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Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

reuters.com

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Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#301

Post by taeric »

cplanas wrote: post #299
taeric wrote: post #165

Earlier quoted context omitted.

Do you have the numbers handy? And note, I mean hit hard with high severity cases. Not just cases. My hypothesis is that it is already everywhere. Most of this exponential growth is just how fast we can deploy testing.

I don't know about severity, but Norway is the European country with the highest infection ratio, after Italy and tiny Iceland. As of today: - Italy: 1 case per 3.996 inhabitants - Iceland: 1/4.285 - Norway: 1/6.710 - Denmark: 1/9.081 - Switzerland: 1/10.035 - Spain: 1/14.831 - France: 1/23.292 - Germany: 1/30.160

From my searches, they are currently at zero deaths? Low, at any rate.

Feels like this supports my hypothesis. If anyone starts looking, they will find cases. Only if you have a baseline lung damage rate that is elevated will you see severe cases.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#302

Post by grey-area »

toolz wrote: post #166
paulryanrogers wrote: post #147

Earlier quoted context omitted.

Fatality numbers won't reflect those who developed permanent lung damage or had to go into intensive care. Best not to suggest anything that might down play the seriousness considering how infectious this virus is. (Otherwise it may encourage risky behavior.)

but what about the risks of over-selling this disease? Look at Italy for example. I've read self-reports from healthcare workers claiming 200% hospital capacity. I can only image the needless death resulting from such panic. Mind you that isn't covid 19 putting them over-capacity. In the worst hit region in Italy (Lombardy) confirmed covid 19 cases represent enough cases to take up less than 10% of their hospital bed…

Hospitals worldwide have very little spare capacity and even less spare ICU capacity. A normal hospital bed isn’t going to help much. They are very likely to be overwhelmed, especially in countries that have not been able to delay initial spread due to lack of testing and containment.

This probably won’t kill millions (though it could worst case) but hospitals being overwhelmed would lead to an exponential rise in deaths, and many deaths from other causes as other treatments are abandoned. The situation is serious and will require significant measures to bring it under control, it is not yet being taken seriously enough in the US.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#303

Post by bryanrasmussen »

toolz wrote: post #218
danso wrote: post #212

Earlier quoted context omitted.

> In the worst hit region in Italy (Lombardy) confirmed covid 19 cases represent enough cases to take up less than 10% of their hospital beds. Do you have a source for this comment? This WaPo story from 6 hours ago says differently: https://www.washingtonpost.com/world/europe/italy-coronaviru... > Giulio Gallera, Lombardy’s health chief, said Thursday that the region would reach its capacity in “five, six or seven da…

lombardy has 7280 confirmed cases [1] lombary has a population of 10MM (wikipedia) italy has 3.18 hospital beds per 1000 [2] the math for that adds up to 31,800 hospital beds 7280 confirmed cases is 22% - so my sources were off or wiki is wrong as originally I recall reading lombardy has a 16MM population. I will say that your article claims they haven't run out of ICU beds yet but that number is surprisingly high fo…

1. Not every hospital bed is the same as a bed for a highly infectious disease

2. Other things still happen to people and those people need to have their hospital beds.

3. I'm not a hospital planner but I think there may be other things that determine capacity than just hospital beds. I worry that the hospital bed metric is actually a bad metric. Obviously adding hospital beds implies adding people to staff those beds, but also adding people probably also means adding all sorts of other infrastructure to support those people.

As a developer it reminds me of a project that goes way off schedule, you don't bring the project back on track just by adding developers because of the overhead more developers add to your system. Probably most hospital administrators have never actually experienced operating at capacity, so estimations of what would happen could be off and are being corrected now.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#304

Post by leethargo »

esistgut wrote: post #210
Diederich wrote: post #34

I noticed something else that might be an interesting correlation: available "acute" hospital beds. I don't have time to do the full correlation, but here's the data: https://stats.oecd.org/index.aspx?queryid=30183 Select "Curative (acute) care beds" Scroll down to the Per 1000 population. Italy: 2.62 Korea (assuming South): 7.14 The list of countries in that table is a good bit shorter than the countries fighting Co…

Italy has not yet reached the limit for ICU beds, whatever it is. People dying here is still within capacity, for now.

I guess you mean the total national capacity, not the local capacity in the most affected towns?

Symptomatic patients are probably not going to be transferred over long distances, right?

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#305

Post by leethargo »

marcinzm wrote: post #150
2019-nCoV wrote: post #13

This outbreak is a litmus test for the competence of countries. It's already shone a bright light on the fragility of global supply lines, cheap travel and open borders. These are the aspects of life most likely to change after this is all over.

>These are the aspects of life most likely to change after this is all over. People will forget about this in a year and go back to life like it's always been. Short term convenience trumps everything except short term negative consequences.

