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Map of usage of intensive care beds in Germany

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Re: Map of usage of intensive care beds in Germany

#61

Post by _ph_ »

DoreenMichele wrote: post #45
_ph_ wrote: post #42

Earlier quoted context omitted.

Not having any real medical knowledge, just as a logical speculation, there is always the possibilitly, that at the point, where people get put on the ventilators, the infection has come to a point where the survivability is extremely low.

That's generally true of ventilator usage. It thus fails to account for the abnormally high death rate of people with Coronavirus put on ventilators as compared to statistical norms for ventilator usage generally.

I think we can conclude only one thing from the number: by the time people are put on ventilators, their survival chance is very low. This certainly means: more ventilators won't save many people - but it may well be, that if 80% of the ventilated patients die, they saved 20% of the patients. That would assume, that the patients had died, if they had not been ventilated. Which of course depends, at which point in the development doctors put patients onto ventilation.

Re: Map of usage of intensive care beds in Germany

#62

Post by DanBC »

hutzlibu wrote: post #43
DoreenMichele wrote: post #16

Earlier quoted context omitted.

I have a really serious lung condition. I used to use mechanical intervention to treat my condition. I have found other methods and no longer do that, in part because such interventions are hard to keep adequately sterile and are known to increase risk of antibiotic resistant infections because of that element. It's really not good to think of this problem space in terms of finding some group without ventilators at a…

How is you experience with oxygen? I can imagine it helps without stress to the lungs, which lung ventilators might introduce?

Oxygen isn't necessarily harmless. https://evidence.nihr.ac.uk/alert/a-reminder-that-too-much-o...

Re: Map of usage of intensive care beds in Germany

#63

Post by Lewton »

usr1106 wrote: post #29
m0zg wrote: post #25

Would be cool to have this for NY as well. I have this nagging suspicion that the press is only showing the small number of hospitals that are overflowing, and not showing the ones that are under capacity, to stoke panic and drive clicks. Similar to the "mass graves" bullshit they wheeled out the other day. To see why it's bullshit, one has to do some basic arithmetic. Consider that if life expectancy in NY metro are…

Yes, you really need to follow death rates. According to some claims up to 70% of corona infections could not result in observable symptoms. However, if you take just dying people, it would not come as a surprise that they are so weak that the additional infection can produce visible symptoms and their death is attributed to COVID. In some places in Lombardy (Italy) the death rate is clearly higher. You didn't need t…

> According to some claims up to 70% of corona infections could not result in observable symptoms.

This is a ridiculous claim

Any place that has done random sampling is reporting a very low asymptomatic rate

Re: Map of usage of intensive care beds in Germany

#64

Post by hutzlibu »

DoreenMichele wrote: post #60
hutzlibu wrote: post #59

Earlier quoted context omitted.

I know that, I did not really ask for advice, more for your experience. And since you do not have experience with oxygen, I was merely suggesting it, as I heard how it helps people with breathing problems and I do not see the need to have the masks 100% sterile if it is your personal mask. But I am also not a doctor ..

My personal experience is that you do need to diligently sterilize things like masks that only you use. I spent years boiling medical equipment daily. I had a nebulizer for a time to administer inhaled treatments. It had to be carefully sterilized. Failure to adequately sterilize your personal medical equipment is sometimes a source of very nasty antibiotic resistant infections. Your own germs or not, once they leave…

Thank you, for sharing.

Re: Map of usage of intensive care beds in Germany

#65

Post by akiselev »

m0zg wrote: post #30
woodruffw wrote: post #27

Earlier quoted context omitted.

The New York Times put out an article just yesterday[1] that directly addresses most of your doubts. In summary: * Substantially more people have died in both NYC and NY state than is demographically expected, suggesting a significant effect from the virus. * Virus deaths are probably still under-counted, as bodies retrieved from homes aren't being tested. Patients with significant comorbidities may also be being mis…

Yes, Hart Island is being sold as "mass graves". Plus this right here clown (of "come to celebrate the Chinese new year, in spite of coronavirus" fame) said the other day there'd be _temporary burials_ in city parks: https://twitter.com/MarkLevineNYC?ref_src=twsrc%5Egoogle%7Ct... My point is, as bad as the situation on the ground is in NY, the single digit percentage uptick in the overall number of deaths would most…

> crowding in the hospitals seems like a load balancing problem to me

The problem is that once a patient is so far gone that they are on a ventilator in the ICU, even the regular movements of going over speed bumps and potholes become potentially life threatening.

