T Nation

COVID19: Perspective From A (Sort Of...) Expert-Adjacent Person

I wonder how our shipyard is going to affect the rest of us in Maine. All Bath Iron Works are doing is offering unpaid time off or use vacation, so of course thousands of workers are going to work stacked on top of each other in confined spaces.

The rest of the state is on board. Except our largest job site. First confirmed cases at the yard were last night. I wonder if it’s too late…

2 Likes

In my experience with ICUs they’re a bridge between life and death. I’ve only been in a couple though. :joy:

Anyways, it doesn’t surprise me. When someone is at that point they’re either going to perk up and move to a different level of care pretty quickly or onward and upward.

1 Like

Eye Dentist and Activities Guy posting on t-nation PWI again. Coronavirus not everything surrounding you is bad. Good to have your guys presence here and as always excited to learn from you both.

3 Likes

Absolutely!

1 Like

Sorry about getting a laugh at your expense in the other thread, I either forgot or didn’t know your credentials at the time.

1 Like

99% of Those Who Died From Virus Had Other Illness, Italy Says

https://www.bloomberg.com/news/articles/2020-03-18/99-of-those-who-died-from-virus-had-other-illness-italy-says

My opinion is that the way this is being handled will result in too much negative effects on the economy, there must be a better way to do things. I’m not an expert so don’t expect a full proposal from me, but something along the lines of isolating those over 60 or 70 as well as those with health issues that put them at risk, and of course people with symptoms need to stay home. I know the OP isn’t here to discuss economics, but the way we are going the economy is going to be fucked for the forseeable future and that will lead to a whole new set of problems which can include death.

And what’s your proposal for hospitals that can’t handle all of those in need of intensive care, 40% of whom will not be the elderly?

So real quick, a word on this, because it’s technically true but also less comforting than you might think for you young strappers who are convinced you’re fine because you don’t (know or think) you have any pre-existing conditions. The definition of “other illness” used in this figure is incredibly broad (hypertension counts as an “other illness” here; so does diabetes; by this definition I’m gonna guess that at least 50% of adults have something that would put them in this group, and it may be higher than that). We’re not just talking pre-existing conditions like cystic fibrosis or multiple sclerosis here, guys.

5 Likes

In the USA, 100million have diabetes or pre diabetes. 80 million have high blood pressure.

So your completely isolating 1/3 of the population, conservatively. Is that much better than the current situation?

1 Like

I don’t know about data on this without looking for it, but yes, this has some face validity. I have a friend that’s an intensive care doc in New Zealand and he’s still optimistic that if they lock it all down now they may escape this relatively unscathed.

You’re not an island, but the advantages you cite are kind of the same. Small town, few visitors, low enough population density that you don’t have a ton of big crowds gathering, so I do think it’s possible on first glance. The downside is that I’m guessing you have very few ICU beds locally, so if it does hit the area, you’ll probably reach capacity very quickly?

I already said that they should be isolated. It’s no different from what is already being done, except that those at risk would be isolated rather than everyone.

Well, which exact conditions increase risk is what needs to be determined.

Maybe the situation for the US is worse than I realized due to widespread obesity and the condition of the medical system. I was not aware of those statistics, but again it’s not like that in the rest of the world.

Idk man. Blood pressure, diabetes, >60yrs, cancer, smoker, etc… All are high risk that would have to totally isolate as the outside world becomes a CV party they could not enter at all. I bet in every country 30-50% of the population qualifies as high risk.

That’s not really answering the question he asked. He didn’t ask what you should do with people at risk, he asked what you propose that hospitals do once they start getting overrun with patients in need of ventilators and ICU care.

Yeah, and they’re working on it, but I’m just telling you the initial reading of “99 percent of people who died from this had a pre-existing condition” does not really mean much, since a whole fuckin’ lot of the population has a “pre-existing condition” by these standards. I think most people hear “pre-existing condition” and think they’re talking something serious, like cystic fibrosis or pulmonary hypertension, that only a small slice of the population has. But nearly everyone has an “other illness” cited in this headline, so it’s not like this really shaves off that much of the population.

