Map of usage of intensive care beds in Germany
interaktiv.morgenpost.de
interaktiv.morgenpost.de
The number of hospitals that report that their ICU capacities as:
Blue: Has Free Capacities (639 currently)
Yellow: Some Contention (326 currently)
Red: Fully Utilized (41 currently)
Covid 19 patients in ICUs: 2453 (76% of which are on ventilators)
ICU beds reported by hospitals: 19,663 (58% in use currently)
The translation I saw described yellow as something like "emerging bottlenecks." There seem to be a lot of them in Bavaria, where I have relatives.
For example, I found a "clinic" for neurodiagnostic that has zero patients and is "fully utilized".
This agreement comes on the heels of the rejection of what 9 Eurozone countries including France had asked initially: A Eurobond, or coronabond as it made some headlines. That would have allowed the EU as an entity to borrow money instead of individual counties, but the governments of Germany and Netherlands seems that were against it.
See it this way: everyone knows Italian debt at 140% of GDP is unsustainable. Successive governments have promised again and again to do something about it, but then each finds a reason not to follow this promise. The Italian state is leaking money in all corners with many politically friendly businesses making huge gains at the cost of taxpayers. The default is mostly inevitable if there is not finally a serious attempt to address this issue.
Successive Italian governments have asked for mutualised debt - while increasing the national deficit and debt further each year. It would be crazy for any other government to give Italy a blank check and say "okay take whatever loans you need, wecll guarantee it". It means you are consciously taking up the risk of default for yourself while having no way to stop overspending or fix the underlying systemic issues. This means Italian governments have even less incentive to change the horribly corrupt and broken system.
That other countries say no is not a decision against the Italian citizens. It would be irresponsible towards their own citizens to take this up without some kind of real guarantee that Italy will finally fix the systemic issues, because the past 20 years of promises have been broken.
But the problem is that unless this happens on European level, providing loans to economies that for whatever reason have not yet recovered from the crisis of 2010 is only going to make things worse for them. Putting more austerity on these countries provides the perfect ground for movements in favor of Italexit and Grexit. If that happens won't it affect the Eurozone as a whole and, by extensions, the economies of the surplas countries?
In other words, can we afford not to deal with it at a European level?
In my understanding there is only a blunt no to the coronabond, not a request fro more condition.
It was unfortunate that it started with Italy, and been the first with an outbreak like that in Europe push them to take brave decisions.
To me it feels more like that these countries don't want to help because they feel it's Italy's fault and they need to pay.
But what about all the money that was given for free to Germany to rebuild after the second war war, despite a long history of aggression?
It's not a surprise that people wants to break the EU, it's sad to see this project heading this way.
I think this started without "order" from the central government, more as a result of direct action of hospitals in regions close the borders. It doesn't make sense to not help out when a hospital on one side of the border has free capacity, while another hospital a few kilometers away across the border currently has more patients than it can handle.
Visualization: https://coronavis.dbvis.de/en/
Press release (English): https://www.campus.uni-konstanz.de/en/science/university-of-...
So it's pretty mixed actually. Only gives me more countries to be worried about :(
For IC beds, do you give patients the choice between going home to die a week later and a bed in IC that will make them live a bit longer, but with a less comfort and less contact with their loved ones, or do you always go for “all life is sacred”?
Some countries discus this with patients, even if the IC option has a chance of survival. That may sound unethical, but survival, for many patients, will be with much lower quality of life. They may have to move to a care home, stay on medication with severe side effects, may have to train hard for months to even be able to walk again.
Patients that already have a low life expectancy may choose to stay out of IC.
Turkey has me the most worried at the moment. Turkey is maxing out its testing capacity every day, with cases rising by 4k like clockwork; 47k cases with very few recovered and it's accelerating. Their infrastructure can't handle the existing cases much less another 50k+ in the coming 7-10 days.
And then Russia. I wish there was a clearer picture of what was going on there. For example:
"Suifenhe in China’s far northeastern Heilongjiang province has seen an influx of Chinese people returning home, many infected with the virus, travelling by road from the Russian far eastern city of Vladivostok after flying there from Moscow."
https://www.reuters.com/article/us-health-coronavirus-china-...
