BonsaiGreen said:
Look, why don't we try this.
The president is going to address the nation in about an hour. Please try to just focus on his message and his posture on this matter. Try not to see this through a political lens, but through a human lens.
Then, come back on here, and let's discuss what he said.
scottimus said:
Extraordinary Decisions Facing Italian Doctors...Pretty intense read. Wonder if this is what Trump will be speaking about.
https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/?fbclid=IwAR2bxAkSjycoS7_hae2-Ex1KXUPZXN1gJ_K9bWYur2PvinQFWTLxHuXrXHUQuote:
The Extraordinary Decisions Facing Italian Doctors
There are now simply too many patients for each one of them to receive adequate care.
Two weeks ago, Italy had 322 confirmed cases of the coronavirus. At that point, doctors in the country's hospitals could lavish significant attention on each stricken patient.
One week ago, Italy had 2,502 cases of the virus, which causes the disease known as COVID-19. At that point, doctors in the country's hospitals could still perform the most lifesaving functions by artificially ventilating patients who experienced acute breathing difficulties.
Today, Italy has 10,149 cases of the coronavirus. There are now simply too many patients for each one of them to receive adequate care. Doctors and nurses are unable to tend to everybody. They lack machines to ventilate all those gasping for air.
Now the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow in these extraordinary circumstances. The document begins by likening the moral choices facing Italian doctors to the forms of wartime triage that are required in the field of "catastrophe medicine." Instead of providing intensive care to all patients who need it, its authors suggest, it is becoming necessary to follow "the most widely shared criteria regarding distributive justice and the appropriate allocation of limited health resources."
The principle they settle upon is utilitarian. "Informed by the principle of maximizing benefits for the largest number," they suggest that "the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care."
The authors, who are medical doctors, then deduce a set of concrete recommendations for how to manage these impossible choices, including this: "It may become necessary to establish an age limit for access to intensive care."
Those who are too old to have a high likelihood of recovery, or who have too low a number of "life-years" left even if they should survive, will be left to die. This sounds cruel, but the alternative, the document argues, is no better. "In case of a total saturation of resources, maintaining the criterion of 'first come, first served' would amount to a decision to exclude late-arriving patients from access to intensive care."
In addition to age, doctors and nurses are also told to take a patient's overall state of health into account: "The presence of comorbidities needs to be carefully evaluated." This is in part because early studies of the virus seem to suggest that patients with serious preexisting health conditions are significantly more likely to die. But it is also because patients in a worse state of overall health could require a greater share of scarce resources to survive: "What might be a relatively short treatment course in healthier people could be longer and more resource-consuming in the case of older or more fragile patients."
These guidelines apply even to patients who require intensive care for reasons other than the coronavirus, because they too make demands on the same scarce medical resources. As the document clarifies, "These criteria apply to all patients in intensive care, not just those infected with CoVid-19."
My academic training is in political and moral philosophy. I have spent countless hours in fancy seminar rooms discussing abstract moral dilemmas like the so-called trolley problem. If a train is barreling toward five innocent people who are tied to the tracks, and I could divert it by pulling the lever, but at the cost of killing an innocent bystander, should I do it?
Part of the point of all those discussions was, supposedly, to help professionals make difficult moral choices in real-world circumstances. If you are an overworked nurse battling a novel disease under the most desperate circumstances, and you simply cannot treat everyone, however hard you try, whose life should you save?
Despite those years of theory, I must admit that I have no moral judgment to make about the extraordinary document published by those brave Italian doctors. I have not the first clue whether they are recommending the right or the wrong thing.
But if Italy is in an impossible position, the obligation facing the United States is very clear: To arrest the crisis before the impossible becomes necessary.
This means that our political leaders, the heads of business and private associations, and every one of us need to work together to accomplish two things: Radically expand the capacity of the country's intensive-care units. And start engaging in extreme forms of social distancing.
hbtheduce said:scottimus said:
Extraordinary Decisions Facing Italian Doctors...Pretty intense read. Wonder if this is what Trump will be speaking about.
https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/?fbclid=IwAR2bxAkSjycoS7_hae2-Ex1KXUPZXN1gJ_K9bWYur2PvinQFWTLxHuXrXHUQuote:
The Extraordinary Decisions Facing Italian Doctors
There are now simply too many patients for each one of them to receive adequate care.
Two weeks ago, Italy had 322 confirmed cases of the coronavirus. At that point, doctors in the country's hospitals could lavish significant attention on each stricken patient.
