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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

#321

Post by dr_dshiv »

grey-area wrote: post #302
toolz wrote: post #166

Earlier quoted context omitted.

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 de…

Are ICUs even helpful against the disease? I wonder if any triage experiments are being run with randomization.

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

#322

Post by pmontra »

eisa01 wrote: post #317
gpderetta wrote: post #227

Earlier quoted context omitted.

It is possible you are right. IIRC, 17% of those tested were positive in Italy. That's a very high percentage. Very likely the actual infected number is much higher.

Yup, you probably only have to look at the counts of infected tourists coming back. In Norway that is 89 from Italy, and 112 from Austria (25% of the total infected as of writing...)

Is Norway testing everybody coming back into the country?

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

#323

Post by kijin »

toyg wrote: post #313
kijin wrote: post #283

Earlier quoted context omitted.

South Korea also has 4x as many hospital beds per 1000 people as Italy does. They still suffered a shortage of hospital beds in the hard-hit area around Daegu, so much so that some people died while waiting. Italy and other countries with fewer hospital beds will have to resort to what China did: build makeshift hospitals, fast. https://en.wikipedia.org/wiki/List_of_OECD_countries_by_hosp...

Afaik they’ve already started with that in one the affected regions.

Yeah, I also heard that China is sending to Italy the materials they don't need anymore, since they started dismantling the temporary hospitals in Wuhan. That would be very helpful.

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

#324

Post by RobertoG »

zaroth wrote: post #41
skmurphy wrote: post #32

Earlier quoted context omitted.

If you factor in collapse of medical services -- Italy ran out of ventilators / ICU beds--the gap becomes clearer. You have to look at over 60 as more likely to be hospitalized, putting strain on medical system.

This doesn’t account for it because South Korea didn’t even have the number of serious cases that Italy has. The real answer is simply that the number of tests is not equal to the number of cases. The number of positive tests is a factor of the number of tests done, and how selective the testing was allowed to be. It is only loosely related to the number of infected people (technically it is the lower bound).

>>"The real answer is simply that the number of tests is not equal to the number of cases."

I think you are right, but, assuming all the deaths are reported, the obvious implication is that the mortality rate is a lot lower than 3%

If fact, looking to Germany, I would say that it's around 0.2, 0.3 %

That would be the good news, the bad news is that it's extremely contagious, probably because nobody is immune to this thing.

Of course, I'm only a random guy in the Internet, so take it with a grain of salt.

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

#325

Post by Kiro »

brokenmachine wrote: post #281
ivanhoe wrote: post #204

Earlier quoted context omitted.

There are also cultural differences, Italians like to hang out in groups, outside, personal space is much smaller, people hug and kiss and touch all the time. Also they're not really the most disciplined nation, lots of them simply ignored the safety rules, continued to go out, there were even some cases where infected people run away from quarantine. And additionally the spread of virus is not uniform as it depends…

>In South Korea one of the early patients infected more than a thousand other people Really? That's horrifying. Any links about that?

https://graphics.reuters.com/CHINA-HEALTH-SOUTHKOREA-CLUSTER...

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

#326

Post by skmurphy »

T-A wrote: post #233
skmurphy wrote: post #139

Earlier quoted context omitted.

Here are two reports that would indicate that the standard of care has been substantially reduced https://www.theatlantic.com/ideas/archive/2020/03/who-gets-h... "Doctors and nurses are unable to tend to everybody. They lack machines to ventilate all those gasping for air." ---- https://www.euronews.com/2020/03/12/coronavirus-italy-doctor... "Another nurse working in Lombardy, the Italian region the worst hit by COVI…

Going through your links: #1 provides no numbers and no details beyond a claim that "They lack machines to ventilate all those gasping for air." #2 does not even go that far: it speaks of "a huge turnover issue and leaving hospitals at near capacity" (near, not above, contradicting #1) #3 is from an intensivist in Seattle, Washington, not from Italy. I chose the Washington Post link because it provides numbers: "Lomb…

#3 was to show what can happen in one hospital. These patients are hard to transfer. Lombardy is about 9200 sq mi. (about 100 miles square). If you need a ventilator you may not be able to withstand a 50 mile ambulance ride. But I concede I cannot offer conclusive proof that Italy is out of ventilators.

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

#327

Post by lultimouomo »

dr_dshiv wrote: post #321
grey-area wrote: post #302

Earlier quoted context omitted.

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 de…

Are ICUs even helpful against the disease? I wonder if any triage experiments are being run with randomization.

When you have ADRS ICU treatement is pretty much the only thing keeping you alive. "Randomized trial" in this context means russian roulette - if you don't get a ventilator you'll die almost certainly.

Evidence [0] (partly based on COVID-19, parly on MERS) also says that NIV has a significantly worse outcome than ventilation. People are already getting NIV in some hospitals because they ran out of tubed ventilators.

[0] https://www.who.int/docs/default-source/coronaviruse/clinica...

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

#328

Post by 12thwonder »

rb808 wrote: post #33

> South Korea has since reported 67 deaths out of nearly 8,000 confirmed cases, after testing more than 222,000 people. In contrast, Italy has had 1,016 deaths and identified more than 15,000 cases after carrying out more than 73,000 tests on an unspecified number of people. Surely the testing is a huge factor. Test more people you'll find more people infected, so the fatality rate will get smaller. If you're like th…

> If you could quickly and accurately test everyone in the country today we would know how to isolate and the whole thing would be over very soon.

i don't understand. let's say that tests are super accurate, a negative test result does not mean you won't spread virus in the future. You may have virus the next day or an hour later. tests are important for treatments but i don't think they are effective as a basis for isolation.

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

#329

Post by 2rsf »

selimthegrim wrote: post #194
PeterStuer wrote: post #74

There's sooooo many lies being propagated by different governments on the true state of things. This afternoon I watched a live broadcast of parliament in which the minister of health claimed Belgium was doing far more extensive testing than any other country on earth. This at a time when standing instructions to medical personnel are to only test people that are already admitted to hospital because of severe pulmona…

The surgeon general just gave a press conference in Baton Rouge with the governor of Louisiana saying we should only test people (or prioritize testing of) people with symptoms. This when we know asymptomatic people can be contagious for days. The Port of New Orleans is testing embarking cruise ship passengers but not disembarking (!) ones. This when we have community spread in the parish already and have gone from 1…

> we know asymptomatic people can be contagious for days

Although it is technically correct, this is the least contagious way. AFAIK most sick people were near sick persons for a considerable amount of time.

[0] https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/kenkou_iryo...

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

#330

Post by superpermutat0r »

_-___________-_ wrote: post #257
T-A wrote: post #26

Earlier quoted context omitted.

3.65% / 1.75% ~ 2.09, so the difference in age profile might explain a factor 2 in the mortality ratio of Italy vs South Korea. The actual ratio is currently 7.9: 827 out of 12462 cases in Italy (6.6%), 66 out of 7869 cases in South Korea (0.84%).

Please don't conflate case fatality rate with actual fatality rate. South Korea has almost certainly just had more time and "medical bandwidth" to find more of the minor and asymptomatic infections that make up potentially 80%+ of the total, and turn them into cases by diagnosing them.

I thought that actual fatality rate is always higher than measured in case of exponentially growing pandemics. Just imagine the case where it takes 20 days for people to die. Your calculations of fatality rate this early in the disease would be conservative.
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