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 less invasive treatments. I'm glad some doctors are looking for alternatives, but we really need to be a lot more aggressive about that angle.
To compare the effect of ventilators vs none, one needs good studies with randomized groups where one gets ventilators and the other doesn't. But I guess those aren't available and doing them is probably not possible due to moral issues.
I wonder if there are statistics that are the next best thing, death rate of people who doctors would have wanted to connect to ventilators but there were none available. You shouldn't compare it to the death rate of people with ventilators in places where there is ventilator shortage because then obviously there is some element of choice in who gets the ventilator and who doesn't, e.g. they choose the patients with the worst symptoms, or the patients with the largest chances of survival. Most places probably have/had shortages, so the data we have are all pretty bad to judge whether ventilators help, and if yes how much.
It's really not good to think of this problem space in terms of finding some group without ventilators at all. I get your point about the data, but the problem is that lungs are a critical system. If you have lung issues, you are a priority admit at an ER because that whole not breathing thing can kill within minutes. Inability to breathe is one of the quicker ways to die.
What I was previously suggesting was non invasive airway clearance methods and management techniques like being mindful of better positions to sleep in (which is apparently at least part of what some doctors are now doing according to the article I linked above). I got hounded and attacked as "practicing medicine without a license" for talking about my first-hand experience with managing my very deadly condition using such techniques.
You really can't just not treat patients experiencing lung distress and hope they live. That's a good way to kill people.
But I have looked at a little info on ARDS (the process that actually kills people with Coronavirus) and how ventilators work and I'm quite horrified that the world rushed to create more ventilators rather than rushing to say "We must do everything possible to intervene effectively without ventilators. Ventilators must be an absolute last ditch effort after every other possible intervention has been exhausted."
They aren't doing that. They are too quick to put people on ventilators and the fact that doctors are now coming up with non invasive alternatives tells you they haven't been sufficiently aggressive in exhausting all other treatment modalities first.
I have substantial first-hand experience with staying alive in the face of having routine lung distress that could kill me. I knew from the outset that they were putting people on ventilators too quickly, that ventilators are quite dangerous in their own right and that there are, in fact, other options available.
I'm quite frustrated by the whole thing. This absolutely never needed to be this ugly. I'm certainly not the only person on the planet who knew ahead of time that ventilators are problematic and that there are myriad other options available that can be tried first, especially before it gets that severe in hopes of not letting it get to that point.
I cited my source, above. What you're saying is news to me.
Without a source, I can only reply based on general life experience that most doctors are lazy and quick to prescribe drugs and surgery (or similar intervention -- in this case, ventilators) in place of trying to insist on educating patients and taking more low tech, often labor-intensive approaches instead.
I have seen all the handouts saying if you have allergies and respiratory problems, your first line of defense should be things like having wood floors at home instead of carpeting. Not once has a doctor ever sat me down and had a meaty discussion with me about my decor choices or similar. It's always been, at best, "Which drug is your favorite?"
I have really serious lung problems and spent years homeless. While homeless, I used to just stand outside my tent and cough up massive amounts of fluid and gunk so I could breathe when I laid down to sleep.
Based on my experiences with my incurable lung disorder, I'm fairly confident we could be doing more with non-invasive techniques even at fairly advanced stages.
But, yes, first-hand personal experience and anecdata are roughly synonymous, though the first one lacks the generally dismissive implications of the second.
You are responding to a thread that has this in it:
>> If it's any comfort, the death rate is so high with ventilators (80%+, which is bad even for ventilators)
How can both statements be true at the same time? Or is the 80%+ incorrect?
A hypothesis (just a simulation model, totally unproven): https://news.ycombinator.com/item?id=22794837
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 speculating in that regard, but I know they can promote antibiotic resistant infections and one article suggested the high death rate in Italy may have been fueled at least in part by antibiotic resistant secondary infections.
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.
Some doctors are currently making a concerted effort to intentionally delay or avoid use of ventilators because they are concerned about the alarmingly high death rate associated with them. On the face of it, this implicitly admits that doctors haven't heretofore been exhausting all other treatment modalities before ordering use of a ventilator.
