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Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels

 
Anonymous Coward
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02/29/2020 02:14 PM
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Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
Greetings - this is regarding Murica

In accordance to GLP stands, I will refer to my sources as my Uncle.

I have several Uncles and my uncles expect that we will be just fine and dandy until the medical system is overloaded. Death rates will be <1% for some time, then once the system is saturated, the death rate will skyrocket depending on what how much the secondary system can handle the overload.

For example in the united states most metropolitan areas will have 3-5 "tertiary level" centers with the ability to do 3-5 ecmo cases each at maximum. Ecmo requires machines and the staff to run them (perfusionists). Most facilities that do coronary artery bypass will have these.

However, once these are saturated which will be 15 - 25 cases in each significant urban center, you loose the ability to do standard bypass operations.

Opportunity cost.

ICU beds, stepdown beds, and telemetry beds. Standard rooms.

The ICU and stepdown beds should be able to handle around 50-150 people depending on size, this would allow oxygenation up to 100% delivery as long as your lungs are working somewhat, this is where the sickest will be. There are different modes of ventilation that can help, namely pressure mode that can increase the pressure pushed into your lungs that increases oxygen delivery, but most people can't be on these for extended periods of time since it causes barotrauma - lung pops like too much pressure in a baloon.

Your regular medicine beds that can give you oxygen to about a non rebreather mask, which gives you "100%" but since your rate of inhaling tends to be faster than the oxygen delivery, you really get between 60-80%. There are things called high flow systems that are better, and some regular wards can have these hook ups.

Now your hospitals at the community should have these beds. Most hospitals are rated for 300-500 beds but are only half full. The issue has generally been staffing.

So depending on our models, it will take some time to hit critical mass where we have opportunity cost involved with taking care of patients.

Wuhan exceeded their capacity and my Uncles believe their death rate to be higher than reported because lack of accurate data.

If our society overloads the hospital system, the next possible locations of treatment will be urgent cares, skilled nursing facilities, acute rehab facilities, some board and cares, oxygen delivery from health health agencies, nursing from home health, hospice access to oxygen / equipment.

We have plenty of resources that can be procured and used to salvage the community patient IF there is access.

Public health officials should be engaging all lines of defense for our patients.

Quarantine efforts will fail over time unless there is strict monitoring with the military. We live in a "free society" - people will move away from the dead and dying. This is only natural.

So as you can see, America has quite a bit of resources if they are accessible and organized in a way that it can be used in this fashion.

it does us no good to have a ton of nebulizers, oxygen concentrators, oxygen tanks in storage rooms of durable medical equipment companies. Then we need a distribution process. Then a way to identify who needs and should get them.

We have reserves. The question is when do the models exceed our ability to handle these cases and spill over to dying on the streets due to lack of resources -> WUHAN / IRAN with a 15 percent or so mortality rate.

The models we have seen (uncles), show that with the first unknown transmission from a specific area has roughtly 2-4 weeks before the hospital systems will be saturated depending on the public health efforts.

So that means northern california will most likely be the first to have issues around the last week of March.

See how that plays out and prepare your local health officials to create contingency plans to be able to access the medical surplus we have as mentioned above.
Anonymous Coward
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02/29/2020 03:47 PM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
Can the government actually confiscate the medical goods to do this?

Or do they need to announce martial law or something sort of provision that allows them government to commondeer these things?
Crypto-Tard

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02/29/2020 04:09 PM

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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
Can the government actually confiscate the medical goods to do this?

Or do they need to announce martial law or something sort of provision that allows them government to commondeer these things?
 Quoting: Anonymous Coward 78516599


Where are they going to get the medical goods to confiscate?

These good DON'T EXIST. There is no supply (other than China) for many of these items.

This is an excellent post. Once the hospitals get overwhelmed, the death rate will be over 20%.

Last Edited by Crypto-Tard on 02/29/2020 04:09 PM
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Anonymous Coward
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02/29/2020 04:27 PM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
Can the government actually confiscate the medical goods to do this?

Or do they need to announce martial law or something sort of provision that allows them government to commondeer these things?
 Quoting: Anonymous Coward 78516599


Where are they going to get the medical goods to confiscate?

These good DON'T EXIST. There is no supply (other than China) for many of these items.

This is an excellent post. Once the hospitals get overwhelmed, the death rate will be over 20%.
 Quoting: Crypto-Tard


There are some DME (durable medical companies) that do have some surplus supplies but you need staff to distribute and set up this equipment.

You also need to identify the people that need it.

Stock though is just like any business of probably excess of 20-30% of monthly utilization - so you are correct, it's not like we can get a whole bunch of new supplies out of the blue.

