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Risky hack could double access to ventilators

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Re: Risky hack could double access to ventilators

#101

Post by anon946 »

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…

Something that occurred to me was a "hot closet" of some kind that was held at a temperature high enough to accelerate deactivation of the virus without damaging the masks. Perhaps around 130 F would be the right temperature.

Advantage would be that it would not require liquids of any kind and not be labor intensive.

Re: Risky hack could double access to ventilators

#102

Post by Herodotus38 »

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…

We are reusing all N95 masks where I work because there aren’t enough. Each employee gets one. To try and protect the N95 and make it reusable without risk (they are not designed to be reusable) we are wearing a standard surgical mask over it, and this standard mask gets thrown away with each use. Nobody here is going to be able to independently make N95 masks but the simple masks can be made of well filtering thick materials. Plastic goggle/face shields can also be made from clear plastic.

Re: Risky hack could double access to ventilators

#103

Post by tathougies »

lordnacho wrote: post #26
tathougies wrote: post #14

Earlier quoted context omitted.

> Cross contamination is not a concern when someone is dying here and now and likely has the same disease as the guy next to him who is also dying If COVID evolves into multiple strains, then there is a real risk of cross-infection that would make the immune system forced to work harder? Moreover, a lot of the pneumonia deaths are not due to covid itself but rather due to opportunistic infections (often bacterial) th…

But it doesn't have to be covid patients. There will still be people who need a ventilator but aren't part of the epidemic, freeing up ventilators for covid patients.

As an example, my aunt just recently had a heart attack about two weeks before this covid stuff and had to be put on a ventilator. While in the ICU she developed an infection from a rare fungal disease that had been in her lungs for a while but suddenly had the opportunity to grow and cause respiratory distress. A lot of people have strange microbes in them that are being held at bay by the immune system. When all of a sudden you expose an already immuno-distressed person to someone else's novel microbes, you risk opportunistic infections, even in non-covid patients.

I'm sure they can figure out how to re-use ventilators, but there probably needs to be some kind of assurance so that things can't cross.

Re: Risky hack could double access to ventilators

#104

Post by acqq »

btilly wrote: post #71
Findeton wrote: post #32

Earlier quoted context omitted.

When that happens, it's too late. Between the incubation period and the time to death it's about three weeks. At a 20% increase per day that means that even if you stop going out at that moment deaths will be multiplied by 46. If the rate is 30%, the multiplier is 247.

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 across the world show only: the typical doubling time once it really starts going is 3 days, never 5, at least without the beneficial contribution of lockdowns:

Italy dead:

   2020-03-16 1809
   2020-03-19 3405
It's 3 days doubling time there, and they started to quarantine municipalities since February 22, and locked down the whole country on March 10.

https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_I...

Netherlands dead:

   2020-03-16  24
   2020-03-19  76
Doubling time faster than 3 days there. Not much of measures.

https://en.wikipedia.org/wiki/2020_coronavirus_pandemic_in_t...

So "the risky hack" this article is about buys one not more than 3 days under the circumstances.

Speed of deaths is a good indicator because the number of those who die and those who need an intensive care unit are very close.

A lot of countries aren't able to test as much as it would be needed, so the number of "verified cases" which have less serious symptoms tends to be lower than the actual numbers. But those who die and could have been exposed to the virus and have matching symptoms are more consistently tested.

Main point: the US data can't be considered in vacuum, we know much more than US was able to test due to their botched procedures. But across the world, it's nowhere 5 days, as soon as the number of dead is more than a single digit.

Re: Risky hack could double access to ventilators

#105

Post by sp332 »

btilly wrote: post #71
Findeton wrote: post #32

Earlier quoted context omitted.

When that happens, it's too late. Between the incubation period and the time to death it's about three weeks. At a 20% increase per day that means that even if you stop going out at that moment deaths will be multiplied by 46. If the rate is 30%, the multiplier is 247.

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/

Re: Risky hack could double access to ventilators

#107

Post by neonate »

atdrummond wrote: post #67

There are some odd quotes and grammatical mistakes in this article. For example: “You wouldn’t want to put a patient with severe bronchospasm [sudden contractions of bronchial muscles in the lungs] with a patient that does not have bronchospasm because that would.” Likewise, one of the cited authors’ names, Babcock, is misspelled in the piece as Babcok. I’m not qualified to assess whether this risk is worth it but I…

Is it because they do sick ass shit or because they're rad as hell?

https://www.youtube.com/watch?v=FWVNDfDSE44

https://www.youtube.com/watch?v=EWbgKCENqn0

Re: Risky hack could double access to ventilators

#108

Post by bcrosby95 »

hnarn wrote: post #58
kaetemi wrote: post #46

Earlier quoted context omitted.

Half a dozen somehow sounds more impressive than six...

Tangentially (this is HN after all) I also feel like "half a dozen" gives a more fuzzy confidence interval than a regular number ("6"). Of course, half a dozen literally means the amount 6, but am I the only one that reads them slightly differently? I almost see an implicit "about" before the phrase: "[about] half a dozen".

It's a technique you can use in software estimation too.

There's an implied difference between saying something will take about 2 months vs 8 weeks vs 57 days, even if they're all technically the same amount of time.

Re: Risky hack could double access to ventilators

#110

Post by bitexploder »

theturingnerd wrote: post #19
bitexploder wrote: post #3

This is really neat. It seems a lot of the risk is how specific lung capacities and conditions interact with the ventilator and how much oxygen someone needs. My question to any MDs reading this: how often do you have to tweak ventilator volume for patients using one? What is the feedback loop? Blood oxygen levels?

(physician here) Vents can be quite tricky to get right; primarily because as disease progression continues on many things change. We are always trying to balance the deleterious effects of the intervention (in this case, the vent) with the goals of care. What most people don't know is that vents cause a lot of injuries on their own. (See ARDS). Hypoxemic respiratory failure is serious stuff, and it's almost always n…

Thanks for this explanation.
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