COVID-19 - different containment approaches around the world - Page 60 - The Horse Forum
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post #591 of 1440 Old 03-20-2020, 09:04 AM
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Here is a very great and factual link about the coronavirus. I found it very interesting.

https://ourworldindata.org/coronavirus

Something it points out is that we do not have information that can help us understand the mortality rate of the disease yet.
Looking at the case fatality rate, it is something that changes and is a fluid fact.
Quote:
We see that in the earliest stages of the outbreak the CFR was much higher: 17.3% across China as a whole (in yellow) and greater than 20% in the centre of the outbreak, in Wuhan (in blue).

In the weeks that followed, the CFR declined. The WHO reports that “the standard of care has evolved over the course of the outbreak”. The CFR fell to 0.7% for patients with the onset of symptoms after February 1st.

We also see that the CFR was different in different locations. By 1st February the CFR in Wuhan was still 5.8% while it was 0.7% across the rest of China.
They also point out that this virus can take a long time to die from, so we can't know about people who are still going to die, which will probably increase as time goes on.
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post #592 of 1440 Old 03-20-2020, 09:43 AM
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It has not really hit where I am yet. Over 8500 people tested for 64 positive. The aim as far as I understood was not stopping the virus, but slowing the spread. I think our state is doing ok so far, especially when so many of the population (including health care workers) are ignoring the advice coming from the government and many more promoting civil unrest online. I am in the high risk category, school holidays always increases my risk of illness tenfold, so I can really understand why they are keeping the schools open at this stage. Close them too early and it would speed up the spread. In truth, I am not politically minded, nor all that confident in the medical system, having spent many years in their care. I think it is important we try to stay on the same page listening to leaders rather than fighting their advice and taking things out of context in panic stricken states of mind.

I went to do my normal weekly shop last night. Besides the toilet roll and soap/sanitizer aisle, all else was available, albeit some low stock. Fresh food and cooking ingredients were plentiful. Ready made meals and pasta were limited. I live out of the city so I tend to do a big shop every few weeks (200km round trip to get to coles). I got everything I normally would with no problem, not even a line at the check out. People on the coast seemed very calm and orderly. I did not see any of the violence or hoarding that the tv news is showing. Everything seemed to be business as normal with a few more signs about hygiene. I was pleasantly surprised and it did feed the sense of calm in me, having been prepared for long periods of isolation before this hit. I have never been so thankful to live where I do.


I cannot imagine what it is like overseas until it actually gets here. My prayers are with you guys heavily affected at this time. All I can hope for my elderly neighbours is that the vaccine is approved before that happens. Admittedly, some have confessed they would rather go out quick than rot in a nursing home with stroke or dementia. People don't move to this town to cheat death, they come here to welcome it.
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post #593 of 1440 Old 03-20-2020, 10:19 AM Thread Starter
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I am not a virologist, so the behaviour of viruses over time is something that escapes me. However, I do know that novel viruses tend to mutate in the beginning. This would explain differences in how the virus has affected populations differently in different areas until now.


Quote:
In the weeks that followed, the CFR declined. The WHO reports that “the standard of care has evolved over the course of the outbreak”. The CFR fell to 0.7% for patients with the onset of symptoms after February 1st.
This is inspirational. Results can be improved over time, but the ability to do so requires an extreme approach.


To get to that point of a 'flattened' curve, several step were taken in China that have not yet been taken here in Spain:

1) Wuhan was completely blocked off. People are calling for this to happen in Madrid.

2) Containment facilities were built in one week for milder cases and asymptomatic positives. Several hotels in Madrid have been donated for use in this crisis, and I know that at least one is now functioning with more than 300 rooms. That was done in a matter of 3-4 days.

3) China has the manufacturing power of no other country on Earth. They were able to quickly respond with greater production of medical materials. Here, there are not enough respirators, while doctors and nurses are working with trash bags and homemade surgical masks in some hospitals because they do not have enough PPE for such an event. We don't have the same manufacturing prowess.

4) China does not have the same regard for civil liberties that we have in Western societies, so here politicians have had to get involved, make decisions and pass laws. That has taken time. Meanwhile, there are people that scoff at isolation and citizens want the military to enforce State of Alarm isolation laws.