One week ago, Italy had 2,502 cases of the virus, which causes the disease known as COVID-19. At that point, doctors in the country's hospitals could still perform the most lifesaving functions by artificially ventilating patients who experienced acute breathing difficulties.
Today, Italy has 10,149 cases of the coronavirus. There are now simply too many patients for each one of them to receive adequate care. Doctors and nurses are unable to tend to everybody. They lack machines to ventilate all those gasping for air.
Now the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow in these extraordinary circumstances. The document begins by likening the moral choices facing Italian doctors to the forms of wartime triage that are required in the field of "catastrophe medicine." Instead of providing intensive care to all patients who need it, its authors suggest, it is becoming necessary to follow "the most widely shared criteria regarding distributive justice and the appropriate allocation of limited health resources."
The principle they settle upon is utilitarian. "Informed by the principle of maximizing benefits for the largest number," they suggest that "the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care."
The authors, who are medical doctors, then deduce a set of concrete recommendations for how to manage these impossible choices, including this: "It may become necessary to establish an age limit for access to intensive care."
Those who are too old to have a high likelihood of recovery, or who have too low a number of "life-years" left even if they should survive, will be left to die. This sounds cruel, but the alternative, the document argues, is no better. "In case of a total saturation of resources, maintaining the criterion of 'first come, first served' would amount to a decision to exclude late-arriving patients from access to intensive care."
In addition to age, doctors and nurses are also told to take a patient's overall state of health into account: "The presence of comorbidities needs to be carefully evaluated." This is in part because early studies of the virus seem to suggest that patients with serious preexisting health conditions are significantly more likely to die. But it is also because patients in a worse state of overall health could require a greater share of scarce resources to survive: "What might be a relatively short treatment course in healthier people could be longer and more resource-consuming in the case of older or more fragile patients."
These guidelines apply even to patients who require intensive care for reasons other than the coronavirus, because they too make demands on the same scarce medical resources. As the document clarifies, "These criteria apply to all patients in intensive care, not just those infected with CoVid-19."
My academic training is in political and moral philosophy. I have spent countless hours in fancy seminar rooms discussing abstract moral dilemmas like the so-called trolley problem. If a train is barreling toward five innocent people who are tied to the tracks, and I could divert it by pulling the lever, but at the cost of killing an innocent bystander, should I do it?
Part of the point of all those discussions was, supposedly, to help professionals make difficult moral choices in real-world circumstances. If you are an overworked nurse battling a novel disease under the most desperate circumstances, and you simply cannot treat everyone, however hard you try, whose life should you save?
Despite those years of theory, I must admit that I have no moral judgment to make about the extraordinary document published by those brave Italian doctors. I have not the first clue whether they are recommending the right or the wrong thing.
But if Italy is in an impossible position, the obligation facing the United States is very clear: To arrest the crisis before the impossible becomes necessary.
This means that our political leaders, the heads of business and private associations, and every one of us need to work together to accomplish two things: Radically expand the capacity of the country's intensive-care units. And start engaging in extreme forms of social distancing.
Socialized medicine at work.
But seriously, not a good situation.
IrishTxAggie said:AgStuckinLBK said:
Part of Italy's death rate problem is that they're just not treating anybody above 65 OR with lots of comorbidities. (Info not from 4chan, from actual people over there).
They're literally just letting these people die and these are the ones that have a high mortality with treatment.
Fair enough. But it's also true there's been quite a few of us who have been regularly posting new data and updates to existing COVID-19 data from public health and research sources in various U.S. states and countries around the world as it becomes available. It's been nice to have a F16 thread where much of the discussion has been analytical, data-based, and informative in nature for a change.riverrataggie said:MetoliusAg said:
This thread is for speculative discussion on Covid-19 developments.
Edited
Game officially postponed.lunchbox said:
The start of the OKC Thunder vs Utah Jazz game is being delayed and the game may be called. One of the players, Rudy Gobert, is sick...and this is after he made a point a few days ago that he wasn't worried about CV...by touching all the microphones in the room.
The median age of those being hospitalized in Italy is 65. I haven't seen any other age-related stats.Exsurge Domine said:scottimus said:
Italy reporting almost 200 deaths today....
https://www.nbcnews.com/health/health-news/live-blog/coronavirus-updates-live-u-s-cases-top-1-000-spread-n1155241/ncrd1155806#liveBlogHeaderDoes Italy track flu deaths everyday? Interesting to see the numbers.Quote:
Almost 200 people died from the coronavirus in 24 hours, Italy's Civil Protection Agency confirmed Wednesday the highest daily increase in absolute terms registered anywhere in the world since the respiratory illness emerged in China at the end of last year.