I don't know how to answer your last question. I've talked extensively about my firsthand experience with using alternative treatment modalities with my life threatening lung issues, but I'm not a doctor and I don't really have the background to assert anything more than I've already covered, which, as usual, is being dismissed by some commenters as anecdata.
Since I've already qualified it up front as "my firsthand personal experience," it seems entirely pointless to belabor any points about my opinions.
If the opinions of some random internet stranger (aka me) don't satisfy you and the opinions of medical professionals in the source I posted don't either, I think you probably need to do some digging to come up with the sorts of info that interest you.
You can readily Google the idea and come up with multiple articles indicating that lung problems can cause heart problems and heart problems can cause lung problems. As I stated above, the heart and lungs work closely together, so it's not uncommon to have problems with both at the same time.
(Please kindly don't try to tell me that's not what I said. It's 3am here and these are comments on a forum, not a PhD thesis. I'm telling you it means the same thing to me. I've given my clarification as best I can and I didn't say "primarily," I said typically, which really doesn't sound the same to me. Given how the heart and lungs work, I think my friend was likely correct that the direction of cause and effect typically starts with the lungs and goes to the heart from there, but not always, of course.)
I'm "only" a Veterinarian, so I'm not quite current in the distribution of how this works in Humans, but from my understanding it's normally the heart that affects the lungs, not the other way around.
That statement might be true inside a specific context, like infections, maybe.
So they don't parse the same for me, though I can see them parsing the same for someone else.
The lungs serve as a filter for everything you breath in. Modern air is generally pretty polluted. I imagine that everyone's lungs get de facto pretty gunked up these days, like the filter on a home AC that never gets changed and then we wonder when other pieces of the system start showing strain.
I imagine it frequently goes unrecognized as starting in the lungs, but I think it probably does. Please note that "starting" there also doesn't preclude other contributing causes, which is another reason I object to the word primarily. Saying "First X happens and then there tends to be a cascade effect from there" absolutely isn't the same as saying "X happens and X is the entire cause of the problem with zero other factors contributing to it."
Edit: I will add that I believe it starts with the lungs in part because reading up on altitude sickness did wonders for my understanding of my condition which has substantial gut involvement. When there is a defect in air quality, it rapidly starts impacting other systems, like the gut, liver and kidneys, and there are huge knock on effects that can be outright deadly.
Before reading up on altitude sickness, I had this hand wavy idea that the gut and lung issues are related, but afterwards I had a clear and definable connection and that connection is how the body processes blood gasses. So, obviously, the connection is the circulatory system, which is powered by the heart.
A downside of oxygen is that it's very flammable. Also, to whatever degree it involves a cannula, masks, etc, it has some of the same issues in terms of sterility challenges.
I've generally relied on things like airway clearance and dietary intervention in recent years.
Nit: oxygen is not flammable. Other things are flammable in its presence. A lump of coal, for example, burns white hot when oxygen is blown on it from a welding torch.
Still, it's a fire hazard.
The fire hazard is a real threat, yes, but I imagine, if I ever would have serious trouble breathing, the first thing I would get is a bottle of oxygen to ease it.
I've left comments previously about airway clearance techniques and home remedies I've used. They probably aren't hard to find if you care to read them.
I have an incurable condition and impaired immune system. I personally don't like dealing with anything like masks. I've done it in the past. I know how hard it is to keep them adequately sterile.
I am not a doctor. I am not here to give medical advice in comments.
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 your body and grow on a surface and come back in contact with you, you had better take it seriously as a threat to your health.
To reiterate: Some doctors are concerned the ventilators are actually killing people. They are concerned because the death rate is shockingly high for ventilator usage, much higher than is typical with ventilators.
The evidence is mounting that use of ventilators should probably be an absolute last ditch treatment option for people with Coronavirus and that other treatment modalities should be used first. Some of these are as simple as recommending different sleep positions to ease lung distress, something I talked about previously.
It's not news at all that some positions are harder on the lungs than others. It's been medical practice for decades to put people on inclined surfaces when they have pneumonia to reduce the amount of lung surface being submerged in fluid. It has a known track record for improving survival and it's non invasive and doesn't require fancy equipment or training, etc etc.