Off the top of your head, quick, what’s the prevalence of hypertension and diabetes in Canada? It’s lower than the US, but not by much, dude. (Canada estimates around 25% HTN and 7-8% diabetes; US is about 30% and 10% depending on whose numbers you look at)

2 Likes

You don’t get it. Even if you don’t have the underlying conditions that make you a greater risk to die, you can still get infected and need hospitalization. That includes you and me. When hospitals are filled to capacity, then what?

Correct if I’m wrong as I’ve told this to Chris before. The fear is not just “how many people will die of coronavirus if we don’t take this action.” It’s also how many people will die of other conditions when we don’t have enough resources to meet all the other medical needs.

Coronavirus itself doesn’t need to kill tons of people itself to be a massive issue. Creating a situation where we have no resources puts all the people with other potentially deadly issues at a much higher risk. Let alone all the preventive measures to prevent future illness that would need to be put on the back burner.

He’s not wrong to worry about the economy. I’m worried to death about it. But what’s that economy look like if this whole thing goes to hell? Then we are fucked beyond measure.

1 Like

Not AG obviously, and not scientific–but I can reasonably deduce by symptoms now that I was experiencing CHF for At Least 5 years before I had a major event and diagnosis. So it could potentially effect hundreds of thousands of people who don’t yet know that they are vulnerable.

But the mechanisms by which the virus cause serious problems is discussed in the vid I linked above at around the 50-60 min. mark, main ones being the ace1 and ace2 receptors of the heart and lungs.

So anything affecting those.

3 Likes

Yes, that is broadly correct. If ICU’s are full/overflowing with COVID19 patients, the overall system is affected. That means everyone that needs an ICU bed has to wait longer (or get set up in the hallway). Plus, hospitals will start needing to take lots of extra precautions with all presumptive cases, slowing down literally everything in the hospital - e.g. cardiologists who are treating heart-attack patients need to start assuming that everyone has COVID19, more PPE required, more precautions required, etc. If you guys are reading the news, you should know that hospitals seeing COVID19 patients are already running short on masks and N95’s. The admin geniuses at the hospital are used to buying just enough stuff to keep things running, we don’t have all that much surge capacity.

2 Likes

That is the uncertain part, who really is at a higher risk. I don’t think that Bloomberg is in the fake news business, and also statistics show that the death rate is 0.2% for those under 40 years old.

It’s already an issue anywhere that there are enough cases. They need to build more ventilators, which is already being done, and again it seems like those at lower risk of death are also at lower risk of needing a ventilator, no?

Hey, I’m just repeating what the Italian government said, not China. But have a look at this, 0.2% death rate under 40:

I had no idea it was so high.

Then we are fucked, and hospitals were already at 120% capacity in most of Canada.

You guys seem to think that I oppose any measures to reduce the spread, and that is not the case. I’m just concerned about the effects of shutting down nearly everything, and I think there could be a less damaging way to handle this that would still be effective in reducing the infection rate.

I posted this in the other thread, might as well put it here since we are on the same topic. No, we aren’t South Korea, but maybe we could learn a thing or two from them.

And about the callousness of it’s only old people who are dying; there are also doctors, nurses, hospital staff, emts, firefighters and police who are going to get exposed to it and get sick. Some will probably die. Being overworked won’t exactly help in that regard. Having to work while sick definitely won’t help. These are not elderly people and many have kids.

The question is how can this situation be handled for the best outcome in terms of health and the economy. I’m not an expert on either, but based on what I have been reading lately I get the feeling that there might be another way to do this that will result in a better long term outcome.

Nobody wants people to die, and nobody wants hyperinflation and shortages of everything, so what can be done to minimize both? If I had a plan then I would be on the news, not on T-nation.