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Old 4 April 2020, 11:04 AM   #5056
joeychitwood
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Quote:
Originally Posted by mountainjogger View Post
Doc:

1. How does an overwhelmed medical system impact odds of surviving if you need supportive care, not just extreme medical attention like a ventilator.

2. After the first wave of a virus hits, like it has in China, how does this impact the likelihood of transmission if people return to work and practice social distancing, masks and hand washing. That is to say, with less potential carriers are the odds of a second repeat wave this serious diminished?

3. If you do not flatten the curve, does this impact the odds of a first responder dying?

Thanks Joey.

Stay safe.
Regarding question one, I’ve worked on a few occasions in the past where our emergency department was overwhelmed briefly. We always had the knowledge that soon, the volumes and acuity would return to normal, and that helped us mentally deal with the crush of patients. Animal studies have shown that when faced with overwhelming stress without a way to reduce it, the animals suffered rapid and serious physical and behavioral decline. The healthcare workers in this pandemic face unimaginable stress and a threat to their own life with no relief in the foreseeable future. Depression, PTSD, practice errors and decreased mental acuity will all become common. This combined with shortages of equipment, beds and staff reduces the odds that the seriously ill will get the care they need.

I am no expert in epidemiology, but almost certainly, there will be continued bumps in the numbers of sick and dead patients as time passes until a vaccine becomes widely available. Most likely, many more people than we know of will have immunity to Covid-19 by later this year due to mild or sub-clinical infections, since without widespread testing, no one really knows the denominator of the mortality equation. More immune people means fewer people who get sick with subsequent reappearances of the virus.

I really don’t know the answer to the third question, except to say that the likelihood of more serious infection in anyone increases with viral load, which is influenced by the number of sick patients with whom a healthcare worker comes in contact and by the intensity of that contact, i.e. intubating critically ill people, caring for vent-dependent patients, etc.
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