Embrace The Suck

h/t WRSA

Italy Lombardy region is on the brink. Retired doctors summoned, nursing students field promoted to graduation. Just under 10% of Lombardy's #COVID19 cases need ICU. 10% of doctors/nurses have already caught #coronavirus and in quarantine. Jesus.

 The head of the Lombardy's intensive care crisis unit says the health system is on the brink of collapse, intensive care being set up in hallways. By March 26 they predict ~18,000 #Covid19 cases in Lombardy, of which ~3,000 will need intensive care.

The U.S. will not  automagically do it better because "'Merica, f**k yeah!". In fact, more than likely, we'll do it worse. 50 states' licensing boards are not going to overnight drop their standards for getting a nursing license. Which license only confers on a shiny new grad the 80% likelihood than on any given day, they won't kill their patient outright. It takes six months of baby-steps precepted training to make a specialty nurse that can operate without training wheels, and 10-18 months' time practicing in that specialty to become a certified functional badass. You won't teach nurses how to function faster simply by pointing a blowtorch up their butts, and getting a license is a wee bit more involved than getting a diploma from the Wizard of Oz.

And we're not set up (and never have been), outside the 4 BL-IV level bio-hazard wards in the entire U.S., to deal with a highly infectious pandemic, nor surge capacity anywhere to 4000% of normal census.

Not. Going. To. Happen. Evah.

So what you'll get, is what I've described on these pages previously.

A FEMA Kung Flu Treatment Center in a sports auditorium, or convention center.
No isolation. lots of cots in an open-air open-grid coughatorium. Genius!
No licensed personnel (except some poor schlub or two, holding the bag and supervising an army of well-meaning amateurs).
No PPE equipment for staff, and certainly nowhere near enough of anything, but patients.

Were talking, on our best day, Crimean War-era levels of hospital care.
(Hint: Horrible hospital care put the "crime" into Crimean. 900,000 soldiers out of 1,650,000 soldiers on all sides died in it, most from disease, not combat or wounds from it.)
Care so bad Florence Nightingale had to invent modern nursing science to fix the death rate. How did America do at that? Google Civil War hospitals 6-10 years later, and Clara Barton. Same damned thing, even with years of a head start.

Because you can't pull hospital beds (just regular ones, let alone ICU beds) for millions of people out of your ass on the fly if you don't know what you're doing, and we won't do that either. By the time anyone realizes this and takes it to heart, it's going to be time for bulldozers and bonfires.

I repeat for emphasis:

Shit Mardi Gras.



This is why I keep telling you to do things so you don't get this virus. Maybe you'll be in the lucky 80%, for whom it's just a PITA. Millions of your friends, neighbors, and your family, FFS, may not be as lucky. Start working out how you and yours might start self-quarantining, before it becomes mandatory instead of an option. And if you can do so, do it.

And you should take a long, loving look at the healthcare system that was the envy of the world. Take some souvenir photos. If this goes Shit Mardi Gras, like it apparently has in Italy, it's probably going bye-bye for the duration. If not altogether and for good.

Pay close attention to those last two points at the bottom.
Math optional, but recommended. When 40% of your staff is
 symptomatic, in a viral outbreak with a 2-28 day latent
period, you're not crippled; you're DONE.

Start wrapping your heads around the increasing likelihood of those unpleasant realities.

It'll hurt less than waiting until you do a faceplant in the brick wall at 60MPH if you wait until five minutes after it's already too late.

Like the government - here, there, everywhere - is doing.

I'd love - LOVE -  if I turn out to be all wrong on this (as would half a dozen armchair sceptics with low-level IQs and government-level critical thinking skills).
And I'm frankly scared shitless of being spot-on. It's not fun to contemplate.

But I've yet to see any promising news from anywhere, and I've been sciencing the shit out this since late January, when it hit radar.

And a curmudgeonly pessimist is rarely ever disappointed in how things turn out, but occasionally pleasantly surprised.