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What doctors on the front lines wish they’d known a month ago

nytimes.com

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Re: What doctors on the front lines wish they’d known a month ago

#51

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Re: What doctors on the front lines wish they’d known a month ago

#53

Earlier quoted context omitted.

Unfortunately, the answer seems "no" so far. Based on for example [1], the infection fatality ratio appears to be 10 times worse than the seasonal flu for people aged 30-39. Also, hospitalisation rate is higher (e.g. in age group 30-39, the study estimates that 3.4% of the infected people were hospitalised), which is higher (even for younger people) than the hospitalisation rate of the flu. [1] https://www.thelancet.…

Without disputing that (and thx for link), it's worth noting that the "flu" has been killing a large number of people year in and year out for as long as we can remember. The long-term death rate of COVID-19 remains to be seen. The final verdict on how bad it was will depend on whether or not lengthy immunity is attained (including to mutations).

> it's worth noting that the "flu" has been killing a large number of people year in and year out for as long as we can remember.

> The long-term death rate of COVID-19 remains to be seen.

At the moment we count flu deaths differently to covid-19 deaths.

Counting deaths due to flu is hard. We've only just started this work for Covid-19 by putting in standards for death certification. These stats lag the real time counts by some time, and they're always higher than the real time counts.

So, we're taking a method for counting flu than over-counts, and a method for covid-19 that undercounts, and then saying "covid-19 isn't that bad".

And that's just looking at deaths. We also need to look at hospitalisation (because we want to look at all the harm caused by different illness to assess whether our measures are reasonable or not; and because iatrogenic harm is a thing) and we see that covid-19 does put a lot more people in hospital than flu normally does. And this difference is only partly explained by rates of immunisation against flu.

Re: What doctors on the front lines wish they’d known a month ago

#54
post #35

Earlier quoted context omitted.

Yeah, but I don't understand what is significance of that claim. We have flu vaccine and general push to make people vaccinate every year. Up to mandating it for hospital workers at some places. Some employers are organizing them for free for employees. We do close schools here and there for a week or so when flu is getting large to get it under control. We do close hospitals for visits at this times.

One implication is that COVID-19 might not be "just the flu". It might actually end up being far less damaging than the flu, as viewed over decades. And we don't trash our economy and the lives of the working class that depend on it due to flu deaths, even though they are still quite dramatic. Personally, I'm conservative on this, and have barely left my place in the last eight weeks. I can work from home and will su…

By "viewed over decades" we count in period when vaccine is supposed to exist, when we have cheaper tests and know to put on masks when something happens and when majority of population has antibodies. Even the most pessimistic estimates expect the issue to be dealt with in decades.

Also, the thing to consider is that working class is whonis most at risk from this. Rich people have less comorbidities, can afford healthcare and are much more easily to work from home and buy via deliveries.

This is basically reason why African Americans die the most - working class can't isolate themselves so easily. They are the group to die more then same age non working class.

Re: What doctors on the front lines wish they’d known a month ago

#56
post #28

Earlier quoted context omitted.

Obviously, not everyone in ICU is on ventilator. This is true in both countries. If there was dishonest statistical comparison, this is the one.

It is a question though. I have no idea.

That is not question. That is easy to figure out public information.

Re: What doctors on the front lines wish they’d known a month ago

#57
post #56

Earlier quoted context omitted.

It is a question though. I have no idea.

That is not question. That is easy to figure out public information.

I’ve spent an honest 20 minutes looking for corona ICU survival statistics. It might be public, but not easy to google.

In the UK it seems to be 50%.

Re: What doctors on the front lines wish they’d known a month ago

#58
post #56

Earlier quoted context omitted.

That is not question. That is easy to figure out public information.

I’ve spent an honest 20 minutes looking for corona ICU survival statistics. It might be public, but not easy to google. In the UK it seems to be 50%.

The easy to find part is that not everyone in ICU is not attached to ventilator. Most people are not attached there.

Re: What doctors on the front lines wish they’d known a month ago

#59
post #35

Earlier quoted context omitted.

Yeah, but I don't understand what is significance of that claim. We have flu vaccine and general push to make people vaccinate every year. Up to mandating it for hospital workers at some places. Some employers are organizing them for free for employees. We do close schools here and there for a week or so when flu is getting large to get it under control. We do close hospitals for visits at this times.

One implication is that COVID-19 might not be "just the flu". It might actually end up being far less damaging than the flu, as viewed over decades. And we don't trash our economy and the lives of the working class that depend on it due to flu deaths, even though they are still quite dramatic. Personally, I'm conservative on this, and have barely left my place in the last eight weeks. I can work from home and will su…

Honestly, I see the worry that we are overreacting. But you are way more likely to end up in the hospital with covid with rates of around 10-15%. Super broad strokes, if you get the flu every year and are at least 20 years old, what is the probability you would have be hospitalized if covid=flu?

I think we are considering things carefully. I can’t remember the last time you saw both dem and rep governors agree on anything, yet they are all agreeing on stay at home orders and testing.

Re: What doctors on the front lines wish they’d known a month ago

#60
post #55

Since January leaks from Chinese health care warned about all of this. Was there internet ban in US I was unaware of? Or a widespread belief in exceptionalism?

It's not even leaks, it's included in the Official Coronavirus Treatment Plan:

"(4) Salvage therapy: for patients with severe ARDS, a recruitment maneuver is recommended.

When human resources allow, prone ventilation should be carried out for 12 hours or more every day. "

https://www.chinalawtranslate.com/coronavirus-treatment-plan...

There's simply a shocking degree of arrogance from the West to refuse to learn even the most basic things from Asia about this.

For example, people are finally grudgingly admitting that CT scans could play a useful role in diagnostics after months of CDC & ACR denialism: https://www.statnews.com/2020/04/16/ct-scans-alternative-to-...

edit: More details in Jack Ma Foundation produced Handbook of COVID-19 Prevention and Treatment

(3) Prone Position Ventilation Most critically ill patients with COVID-19 respond well to prone ventilation, with a rapid improvement of oxygenation and lung mechanics. Prone ventilation is recommended as a routine strategy for patients with PaO/FiO2 Prone ventilation while awake may be attempted for patients who have not been intubated or have no obvious respiratory distress but with impaired oxygenation or have consolidation in gravity-dependent lung zones on lung images. Procedures for at least 4 hours each time is recommended. Prone position can be considered several times per day depending on the effects and tolerance.

https://www.alibabacloud.com/universal-service/pdf_reader?cd...

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