Germany should act like Italy, but they don’t, because its a federal system, and it’s essentially left to every local public health care jock to decide if anything is being closed or not. So we have “ghost” games with no public audience in Bavaria, Northrine Westphalia, and other states, and a live soccer game with thousands of visitors taking place in the world leader of stupid city councils, Berlin.
Correction, just read that the local health care jock of Treptow Koepenick has now also seen the light… just unbelievable.
EuroFlyer wrote:
Germany should act like Italy, but they don’t, because its a federal system, and it’s essentially left to every local public health care jock to decide if anything is being closed or not. So we have “ghost” games with no public audience in Bavaria, Northrine Westphalia, and other states, and a live soccer game with thousands of visitors taking place in the world leader of stupid city councils, Berlin.
Germany has so far been “ahead of the curve” because we have more laboratories that can do the tests and used this more than other nations. That is why, at the moment, things look comparably good here with over 1100 infected but only 2 deaths. Yet there is no reason to believe that we will end up significantly better than Italy. One has to take into account that Northern Italy is an extremely wealth, well equippend region. Their healthcare system is top notch. Yet, it is already exceeding its capacity.
In Germany, where we regularly have to close intensive care beds due to a lack of personnel, things won’t be better. We may have more ICU beds than any other European nation on paper, but I am uncertain how much good that will do us. The population seems to be divided into two camps:
One who is in panic mode, panic buying everything they can and running around with masks, and a second camp who act as if all this was none of their business. The best cause of action would be neither of these extremes. The lack of political leadership and the federal structure, as you noted, make it harder to enact a coordinated and evidence based approach.
Lots of Chinese business travellers to Northern Italy: textile, auto, machine industry,… and lots and lots of old people, more than in other EU countries.
The doc in the video seems to agree with the docs here.
Looking at the figures, it seems that reasonably healthy people are benefitting a lot from ventilation. They spend a week or 10 days on a ventilator then they can be stepped down for less invasive management. i.e Oxygen on the ward, then home.
Thinking this through, I now understand why China was so keen to build new capacity. Every ventilated bed is likely to save several fit youngish patients over the course of an outbreak. If you’re conservative, two or three. If you’re optimistic, perhaps 6. Presumably someone has got better numbers.
If you can slow the onset of the outbreak, you can do even better.
Some of the London hospitals have been building extra wards and dusting off old ventilators. I suspect though that the limiting factor, as for Medewok, will be staffing. The difference being that we struggle in the UK to keep 6.6 beds per 100,000 open, whereas he struggles to keep nearly 5 x that capacity open. The other limiting factor will be supplies such as masks and aprons. Supplies are limited.
In the UK, the other issue is that doctors tend to be frightened of their shadows. We live in a very regulated world – on the forums a lot of discussion is about whether we will be sued for making rationing decisions, or being co-opted to roles outside our usual competencies, or sued for not providing the same standard of care that might be expected outside a pandemic scenario. One rule is that you have to do a certain amount of ongoing education but all the courses are being cancelled. Will we lose our careers for not managing to go on courses during the pandemic? It’s ludicrous people are thinking about issues such as these. Simple reassurance would suffice.
https://www.skylinewebcams.com/it/webcam/italia/veneto/venezia/piazza-san-marco.html
Some views from Italy .
ormazad wrote:
Some views from Italy .
AGENDA 21 in action…….
BeechBaby wrote:
AGENDA 21 in action……
Please explain.
kwlf wrote:
Looking at the figures, it seems that reasonably healthy people are benefitting a lot from ventilation. They spend a week or 10 days on a ventilator then they can be stepped down for less invasive management. i.e Oxygen on the ward, then home.Thinking this through, I now understand why China was so keen to build new capacity. Every ventilated bed is likely to save several fit youngish patients over the course of an outbreak. If you’re conservative, two or three. If you’re optimistic, perhaps 6. Presumably someone has got better numbers.
If you can slow the onset of the outbreak, you can do even better.
Some of the London hospitals have been building extra wards and dusting off old ventilators. I suspect though that the limiting factor, as for Medewok, will be staffing. The difference being that we struggle in the UK to keep 6.6 beds per 100,000 open, whereas he struggles to keep nearly 5 x that capacity open. The other limiting factor will be supplies such as masks and aprons. Supplies are limited.
In the UK, the other issue is that doctors tend to be frightened of their shadows. We live in a very regulated world – on the forums a lot of discussion is about whether we will be sued for making rationing decisions, or being co-opted to roles outside our usual competencies, or sued for not providing the same standard of care that might be expected outside a pandemic scenario. One rule is that you have to do a certain amount of ongoing education but all the courses are being cancelled. Will we lose our careers for not managing to go on courses during the pandemic? It’s ludicrous people are thinking about issues such as these. Simple reassurance would suffice.
Thought provoking stuff. It is certainly imperative to slow down the onset of the outbreak, that way we can (hopefully) hook everyone to a ventilator who needs one.
What surprises me is that colleagues in the UK are really so afraid of bureaucratic/legal consequences. Of course the profession is very regulated … everywhere nowadays, I guess … but in times of crisis we shouldn’t even spend a second thought on this kind of stuff. If the best care possible under the given circumstances is provided, there should be no repercussions whatsoever, even if many will die.
This might be the time were colleagues from non-intensive specialities might have to dust off their skills on how to ventilate a patient…
This is interesting, though not surprising
The black curve is probably an over-simplification because it looks like it assumes that the entire population will catch it, but it is obvious that this does not happen with the normal flu. This virus is more infectious / contageous than the normal flu, however.
Today’s UK data:
A key piece of data we are no longer getting is “community transmission” i.e. cases not traceable to a specific overseas trip (or a person which came back from one) and I believe this is because most of the numbers are people returning from ski trips from (mainly) Italy. Some countries which have been willing to release data have pretty well confirmed that most or all of their cases came from that route. And the govt doesn’t want idiot thugs (who exist in every country) to go around beating up Italians (700k Italians live in the UK). The Italian ambassador was on the TV yesterday or the day before saying there have been some problems there.