In a year, it might still not be over.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#306

Post by oarsinsync »

mlinsey wrote: post #260
toolz wrote: post #218

Earlier quoted context omitted.

lombardy has 7280 confirmed cases [1] lombary has a population of 10MM (wikipedia) italy has 3.18 hospital beds per 1000 [2] the math for that adds up to 31,800 hospital beds 7280 confirmed cases is 22% - so my sources were off or wiki is wrong as originally I recall reading lombardy has a 16MM population. I will say that your article claims they haven't run out of ICU beds yet but that number is surprisingly high fo…

Most hospitals don't have all that much slack in bed capacity; especially at the tail end of flu season most of those beds are already filled. The hospitals may be extrapolating the growth rate of the disease and realizing how soon they will have problems. Or given the nature of the outbreak it could be that even within Lombardy there are areas with much higher concentrations of cases, like there are more cases, inc.…

> Most hospitals don't have all that much slack in bed capacity; especially at the tail end of flu season

Remember that there's a difference between hospital beds and ICU beds.

In the UK, we maintain 80% utilisation of our ICU beds all year round[0], with very little change in the number of beds available in real number terms. We have ~4100 total ICU beds, which can be expanded to ~5000 if all operating theatres, etc are shut down and used as ICU equivalent instead.

While getting past flu season will help the total number of beds, it does nothing for the ICU.

This is the other reason why it's increasingly important to https://www.FlattenThesCurve.com and employ social distancing techniques. The rate of patients being admitted into ICUs needs to be slowed as much as possible. Once we're out of capacity, every additional patient has a much higher probability of dying than the overall fatality statistics indicate.

[0] https://www.england.nhs.uk/statistics/wp-content/uploads/sit...

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#307

Post by martinpw »

jotm wrote: post #272
AlchemistCamp wrote: post #172

Earlier quoted context omitted.

Singapore has been competent, but Taiwan's response has been more impressive. It's very close to the hot zone, millions of people travel to and from mainland China every year, it has roughly the population of Australia living on 10% of the land Japan has, the WHO refuses any cooperation, and yet there have been under 50 cases and no local transmission. Not only that, but as a democratic state, Taiwan's control measur…

Meanwhile, around here people break advised self quarantine because "fork off, I'm fine". No trust in government and a general attitude of "it's just a flu, and I got things to do"...

Where is "around here"?

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#308

Post by jotm »

martinpw wrote: post #307
jotm wrote: post #272

Earlier quoted context omitted.

Meanwhile, around here people break advised self quarantine because "fork off, I'm fine". No trust in government and a general attitude of "it's just a flu, and I got things to do"...

Where is "around here"?

Romania, which is also severely underprepared for a real outbreak. At least they're locking down borders and checking people, there's a lot of them going to/from work around the EU.

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#309

Post by taeric »

taeric wrote: post #215
Camillo wrote: post #211

Earlier quoted context omitted.

The daily historical on that website goes back to February 12th. Wuhan has been in lockdown since January 23.

I'm now on my phone, but the site I used went back longer. I'll compare when I can. And again, China was worse. Italy is just worse than all places I checked that had a lot of cases, but not as many severe cases.

For reference, this is the site I found that went back farther. Milan is not constant days of 150, as Hubei is. That said, it is littered with many high value days. Contrasted with Seattle, which has been steady below 60 for the time period.

Take this over to Australia [below], and you can see that even they had terrible air as recently as mid January.

Contrast to Norway [also below], which has hovered on fine air quality for the entire time. Same for Japan, all told.

Basically, the worse your air quality, the more severe cases you are seeing. To a marked degree.

Edit: Just eyeballing, Milan is worse than Seoul. Agreed not as bad as Hubei. But between.

Seattle: https://air-quality.com/place/united-states/seattle/9e80e347

Hubei: https://air-quality.com/place/china/hubei/7991f3c2

Milan: https://air-quality.com/place/italy/metropolitan-city-of-mil...

Australia: https://air-quality.com/place/australia/victoria/def9c265

Norway: https://air-quality.com/place/norway/troms/a70875e7

Japan: https://air-quality.com/place/japan/tokyo/c8969bc2

Re: Italy and South Korea virus outbreaks reveal disparity in deaths and tactics

#310

Post by Heliosmaster »

oarsinsync wrote: post #306
mlinsey wrote: post #260

Earlier quoted context omitted.

Most hospitals don't have all that much slack in bed capacity; especially at the tail end of flu season most of those beds are already filled. The hospitals may be extrapolating the growth rate of the disease and realizing how soon they will have problems. Or given the nature of the outbreak it could be that even within Lombardy there are areas with much higher concentrations of cases, like there are more cases, inc.…

> Most hospitals don't have all that much slack in bed capacity; especially at the tail end of flu season Remember that there's a difference between hospital beds and ICU beds. In the UK, we maintain 80% utilisation of our ICU beds all year round[0], with very little change in the number of beds available in real number terms. We have ~4100 total ICU beds, which can be expanded to ~5000 if all operating theatres, etc…

There's a typo, it's https://www.flattenthecurve.com/
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