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Risky hack could double access to ventilators

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Re: Risky hack could double access to ventilators

#111

Post by earthtourist »

bootlooped wrote: post #98
Herodotus38 wrote: post #95

I encourage anyone wanting to help to try and finds ways of manufacturing the essentials of PPE that we need to limit spread, as that will have a much bigger impact. Every hospital and clinic in my area is running out of masks (both N95 and surgical), gowns, plastic goggles and starting to get into issues with disinfectants. Having double ventilator use is a nightmare scenario for various reasons. There are much bett…

It would be good if they found a way to decontaminate the masks so they could be reused a finite number of times, instead of treated as totally disposable. As far as what I've read, there are many things that can kill the virus: hydrogen peroxide, alcohol, uv sanitizing lights, heat, time... Seems like you could come up with a cheap and simple routine that would be 99+% effective, at least for coronavirus specificall…

That's been my question as well. Why doesn't spraying N95 masks with isopropyl alcohol work?

1. Spray mask with alcohol.

2. Place in the sun or under UV light.

3. Wait as many hours/days as possible before reuse.

Seems better than re-using a highly contaminated mask day after day. I'm not an expert so I could easily be wrong though.

Re: Risky hack could double access to ventilators

#112

Post by mellavora »

pbhjpbhj wrote: post #43

Have governments made orders (legal or purchase) for manufacture of ventilators by large scale companies? Presumably ventilators are a relatively niche product - what's in them that the World's industrial complexes can't ramp up production of within a couple of weeks? I imagine it's the pumps that's the limiting factor? Given humanity already has the working tested, established designs. Can't governments requisition…

I keep seeing people asking "Why can't we just quickly spin up technology X?" where this is here ventilators, otherwise vaccines, etc...

without much awareness of how much specialization goes into almost every aspect of every job. Hell, even fast-food workers-- a skilled grill operator at McDonalds -- take time to train up.

No, we cannot quickly undo the 20 years of systematic dismantling of our core infrastructure. We are in for a very rude wake-up call.

And then, once we are awake, and are dealing with our new realization on the complexity of our economy, where every part depends on every other part functioning, and trying to get this restarted with a significant number of the parts NOT working...

Then we realize that the economy is embedded in an even bigger system called "life on earth" which we have degraded and destroyed on a much larger scale than our economy.

If you think the weakness in our society which the virus uncovers are a big deal, you simply lack the full picture.

Re: Risky hack could double access to ventilators

#113

Post by thu2111 »

Zenbit_UX wrote: post #78
Continuous wrote: post #48

This is ridiculous! Hacks are ok with web and app deployments where you are able to patch and fix to your heart's content and the damage is not life threatening. I have worked with the medical industry, the amount of formal validation and verification that goes through on software is insane compared to what we have in the "move fast and break things" world. Even if it is "temporary" and "desperate" I would stay away…

Such a foolish statement, you clearly don't understand the number of lives lost due to ventilator shortages right now or you'd delete your comment in embarrassment. Doctors should be using absolutely any method available to them to maximize lives saved. You don't need to "have worked with the medical industry" to understand this perspective.

How many lives have been lost due to turning up at a hospital and not being able to find a ventilator so far? Do you have a precise stat?

As of about 48 hours ago Lombardy's hospitals were not turning anyone away:

https://www.cnbc.com/2020/03/19/italys-death-rate-reaches-re...

Medical facilities in Lombardy will “soon” be unable to help new coronavirus cases, regional Gov. Attilio Fontana said Wednesday, as he urged everyone to stay at home.

Re: Risky hack could double access to ventilators

#114

Post by btilly »

sp332 wrote: post #105
btilly wrote: post #71

Earlier quoted context omitted.

Not quite that bad. Current measured growth rates are closer to 15% per day (5 day doubling time). And people's behavior changes not when people die, but when people get sick. Which happens (depending on your sensitivity) only 1-2 weeks after exposure. But the basic principle still applies. We are trying to buy as much time as we can to ramp up emergency provisions. And are trying to avoid overwhelming emergency room…

The growth rate is different in different countries. The USA is currently on a 35% slope. http://nrg.cs.ucl.ac.uk/mjh/covid19/

That is growth rate as measured by confirmed cases. However given various restrictions on availability of testing, confirmed cases and real cases are likely to tell very different stories. Given that most countries refuse to test, refuse to test, hit an "oh shit moment" and start ramping up, the confirmed rate that your link uses measures testing more than actual infection rates.