Though it lacks the geegaw "ooh, shiny!" appeal of people cooking up open source ventilator projects, so no one is all excited to talk about such simple and readily available interventions that any idiot can do, even from home, even without a formal diagnosis or doctor's prescription.
Edit: My source doesn't baldly state, as I did, that doctors are concerned that ventilators are killing people. It more delicately states that ventilators may be harming certain patients and then cites the crazy high death rate as evidence of this possibility.
I stand by my more bald framing of the issue. I'm aware it's not PC, but there comes a point past which efforts to be PC do a disservice to the truth.
No inference can be drawn from data points such as death rates with and without ventilators, since ventilators are not randomly assigned. This is just basic statistical inference and the reason why you don't have ANY official sources or guidelines following your directive.
It would still be likely that the people dying with ventilators would die without them, and there is indication that people that survive with ventilation would not have survived otherwise.
Consider, for example, the correlation of death rate for countries without enough ventilators and those (such as Germany) with enough ventilators available. The difference is very large.
Consider also that Chinese doctors recommend the exact opposite to what you say. A lot of people die from heart or organ failure because of the stress oxygen distress induces.
There are a lot of cases where recovery would be possible if it weren't for organ failure. In these cases, ventilation seems to help.
In that sense, there is clear evidence that ventilators are useful and, at least on a population level, outweigh the risks.
We can not (ethically) run experiments in these situations, so it would be wise to refrain from making questionable analyses based on anecdotal data.
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.
https://www.evms.edu/covid-19/medical_information_resources/...
Edit: found the Article: https://www.spiegel.de/wirtschaft/corona-krise-lieferengpass...
Or do they really run with a tiny fraction of beds occupied, in the years between wars and pandemics? It seems a bit wasteful to have that low usage, instead of having the capability stored for a rainy day.
For example, there's a red circle next to Bremen, Alle-Weser-Klinik Verden, they have 131 beds [1]. Verden has about 27k inhabitants. There's a large blue circle in Baden-Wuerttenberg, Klinikum am Gesundbrunnen, they have 970 beds [2]. It's in Heilbronn which has 120k inhabitants.
So in a way, this is a population density map https://xkcd.com/1138/
[1] https://de.wikipedia.org/wiki/Aller-Weser-Klinik
[2] https://www.slk-kliniken.de/ueber-uns/daten-fakten/die-slk-k...
11/04: 2088, 76% on ventilators 10/04(?): 2453, 76% -"-
04/04: 2680, 83% -"- 03/04: 2421, 83% -"- 02/04: 2139, 83% -"- 01/04: 1876, 82% -"-
Can't find data for in between 04/04 and 10/04, since DIVI stopped publishing daily reports apparently, but must have peaked in between.
https://www.intensivregister.de/#/intensivregister https://www.divi.de/images/Dokumente/DIVI-IntensivRegister_T...
But I have the feeling, in Germany we are doing pretty good for ourselves.
I don't think this will be over soon, but when I look at our numbers, I just can't see it getting much worse, let alone as bad as our neighbors or the US has it...
At some point there wasn't anything to act on. Cases where far and few between and have been individually isolated for a time. There was no way to find community spread because there was no way to identify other cases without testing millions. And the official incidence rate is still about one in a thousand people.
I think we're doing well and still don't meet friends or go out often.
In contrast to literally every other large European country, we did a lot of testing (compare for example CDR for France against Germany, we did ten times more tests especially early on). If you run the numbers on tests vs. infections, assuming that death rates are more accurate, you have to conclude that Italy, Spain and France likely have a magnitude more cases than tests would suggest.
Initial infections were mostly young people at the carnival events. This helps with the death rate.
Furthermore, Germany is more decentralized than any other country in the EU, and has "decent" capabilities spread.
We had a good start. Call it luck. However, it'll get worse, especially since people are itching for it to be over.
Here in Germany, we have the "weekend reporting" lull, where cases go down. Each time, people in big cities somehow take this as "peak reached" and go out. All actions have a two-week lag, so we don't really know anything about what works and what doesn't. Yet.