5) The Chinese say they have 'defeated' the virus, but it is still active. After 3 months, people are still in isolation in their homes, and new infections are now manageable with the new resources and supply chains they have created. Here in Europe, we are a long way from that point.


So, I truly hope that the US and other areas of the world are taking note and getting prepared. Factories need to be converted to manufacture the medical supplies needed. NOW. I am sure many of you have seen Cuomo's speech in which the projected need for respirators is 30,000, yet they only have 5000-6000. That is the kind of calculations that were not made here in time, and that need has still not been met.
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post #594 of 1440 Old 03-20-2020, 11:53 AM
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Worries from the medical community in the US state that their biggest issue right now is we're already running perilously low on the necessary paralytic drugs to put people on ventilators. Without those drugs, even the ventilators they do have are worthless.
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post #595 of 1440 Old 03-20-2020, 11:54 AM
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Speaking strictly r/t the available resources, Nurses are already in short supply and prior to the onset of the current coronavirus, we already had staffing shortages.

Every year, hospitals depend on an influx of new graduates to fill vacancies. Every year, new grads quit nursing because of the reality of the work is overwhelming to them once they are on their own off orientation.

This year, with schools going online and clinical rotations stopped, I am concerned that a reduced number of new grads will even apply, and will leave sooner. They will seek out the higher paid positions, and the staff nurse positions will be left unfilled.


We currently are offered plenty of overtime opportunities, where normally this time of the year overtime is severely restricted by managers.


What happens when the nursing staff becomes sick? Where will they go?
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post #596 of 1440 Old 03-20-2020, 12:08 PM Thread Starter
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EDITING...

While I was writing this, the hospital called to cancel my son's CT scan for the 26th.


@SilverMaple , excellent point about the paralytics. I had no idea.


@AnitaAnne , when this is over, there needs to be a top-to-bottom assessment of our healthcare systems (and I mean WAY up top, including the WHO, etc). I am assuming that doctors in the US are well paid, but in other countries they are not, and nurses all over are underpaid for their essential care. As a society, we need to straighten out our priorities, and I like the initiatives I had heard elsewhere (was it New York?) offering free education to top students who chose to study the health sciences if the student then practiced for 5 years or so at public clinics. Sort of like ROTC for the armed services, but for doctors and nurses.
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post #597 of 1440 Old 03-20-2020, 12:08 PM
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To address the issue of social distancing from another perspective, one has to realize that the decreased traffic will mean (hopefully) reduced accidents which in turn will mean reduced demands on all levels of medical staff.

No MVC would reduce the need for the EMTs, the ED staff, the surgery staff, the floor staff, the ICU staff, etc. Even the admissions and social service staff needs would be reduced.

I am an orthopedic nurse, and I cannot over emphasize the number of elderly that fall and break bones (usually hips but not exclusively) because of going to church, going out to eat, fixing big meals for family visits, etc.

By practicing social distancing, most of these accidental falls could be eliminated, keeping the elderly out of the hospitals and reducing their risk of a number of complications.


The nursing homes are all closed to visitors; yet the elderly still are being placed there for rehab after falls. This puts them at greater risk.


Everyone please just stay home for a while. Enjoy your family time together. Visit relatives and friends virtually. By doing this we all can conserve resources and save lives. Thank you.
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post #598 of 1440 Old 03-20-2020, 12:14 PM Thread Starter
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Excellent, practical points, @AnitaAnne .
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post #599 of 1440 Old 03-20-2020, 12:35 PM
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Quote:
Originally Posted by Spanish Rider View Post
EDITING...

While I was writing this, the hospital called to cancel my son's CT scan for the 26th.


.
Sorry this is delayed, hopefully will have available soon.

The demands on equipment are also intensified, as depending on the patient and equipment used, after use has to be completely disassembled and sanitized. Thus reduced availability of equipment and staff involved.
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post #600 of 1440 Old 03-20-2020, 12:38 PM Thread Starter
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@AnitaAnne , I assumed it was coming, and this actually gives us a sense of relief. He is fine, not in an emergency situation, and if he does have a tumor it is most likely benign and just messing with his adrenal function.
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