|S3: Shit Mardi Gras.|
Worse than a Shit Show (S1).
Worse than a Shit Circus (S2).
Better than a Shit Riot (S4).
1) On March 17th, we had 4000 confirmed cases. Today, April 4th, it's at over 300,000 confirmed cases.
We have more than that; you know it, I know it, Yellow Dog knows it. But that means, minimum, this is doubling every three days, and has done so six times in the last nineteen days.
That's eight million cases by the 19th of April, give or take.
And spotting this the low end of only a 1% CFR, that's 80,000 dead in two more weeks, which surpasses any flu season, and is 4 times worse than the average one.
In perspective, it's nearly a year's worth of U.S. combat deaths from WWII, in just 2 more weeks, if it rolls out that way. It may be better or worse, but it's sure as hell not anywhere close to good yet.
So, can we please finally STFU about how this is "just the flu", and how "the cure is worse than the disease", when opening the floodgates takes the spread of this to Mars, on a rocket ship?
It's doubling every three days now, not just because of testing, but because it can, and this is with most of the country on at least voluntary stay-at-home, to restrain the spread (which is working, when dumbasses actually do it).
You can think happy thoughts when cases and deaths (over 1100 since yesterday) peak, and come down the other side of the roller coaster. Not before.
2) We've covered this material, multiple times, but probably in a response in comments, or on another forum, so once and for all here, a reminder about ventilators and such.
Nurses don't run ventilators.
Respiratory therapists do that.
It takes 2 years to train one, and another year of OJT to get them good at it.
Each RT can manage 4 vents, if you want it done right.
If you don't care about killing people, maybe you can surge that, short-term, to 6 or 8@.
And that's it.
A vent can deliver 100% fiO2, at pressures you need to understand to do properly.
It's known as PEEP. A good setting for a vented ICU patient with Kung Flu is as high as 25.
Average for normal times and cases is much lower, but that's what happens with Kung Flu pneumonia: it requires more force to pop the alveoli open when they're filling with fluid and mucus. Think lungs full of goop, like blowing up a balloon partly full of Elmer's Glue, and you're on the right track.
You can't get to this level of O2 concentration with an oxygen concentrator, and you can't get that level of forced pressure from a C-Pap machine.
Can. Not. Be. Done.
You're trying to fly to Mars in a hot air balloon.
So just no, for all related questions of "Can I do_______?"
And if somebody, anybody, thinks we're good if we just crank out 100,000 or 1,000,000 ventilators, because "'Murica!", then please, tell me how you plan to squat, grunt, and shit out the 25,000 to 250,000 trained respiratory therapists you'll need to run that many vents, which you don't have now just sitting around playing cards and waiting to come to your Pandemic Party in ICU or the ER.
And BTW, the Nawlins ER Doc who wrote this clinical missive (which is probably dead-on balls accurate - it's an industry term) notes that Kung Flu patients on ventilators die at rates between 70% (Seattle) and 86% (worldwide average), to date.
So anyone bad enough off to need to go on a ventilator with this (which means they're also sedated, and in ICU, as either a 1:1 - one nurse:one patient - or 1:2 patient), has between 1 chance in 3, and 1 chance in 7, of surviving to recover and go home. The other 2 out of 3 or 6 out of 7 will simply die, between Day 11 and Day 21 of intubation. Sometimes, even quicker. (Our patient last week lasted 48 whole hours, and coded multiple times before the MDs called it off for good.)
So I repeat, for emphasis:
Stay your happy ass at home, and DON'T catch this.
Somewhere between 97 and 99% of you will probably recover just fine. But 1-3% of you, and not all of them "old" by any standard, are going to die in a coma, isolated, with a plastic tube down your throat, and breathing mucus while you drown in your own body fluids.
If you don't have it now, and don't catch it, you don't have to see about finding that out firsthand, even at 1 chance in 33 or so.
Go back and read this morning's post, and see what you need to be working on. Worrying about this won't fix it. Just know it's still craptastic. Now go get on with your life, such as it may be, and do constructive things with your time.