That's in the best of times. Given that hospitals are running out of PPE, what are the chances that they can even move an infected patient without collateral damage that would further serve to overwhelm the hospitals they are moving the patient to?

Re: Map of usage of intensive care beds in Germany

#66

Post by DoreenMichele »

_ph_ wrote: post #61
DoreenMichele wrote: post #45

Earlier quoted context omitted.

That's generally true of ventilator usage. It thus fails to account for the abnormally high death rate of people with Coronavirus put on ventilators as compared to statistical norms for ventilator usage generally.

I think we can conclude only one thing from the number: by the time people are put on ventilators, their survival chance is very low. This certainly means: more ventilators won't save many people - but it may well be, that if 80% of the ventilated patients die, they saved 20% of the patients. That would assume, that the patients had died, if they had not been ventilated. Which of course depends, at which point in the…

I posted a link in my original comment to a source indicating that's not what doctors are concluding.

It's also not what I'm concluding.

While I'm not a doctor, my life literally depends upon me having a fairly substantial amount of knowledge about things like my lung function. In contrast, you opened with saying you don't have much medical knowledge, this just seems logical to you.

I will suggest you do more reading. Your logic doesn't really hold up in this case.

Re: Map of usage of intensive care beds in Germany

#67

Post by bayesian_horse »

DoreenMichele wrote: post #6
est31 wrote: post #3

Germany is pretty well equipped with ICU beds and they've increased the capacity even further in preparation for Corona. I'm not worried about Germany really. I'm more worried about other parts of Europe like eastern europe. A Czech friend told me they have barely any respirators in the country.

If it's any comfort, the death rate is so high with ventilators (80%+, which is bad even for ventilators) that some doctors are trying to avoid using them, if possible, because they are concerned the ventilators are actually killing people. https://news.ycombinator.com/item?id=22819580 I previously suggested that ventilators were problematic and I wasn't happy with the rush to create more of them instead of promoting…

As far as I know mechanical ventilation is the last resort.

It's all about the oxygen saturation. If that is too low, patients usually get oxygen first, and of course all the other issues need to be treated, if necessary. If SpO% is still too low, they try the ventilator.

My point is: There is a very good reason patients go on a ventilator. They don't get enough oxygen. When they are on the ventilator, they DO have enough oxygen. And you really need that oxygen to survive and recuperate... So not putting them on a ventilator is sort of contra-indicated.

Re: Map of usage of intensive care beds in Germany

#68

Post by bayesian_horse »

DoreenMichele wrote: post #34
MrBuddyCasino wrote: post #31

Earlier quoted context omitted.

The question is, why is the death rate of ventilated patients so high? I would guess that it simply doesn’t fix the underlying issue. A hypothesis (just a simulation model, totally unproven): https://news.ycombinator.com/item?id=22794837

A former registered nurse once told me that heart problems typically start as lung problems. Heart stress isn't at all unusual with lung distress. The two systems very much work together. I have serious lung problems and I used to have arhythmia. I don't have arhythmia anymore. I'm generally healthier than I used to be. I don't know why the death rate on ventilators is so high. I'm not inclined to do a lot of specula…

That line about lung problems being the primary cause for heart problems got to be wrong, without context...

Re: Map of usage of intensive care beds in Germany

#69

Post by Lewton »

chvid wrote: post #33

Germany (like a few other countries) is in the situation "too much lockdown, too few sick". So it has to remove those lockdowns. This creates a fun political dynamic where the authorities who just spend a month scaring the population in doors now has to explain and justify why it is ok to go out and get a little sick.

Germany is NOT at a place where the lockdown is too strong. The spread is still growing exponentially and they will run into issues a few weeks from now if it continues at this rate.

You can’t keep everything open and then shut everything down once you’re at capacity, as it takes three weeks for lockdown measures to show up in the hospitalization rates.

Re: Map of usage of intensive care beds in Germany

#70

Post by bayesian_horse »

DanBC wrote: post #62
hutzlibu wrote: post #43

Earlier quoted context omitted.

How is you experience with oxygen? I can imagine it helps without stress to the lungs, which lung ventilators might introduce?

Oxygen isn't necessarily harmless. https://evidence.nihr.ac.uk/alert/a-reminder-that-too-much-o...

Yes. But the problem is too much Oxygen in the blood. Which there is not, otherwise you wouldn't be thinking about extra oxygen supply...
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