References such as https://www.imperial.ac.uk/media/imperial-college/medicine/s... have used a doubling time of about 5 days. As https://www.statnews.com/2020/03/10/simple-math-alarming-ans... points out, studies of what happened in Wuhan suggest a real doubling time of about 6 days.

There are admittedly a lot of question marks about everyone's numbers.

Re: Risky hack could double access to ventilators

#115

Post by radicalbyte »

anonuser123456 wrote: post #109

People keep talking about ventilators. The only study I've seen w.r.t. ventilator success for COVID-19 treatment showed something like 3% survival for those mechanically ventilated. Do we have more data showing they even move the needle?

I've seen figures showing a 50% success rate. I assume that the success rate is very low with much older patients because intubation itself causes a lot of damage.

Re: Risky hack could double access to ventilators

#116

Post by rincebrain »

acqq wrote: post #104
btilly wrote: post #71

Earlier quoted context omitted.

Not quite that bad. Current measured growth rates are closer to 15% per day (5 day doubling time). And people's behavior changes not when people die, but when people get sick. Which happens (depending on your sensitivity) only 1-2 weeks after exposure. But the basic principle still applies. We are trying to buy as much time as we can to ramp up emergency provisions. And are trying to avoid overwhelming emergency room…

> Current measured growth rates are closer to 15% per day (5 day doubling time) Citation needed. In the US, via Wikipedia: https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_t... 2020-03-17 5656 infected 96 dead 2020-03-19 11980 infected 172 dead That's doubling time of 2 days, not 5. When was it 5 days the last time? If that 2 days continues, in two weeks: 1.5 million infected, 22000 dead. Also, the data acr…

At least some of that growth in the US is probably due to increased testing availability, not infection rate, so I'd suspect "actual" numbers of infected in the US on 3/17 were higher than the data showed. But that's dealing with lots of unknowns.

Re: Risky hack could double access to ventilators

#117

Post by Herodotus38 »

earthtourist wrote: post #111
bootlooped wrote: post #98

Earlier quoted context omitted.

It would be good if they found a way to decontaminate the masks so they could be reused a finite number of times, instead of treated as totally disposable. As far as what I've read, there are many things that can kill the virus: hydrogen peroxide, alcohol, uv sanitizing lights, heat, time... Seems like you could come up with a cheap and simple routine that would be 99+% effective, at least for coronavirus specificall…

That's been my question as well. Why doesn't spraying N95 masks with isopropyl alcohol work? 1. Spray mask with alcohol. 2. Place in the sun or under UV light. 3. Wait as many hours/days as possible before reuse. Seems better than re-using a highly contaminated mask day after day. I'm not an expert so I could easily be wrong though.

I think the issue (although I don't know for sure tbh) is that there is potential damage to the fibers which make it such a good filter. For example, our infection control policy is that we are supposed to throw away the N95 if it gets visibly soiled or liquid gets on it per our infection control. I would imagine damage from UV light could also cause issues.

The reality is that we all need to have our own individual PAPR systems but we simply don't have the supplies and probably won't for weeks or months so we need to do the best we can with what we have and try to minimize the amount of healthcare workers who get sick and spread it or get taken out of rotation and place a bigger burden on the system.

Re: Risky hack could double access to ventilators

#118

Post by notabee »

earthtourist wrote: post #111
bootlooped wrote: post #98

Earlier quoted context omitted.

It would be good if they found a way to decontaminate the masks so they could be reused a finite number of times, instead of treated as totally disposable. As far as what I've read, there are many things that can kill the virus: hydrogen peroxide, alcohol, uv sanitizing lights, heat, time... Seems like you could come up with a cheap and simple routine that would be 99+% effective, at least for coronavirus specificall…

That's been my question as well. Why doesn't spraying N95 masks with isopropyl alcohol work? 1. Spray mask with alcohol. 2. Place in the sun or under UV light. 3. Wait as many hours/days as possible before reuse. Seems better than re-using a highly contaminated mask day after day. I'm not an expert so I could easily be wrong though.