We NEED to be vigilant now, and you need to urge everyone you know to keep distancing and quarantining. Do your part. Yes, it's 27C and sunny outside, but we are not over the bump yet.
IF we keep going like this, we may be able to get over this crisis without ever having a health care catastrophe like France, Spain and Italy. But if we let our guard down too early, then we can get in trouble.
Yes, we were lucky with initial cases and our testing capability. But if we get to infection rates like other countries (10x more than current numbers suggest, at least), then our hospital system will also collapse.
It's best to ignore daily infection numbers, especially here where few cases are sent to RKI over week-ends and holidays. Let's celebrate when the death rate goes toward zero.
The peak of the last weekly cycle was April 2nd, and was the highest peak yet.
The current cycle is still in progress. Cases get added to previous days of the week retroactively. For example, there were days when it looked like case would go down, and then the next day several thousand cases were added to prior days and we went back to the weekly cycle.
We need to wait until next week to make any judgement about what is going on right now.
Up until now, there seems to be a linear increase if we ignore the cyclic component. At least for two weeks, people have been fantasizing about a decline that did not occur.
I agree that it looks like as if we'll have less cases this week. However, since it's holiday, this may be deceptive. We will not know for certain until next week, perhaps week after next week.
It's too early to celebrate. Obviously I share the hope.
https://www.klinikum-fuerth.de/ is missing from the map, which is the biggest hospital in Fürth, Bavaria.
Also interesting: some hospital report some contention, but no COVID-19 cases.
[1] https://www.ortenaukreis.de/Politik-Verwaltung/Verwaltung/Si...
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.
What is not accounted for is, that supplies (masks...) are still scarce and more importandly, most medical personal is working at an unsustainable intensity. There is plenty of reason of desiring even less sick people.
The reasons for reducing the lockdown are practical, social and economic. The lockdown is hard on many people, depending on their social and living situation. Especially in dense cities, most people don't have housing which was designed to be confined to it for many weeks. And apart from that, people want to go out, want to meet other people again. Need to do shopping for clothing, get a haircut. Also, we should try to keep the economy from collapsing.
The trick will be to reduce the lockdown while keeping the minimum safety in place and without too many people acting reckless and endangering the population again.
We want to be close to maximum capacity (but just under) though, and we're not. If "the curve" is too flat, it gets drawn out much more than necessary, and nobody should fool themselves into thinking that this can be a permanent setup. You'll need martial law if you want to confine everyone to their homes for 12+ months.
The current level of lockdown is unmaintainable as this virus is probably going to be here for a year or two. However it is very hard for our politicians to say: It is too expensive to save these lives - other lives are cheaper to save.
In a way the media coverage has been so effective that people actually do not want the restrictions lifted.
We are following the curve just as planned - not over and not under. There are no "overcapacity" and the lockdown isn't "massive" at all. Only a tiny percentage of shops are closed down and the rest isn't close to what a lot of other countries are doing.
Stop spreading FUD and try to appreciate we have a system that is working great in this crisis.
You can follow the writings of our ex pm Lars Lokke who says something similar to what I wrote.
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.
I don't think the measures will be softened before May, but according to the authorities, the ICU capacity will not be overburdened. Stressed to the maximum, yes, but not (or not much) over capacity.
Another issue is that with an R0 this low there will be a much lower rate of immunity. Which in turn means the restrictions can't be lifted because then the whole mess starts up again.
Yes, sounds like Germany nailed it
> Another issue is that with an R0 this low there will be a much lower rate of immunity. Which in turn means the restrictions can't be lifted because then the whole mess starts up again.
Literally no way to avoid this if you want to avoid overrunning the hospitals
It's clear that we can't hold this up until the vaccines are ready. The antibody studies will be crucial to determine how much immunity is there.
Ideally we would take back the restrictions when immunity has broadened enough. But that might take too long. I don't think this kind of shut down is sustainable for another two months.
This is the way to go, because developing this capability will be useful for the future as well. If, instead, our hospitals are at the limits and everyone is on full lock down, no such capabilities will be developed. The health care system will just struggle to keep people from dying and we may have the same situation when this or another virus returns.
