a look: https://www.pbs.org/wgbh/americanexperi ... influenza/. It isn't on YouTube, but it can be streamed for free from the PBS site. The good news: we aren't involved in a world war, and we have technology available to help many sectors of our predominantly service-related economy to work from home. At least somewhat. But we made a bunch of mistakes in 1918, and after watching that PBS video, I think you'll see we started out making very similar mistakes with COVID-19.
But here's a well-done video from Vox on April 1 that is on YouTube and offers a comparison of what we know currently about COVID-19 vs. the flu:
We have a lot more urban population density now than we did in 1918, and I think the worst-case scenario is potentially much worse than PlatinumCouch indicates. For one, Fauci and Birx have said that the real worst-case, even though both discount it as improbable, is more like 1.7 million U.S. deaths. We have no "herd immunity" yet to COVID-19, and we did, at least some, to H1N1 back in 1918. We thankfully understand the difference between a virus and a bacterium (unlike in 1918) and we aren't simply stacking cots shoulder-to-shoulder in triage wards and calling it hospitalization, but COVID-19 is far more contagious than influenza.
From two days ago, here's an interesting article from FiveThirtyEight, a product of ABC News: https://fivethirtyeight.com/features/be ... far-apart/. They've been working on outbreak models weekly. One important opinion they arrived at was only about 12% of all COVID-19 infections in the U.S. have been reported so far. Which likely means the panic-inclined will become even more panicky because with actual numbers artificially low, as more and quicker/cheaper testing is done and more cases are identified the total number and percentages ain't going down anytime soon.
The "how many will die this year in the U.S. due to COVID-19" estimates in that article are all over the place. The orange bar on this graph represents the collective best-guesses, which fall in line with the White House current numbers of 100,000 to 240,000:
TAM and our resident physicians can speak to this better than I can, but what I think I'm also concerned about are the deaths that are not caused by COVID-19, that won't go down in the books in the statistics. The nation has limited medical and hospital resources. If we're to believe what Andrew Cuomo says, New York is on the verge of setting up cots in the streets. (I'm not a huge Cuomo fan, BTW.) But the reality is that only so many ICU beds available, only so many ventilators, only so many physicians and PAs and nurses.
The mean of Dr. Fauci's current estimates would be 170,00 dead from coronavirus. That ain't gonna take until November to sort itself out. If we plop only a fraction of those into hospital ICUs over the next 5 to 7 weeks, the whole medical system will be overwhelmed and brought to a virtual standstill. What happens to the normal stream of people that need inpatient hospital admittance? People who have heart attacks, a stroke, a burst appendix, are in a car accident, need cancer surgery...have an unintentional discharge at the range and shoot themselves in the leg? (I had to bring it around to the focus of the Forum.)
If we take the top three causes of death--stopping at anything respiratory-related--and divide the annual number by 12, it means we see about 118,000 deaths each month in the U.S. from those causes alone, so over 200,000 in a 7 week period. Where do those people go when the inn is full? It's almost like a MASH triage where they will treat injuries to the lower extremities only. Been gut-shot? Sorry, we don't have the resources to treat you. That's what all this flattening-the-curve stuff is about.
My longest post in history, and I've got not a single solitary answer to offer. But I don't think it's to revert to the days of the Black Death and have trucks driving around to pick up the dead like a scheduled trash day. We've got to try to control this thing somehow. Otherwise we'll see the 170,000 deaths in a matter of weeks from the virus itself, plus undoubtedly 100,000-plus more from "normal" emergency medical requirements who kicked the bucket because we were too short on resources to give them the treatment they would have received if they'd had the foresight to get hit by that drunk driver in February instead of May.
Rafe,
Respectfully, All great points. I hope we can all debate this further when this thing is (hopefully) all over.