All of those break down the mask fibers or screw up the electrostatic qualities used to grab particles. There have been studies on it, but there's not really an ideal way that doesn't damage the filtering capacity over time.

Re: Risky hack could double access to ventilators

#119

Post by btilly »

acqq wrote: post #104
btilly wrote: post #71

Earlier quoted context omitted.

Not quite that bad. Current measured growth rates are closer to 15% per day (5 day doubling time). And people's behavior changes not when people die, but when people get sick. Which happens (depending on your sensitivity) only 1-2 weeks after exposure. But the basic principle still applies. We are trying to buy as much time as we can to ramp up emergency provisions. And are trying to avoid overwhelming emergency room…

> Current measured growth rates are closer to 15% per day (5 day doubling time) Citation needed. In the US, via Wikipedia: https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_t... 2020-03-17 5656 infected 96 dead 2020-03-19 11980 infected 172 dead That's doubling time of 2 days, not 5. When was it 5 days the last time? If that 2 days continues, in two weeks: 1.5 million infected, 22000 dead. Also, the data acr…

Epidemiological estimates and projections seem to be based on the 5 day estimate. See https://www.hpnonline.com/infection-prevention/screening-sur... for an example. I am honestly not sure of all the lines of evidence leading to that estimate, but I've seen it used a number of times.

Measuring what is going on by confirmed cases measures ramping out of testing more than the actual growth of the virus. Death figures are likely to be more accurate. But note that we expect it to take 3 weeks before quarantines show up in fatality figures. (A week for exposed to get sick, 2 more weeks before they die.) Therefore Italy shouldn't yet see the benefits of quarantines.

Re: Risky hack could double access to ventilators

#120

Post by acqq »

btilly wrote: post #119
acqq wrote: post #104

Earlier quoted context omitted.

> Current measured growth rates are closer to 15% per day (5 day doubling time) Citation needed. In the US, via Wikipedia: https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_t... 2020-03-17 5656 infected 96 dead 2020-03-19 11980 infected 172 dead That's doubling time of 2 days, not 5. When was it 5 days the last time? If that 2 days continues, in two weeks: 1.5 million infected, 22000 dead. Also, the data acr…

Epidemiological estimates and projections seem to be based on the 5 day estimate. See https://www.hpnonline.com/infection-prevention/screening-sur... for an example. I am honestly not sure of all the lines of evidence leading to that estimate, but I've seen it used a number of times. Measuring what is going on by confirmed cases measures ramping out of testing more than the actual growth of the virus. Death figures a…

What you cite is from: https://www.imperial.ac.uk/media/imperial-college/medicine/s...

topic of which isn't the evaluation of the recorded growth across the world, but to show that lax measures are problematic even using the slower growth rates.

They specifically write just:

"Infection was assumed to be seeded in each country at an exponentially growing rate (with a doubling time of 5 days) from early January 2020, with the rate of seeding being calibrated to give local epidemics which reproduced the observed cumulative number of deaths in GB or the US seen by 14th March 2020."

That's what they use in their model to demonstrate the point.

They never claim it's accurate or quote any sources for that number, because they just use that very "optimistic" value for the demonstration purposes: to show that even with that number, it's not reasonable not to implement serious measures. That's how mathematical proofs are constructed: you construct the lowest bound which doesn't have to be accurate, just to be obviously lower than the actual numbers, and show that even then some assumption doesn't hold.

I'm claiming here that that is not a "current measured rate."

> But note that we expect it to take 3 weeks before quarantines show up in fatality figures.

That's why I've stated about Italy: "they started to quarantine municipalities since February 22." It's not that they let it waiting for "herd immunity" like UK or NL. It was less than 4 weeks ago.

    2020-02-22     2 dead
    2020-03-19  3405 dead
with 3 days doubling time they would have today 2048 dead. It doesn't appear to be possible to be slower than 3 days. With 5 days doubling time they would have now just 128 dead, with 4 days doubling time 256 dead. It's that easy to calculate.

That's the Italian "current measured rate" for a month now.

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