There are other considerations for this, of course. First, fewer people will die. Second, it's not clear how immune a population can be to this virus. And even if herd immunity turns out to be viable, having a low R0 puts us into a waiting position where we can let the virus infect young and healthy people if that's a wise decision.
By this we could reduce the risk of infections by a huge amount compared to the pre-lockdown behavior but still have a pretty normal life. If we managed to get the number of infectios people small enough during the lock down, together with active measures like testing, tracking, etc. it might be good enough to keep the infection rate at or below 1.
To see why it's bullshit, one has to do some basic arithmetic. Consider that if life expectancy in NY metro area is 75 years and 21 million people live there, 1/75th of the population, or 280K people die per year in NY metro area alone. That's 7671 person per day on average. At the time of this writing 7844 people have died of corona in the entire state, total. I'd bet good money a good chunk (if not most) of these people would die of something else if it wasn't corona, so that's not a "net" increase. If you want to tell me these deaths require mass graves, I have some fine swamp land in Florida that you might want to check out.
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- or under-counted.
I live in NYC, and all of my local hospitals are at the limits of their normal capacities (many have been able to expand their capacities, thankfully). The city has been asking for volunteers to come out of retirement.
To my knowledge, none of my friends or family have been able to get non-urgent treatment or tests for coronavirus symptoms; the system is completely focused on (and occupied with) treating those most at need.
Edit: I also forgot to mention: I don't know exactly what you're referring to w/r/t "mass graves," but I'm guessing it has something to do with Hart's Island. The city buries its unclaimed dead there; any uptick in activity probably tracks roughly with death's among the city's general demographics. It wouldn't be surprising for them to need a few more trenches.
[1]: https://www.nytimes.com/2020/04/10/nyregion/new-york-coronav...
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 definitely not overwhelm anything at all, and given the dis-use of the emergency hospital capacity and reduced hospital and ICU admissions over the past few days, crowding in the hospitals seems like a load balancing problem to me.
And if anything, I would not be surprised if the official figures _overstate_ the death toll. Dr. Birx mentioned in the presser the other day that everyone who died _with_ C19 is counted as a C19 fatality, even if they did not die _of_ C19. Died of cancer but also have C19? You'll be counted as a C19 fatality.
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?
They aren't. You're being fed fake news. Hospital admissions and ICU admissions in NY are _way_ down. Nobody is running out of PPE. If you're going to dispute this, please provide a credible source familiar with the situation on the ground. My source is governor Cuomo: https://www.washingtonexaminer.com/news/were-ok-andrew-cuomo.... Don't bother pasting that teary eyed nurse who was "forced to work without PPE". That's fake news. Look it up. She's not a nurse, she's an Instagram "influencer".
> regular movements of going over speed bumps and potholes become potentially life threatening
Yes. Move them ahead of time, before they need intubation. Seems like people are in some kind of a stupor there. These are pretty obvious things.
They aren't. You're being fed fake news. If you're going to dispute this, please provide a credible source familiar with the situation on the ground.
> Nobody is running out of PPE. If you're going to dispute this, please provide a credible source familiar with the situation on the ground.
From a New York City Department of Health advisory to NYC doctors, dated March 20, 2020 [1]:
Like other jurisdictions with general community transmission of COVID-19, New York City (NYC) is facing a critical shortage of PPE
Anyway, let's focus on the actual content of that article: the tiny video clip of the New York state governor's press conference at the bottom, shot less than 24 hours ago. When a reporter asks Cuomo about the PPE situation he says: "If you ask any hospital 'do you have enough PPE?' they will say no. It's like asking a budget director 'do you have enough revenue?' They will say no. And these hospitals are accustomed to having one month or two months stockpile. They're now looking at several days of stockpile. So they are all uncomfortable. But, we only have several days for any hospital and we do have several days for every hospital and we do have a supply that is coming in so compared to how we have been operating on this new dire circumstances, we are relatively comfortable with ventilators and PPE if, big IF, big I, big F, if the hospitalization rate stays down, which will only happen if we continue to do what we need to do." I wasn't born yesterday so you'll have to excuse me for interpreting that as press conference bullshit. Any politician worth his salt with an adequate PPE supply would have used that golden opportunity for a display of confidence, not hem and haw about budget directors. Especially if that politician is overseeing the country's financial center.