I wish I had better news, but our think tank has been sending this information up and I don't know what the public health people are doing with it.

We only have so much time to have processes in place to maximize what we do have.

Keep in mind we have a regular disease burden already that use a lot of resources. Most hospitals try to remain near capacity but this is due to nursing restrictions.

They usually can double capacity as their rooms are usually rated for 2 people but used for private use.

Of course when it gets bad, you have hallways and tents that can be set up, but again, you also need the staff for this.

America can't "force" the nurses and doctors to work and expose themselves to death - unless...of course mandatory enforcement - loss of licenses, coercion.

There are some other places that have some resources like assisted living (some have oxygen), congregate living facilities (which are like skilled nursing).

Again, we also have to remember that congregating patients in such a matter increases cross contamination and spread.

This virus is expected to mutate, we are hoping that if indeed these are bioengineered viruses that there is a suvivability threshold that makes them revert to a "wild type" which is not as deadly.

For example, bacteria that have genes to resist antibiotics develop them because it is a survival benefit with a stressor that selects for their survival. Once you remove that benefit, the cost to keep that protein / gene (in a plasmid) is no longer beneficial and leaves the gene pool.

This virus will mutate, the assumption we have is that if this is a bio-engineered virus, the metabolic load to keep it deadly may not be beneficial to it's reproduction and it will eventually be selected out.
Anonymous Coward
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02/29/2020 05:05 PM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
The point of this thread is: please keep healthy skepticism of the mortality numbers and severity of disease. There are threads stating that this is a "nothing burger". And it is...if we can support every who gets sick with all things being equal.

1) We have unlimited supplies - we don't.

Hospitals will run out of supplies.
As you know the supply chain is already affected.

2) We have unlimited beds. - we don't.

3) We have unlimited staff. - we don't.

Your staff can easily scale up to need. (we don't have this - expect staff to desert / staff that stays will start having patient ratios that are "illegal" in most states)

Police / Military will probably be escorting medi-cal staff to facilities to force people to work.



You shouldn't be lulled into a sense of safety as numbers will look good for the US, just like South Korea.

Watch South Korea, their medical system is slightly different, but it will exhaust and we will start seeing different data in the next couple weeks.

DO NOT FEEL IT'S SAFE BECAUSE CURRENT MORALITY RATES ARE LOW IN FIRST WORLD COUNTRIES.

IT IS BECAUSE THERE IS ACCESS TO HEALTHCARE. ONCE SATURATED, THE NUMBERS WILL CHANGE.
Anonymous Coward
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02/29/2020 05:45 PM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
The only people that can be infected by the 2019-n Coronavirus have less than 98.7 µg/L of Selenium in plasma or serum. Those who have enough Selenium are immune to this and all other enveloped viruses. Selenium can be obtained from Brazil nuts, Selenium pills or Astragalus tea.
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Anonymous Coward
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03/01/2020 02:06 PM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
There are rumors of a quarantine for northern california.

Keep in mind that the disease process in actual northern california is going to still accelerate unless they have significant quarantining occuring at the local outbreaks.

Unfortunately, there is a good chance it has already gone to nevada (reno) and southern california as a lot of natural traffic goes to those areas by car.

Most of the rail traffic is to southern california.

And let's not forget about planes. Lots of commuters to Southern California as well.
Anonymous Coward
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03/07/2020 12:13 PM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
Bump for tards who expect rates to stay low.
Anonymous Coward
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03/08/2020 07:00 PM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
A few updates.

If the South Korean numbers are true and they have been able to level out and even decrease infections, their medical system will not be overload and mortality rates should say under 2% for that country. I believe they are under 1%.

For Italy, as predicted, once their medical system is overloaded their mortality rates will start moving upwards, well over 5%. We expected this to occur around 4 weeks after critical mass and demonstrated growth.

Northern California, still expecting last week of March or 1st week of April to be an issue for the medical system.

Southern California will follow in 1-2 weeks after northern california is saturated.

Homeless populations will still use the emergency departments and the virus should be impossible to contain in the inner city hospitals. If there is any significant growth on a day to day basis, then you are looking at a 4 week interval depending on how many hospitals you have relative to the population.

Our think tank was not tasked to predict the breakdown of the financial side of things or the social order.

We also don't know how long supply chains will last or what the quarantine will end up doing to access to goods / food / etc.

Our only job was to model out the medical system and when it would get overloaded.

The public generally be feeling "safe" until the hospital systems start failing. Expect the government to tote lines that are supporting safety with low mortality rates, until the medical systems are overloaded.