But why stop there? Before someone could even ask the next question, Melissa DeRosa (Secretary to the Governor) interrupts to add: "If I could just make one caveat, there are certain hospitals that we get anecdotal reports on that are continuing to operate under the crisis conservation guidelines on PPE, where they ask people to wear PPE for days at a time versus what the ordinary protocol is and as we're hearing those reports we are reaching out to the hospitals and making sure they have the supply so that they don't have to operate that way." Note that she doesn't say that those hospitals are operating incorrectly because there is no shortage, but that they are still in the process of supplying those hospitals. They wouldn't have to do any of this if there wasn't a shortage, although maybe that's just a little more obvious to someone with actual clinical experience.
I think you've been focusing too much on "Instagram influencers," "teary eyed nurses", and ideological conflicts. I strongly recommend limiting your information intake to official (on Google: "site:gov") or academic ("site:edu" or Google Scholar) sources.
[1] https://www1.nyc.gov/assets/doh/downloads/pdf/han/advisory/2...
Didn't read the rest of your message, sorry. You're being gaslit.
Hint: key words are "change" and "total".
Cuomo, BTW, then proceeds to talk about how models were total horseshit. He doesn't quite characterize them as such, choosing instead to give credit to his own response, but nearly all of the models he quotes assumed the current levels of mitigation.
From your video, 14:00
"This is a little deceptive, because at one time hospitals had discrete ICU wards or ICU beds. Effectively now in a hospital all the beds are ICU beds".
When you misrepresent your own sources it's clear that you're not making a good faith effort to understand what's happening.
Deaths lag admissions by about 15 days.
Deaths are not the only outcome, some people will be in ITU for a few weeks but not dying. They'll then be transferred to ordinary wards, and then back home or to a care home.
Reduced hospital admissions is a bad thing -- we know if someone's having a stroke they need care as soon as possible. If people are having stroke but staying away from hospital we're going to find a bunch of people dying away from hospital, or a bunch of people with long term preventable disability.
> And if anything, I would not be surprised if the official figures _overstate_ the death toll. Dr. Birx mentioned in the presser the other day that everyone who died _with_ C19 is counted as a C19 fatality, even if they did not die _of_ C19. Died of cancer but also have C19? You'll be counted as a C19 fatality.
This is such a frustrating misunderstanding of what's actually happening.
We count flu deaths the same way. But here you're not saying that we overcount flu deaths, you're looking for anything so you can say "covid-19 isn't that bad".
Because of the way covid-19 deaths are counted it's likely they're being undercounted at the moment. A certifier has to say to the best of their knowledge and experience that covid-19 was a contributory factor in the death. That's hard to do when so few people are being tested.
> Died of cancer but also have C19? You'll be counted as a C19 fatality.
Firstly, that's untrue.
See for example this page which talks about the significant under, not over, counting of covid-19 deaths. https://www.nbcnews.com/news/us-news/more-2-200-coronavirus-...
The term you need is "excess mortality", and we know that there's a lot of excess mortality at the moment. What's causing that?
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 the army to transport coffins before. No statistical anlysis required here.
The analysis is further complicated that death rates vary a lot over the year even under normal circumstances. I don't doubt that in some countries a corona peak will be seen, but it will still take months to be sure how big it is.
https://www.euromomo.eu/ shows long term death rates in selected European countries.
This is a ridiculous claim
Any place that has done random sampling is reporting a very low asymptomatic rate
It should be obvious, when you have a virus with an infection rate doubling X number of days and it takes X or more days to start showing symptoms, if you do a random sample, 50% will be asymptomatic. That does NOT mean that they will continue to be asymptomatic
Of course, things get even worse when the disease is left unchecked or hospitals become overwhelmed; some tows in the Bergamo province in Italy reached daily death rates that where 6 times as high as the ones from last year in the same time period.
Edit: The actual numbers for NY show a more than 2x increase so far, see here https://www.nytimes.com/interactive/2020/04/10/upshot/corona...