Track the first major outbreaks to understand your particular areas resources. Since hospital access is very regional in nature, overload can go to the neighboring areas up to a point. Los Angeles County and Orange County, Inland Empire, San Diego will be leaning on each other.
Anonymous Coward
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03/16/2020 03:41 PM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
Just wanted to let everyone know that worse case scenario is tracking like Italy.
Anonymous Coward
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03/25/2020 08:42 PM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
Please stay inside and hunker down if your area hospitals are full.

Death rates will go upwards to 15%.
Anonymous Coward
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03/26/2020 04:38 PM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
Greetings - this is regarding Murica

In accordance to GLP stands, I will refer to my sources as my Uncle.

I have several Uncles and my uncles expect that we will be just fine and dandy until the medical system is overloaded. Death rates will be <1% for some time, then once the system is saturated, the death rate will skyrocket depending on what how much the secondary system can handle the overload.

For example in the united states most metropolitan areas will have 3-5 "tertiary level" centers with the ability to do 3-5 ecmo cases each at maximum. Ecmo requires machines and the staff to run them (perfusionists). Most facilities that do coronary artery bypass will have these.

However, once these are saturated which will be 15 - 25 cases in each significant urban center, you loose the ability to do standard bypass operations.

Opportunity cost.

ICU beds, stepdown beds, and telemetry beds. Standard rooms.

The ICU and stepdown beds should be able to handle around 50-150 people depending on size, this would allow oxygenation up to 100% delivery as long as your lungs are working somewhat, this is where the sickest will be. There are different modes of ventilation that can help, namely pressure mode that can increase the pressure pushed into your lungs that increases oxygen delivery, but most people can't be on these for extended periods of time since it causes barotrauma - lung pops like too much pressure in a baloon.

Your regular medicine beds that can give you oxygen to about a non rebreather mask, which gives you "100%" but since your rate of inhaling tends to be faster than the oxygen delivery, you really get between 60-80%. There are things called high flow systems that are better, and some regular wards can have these hook ups.

Now your hospitals at the community should have these beds. Most hospitals are rated for 300-500 beds but are only half full. The issue has generally been staffing.

So depending on our models, it will take some time to hit critical mass where we have opportunity cost involved with taking care of patients.

Wuhan exceeded their capacity and my Uncles believe their death rate to be higher than reported because lack of accurate data.

If our society overloads the hospital system, the next possible locations of treatment will be urgent cares, skilled nursing facilities, acute rehab facilities, some board and cares, oxygen delivery from health health agencies, nursing from home health, hospice access to oxygen / equipment.

We have plenty of resources that can be procured and used to salvage the community patient IF there is access.

Public health officials should be engaging all lines of defense for our patients.

Quarantine efforts will fail over time unless there is strict monitoring with the military. We live in a "free society" - people will move away from the dead and dying. This is only natural.

So as you can see, America has quite a bit of resources if they are accessible and organized in a way that it can be used in this fashion.

it does us no good to have a ton of nebulizers, oxygen concentrators, oxygen tanks in storage rooms of durable medical equipment companies. Then we need a distribution process. Then a way to identify who needs and should get them.

We have reserves. The question is when do the models exceed our ability to handle these cases and spill over to dying on the streets due to lack of resources -> WUHAN / IRAN with a 15 percent or so mortality rate.

The models we have seen (uncles), show that with the first unknown transmission from a specific area has roughtly 2-4 weeks before the hospital systems will be saturated depending on the public health efforts.

So that means northern california will most likely be the first to have issues around the last week of March.

See how that plays out and prepare your local health officials to create contingency plans to be able to access the medical surplus we have as mentioned above.
 Quoting: Anonymous Coward 78545667


4 thing they short of.

ventilators thousands required
masks
staff
beds

simple unscientific.

so you order equipment from china and virus attached to all those items

solution- manufacture local
Anonymous Coward
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04/05/2020 12:41 AM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
If the hospitals in your regional area are getting full from an ICU standpoint, hunker down.

Not the time to go get groceries
Not the time to go get gas.

Do not go out.
Anonymous Coward
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Canada
04/05/2020 12:42 AM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
Hospitals are still empty Jack.
Anonymous Coward
User ID: 78516599
United States
04/05/2020 02:28 AM
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Re: Mortality Rates will Skyrocket once America's medical system is overloaded to WUHAN/IRAN levels
Hospitals are still empty Jack.
 Quoting: Anonymous Coward 78044784


It's obviously very regional as mentioned in the first post.

Are you a special kind of stupid?





GLP