In response, the country's prime minister, Giuseppe Conte, told reporters the government would allocate 25 billion euros ($28.3 billion) to help mitigate the impact on the fragile economy. Only a week ago, he estimated it would need just 7.5 billion.
From Tuesday to Wednesday, 196 people died, bringing the total number of deaths to 897, the Civil Protection Agency said in a statement. Confirmed cases across the country rose to 12,462 from a previous 10,149.
After an initial lockdown in the north failed to prevent the spread, the government on Monday banned all nonessential travel and public gatherings throughout Italy until April 3, halted all sports events and extended a shutdown of schools.
Also, what % of flu deaths/cases are extrapolated? ...
That's a lot of deaths. Equal to about 1200 in the US in a day. Will be interesting to see the median age
Quote:
Coronavirus crisis hits ice-locked Arctic research expedition
A team member on the huge project has tested positive for the virus, delaying the air mission.
The coronavirus outbreak has reached the Arctic and is imperilling a massive international scientific project, after a team member tested positive for the virus.
The mission, called MOSAiC, is operating from the German research vessel Polarstern, which has been intentionally frozen in Arctic sea ice since last October. From this ice-encrusted platform, a rotating cast of scientists and technicians are sampling the ice, atmosphere and ocean in an attempt to understand the intricacies of the rapidly changing Arctic climate.
The team member who contracted the virus works on the airborne component of the expedition a key part that has now been delayed to protect those on board the ship. This part of the mission will use scientific aircraft to take measurements around Polarstern to provide context for those taken at the ship.
About 20 members of the aircraft team are now quarantined in their homes under direction of the German health agencies, says Markus Rex, an atmospheric scientist at the Alfred Wegener Institute for Polar and Marine Research in Bremerhaven, Germany. Rex is the chief scientist of the MOSAiC mission.
coastsrs said:
The amazing thing about Texas is you can see who has no life and spends countless days arguing against internet posters by clicking their name seeing their post count
VaultingChemist said:The median age of those being hospitalized in Italy is 65. I haven't seen any other age-related stats.Exsurge Domine said:scottimus said:
Italy reporting almost 200 deaths today....
https://www.nbcnews.com/health/health-news/live-blog/coronavirus-updates-live-u-s-cases-top-1-000-spread-n1155241/ncrd1155806#liveBlogHeaderDoes Italy track flu deaths everyday? Interesting to see the numbers.Quote:
Almost 200 people died from the coronavirus in 24 hours, Italy's Civil Protection Agency confirmed Wednesday the highest daily increase in absolute terms registered anywhere in the world since the respiratory illness emerged in China at the end of last year.
In response, the country's prime minister, Giuseppe Conte, told reporters the government would allocate 25 billion euros ($28.3 billion) to help mitigate the impact on the fragile economy. Only a week ago, he estimated it would need just 7.5 billion.
From Tuesday to Wednesday, 196 people died, bringing the total number of deaths to 897, the Civil Protection Agency said in a statement. Confirmed cases across the country rose to 12,462 from a previous 10,149.
After an initial lockdown in the north failed to prevent the spread, the government on Monday banned all nonessential travel and public gatherings throughout Italy until April 3, halted all sports events and extended a shutdown of schools.
Also, what % of flu deaths/cases are extrapolated? ...
That's a lot of deaths. Equal to about 1200 in the US in a day. Will be interesting to see the median age
ccaggie05 said:hbtheduce said:scottimus said:
Extraordinary Decisions Facing Italian Doctors...Pretty intense read. Wonder if this is what Trump will be speaking about.
https://www.theatlantic.com/ideas/archive/2020/03/who-gets-hospital-bed/607807/?fbclid=IwAR2bxAkSjycoS7_hae2-Ex1KXUPZXN1gJ_K9bWYur2PvinQFWTLxHuXrXHUQuote:
The Extraordinary Decisions Facing Italian Doctors
There are now simply too many patients for each one of them to receive adequate care.
Two weeks ago, Italy had 322 confirmed cases of the coronavirus. At that point, doctors in the country's hospitals could lavish significant attention on each stricken patient.
One week ago, Italy had 2,502 cases of the virus, which causes the disease known as COVID-19. At that point, doctors in the country's hospitals could still perform the most lifesaving functions by artificially ventilating patients who experienced acute breathing difficulties.
Today, Italy has 10,149 cases of the coronavirus. There are now simply too many patients for each one of them to receive adequate care. Doctors and nurses are unable to tend to everybody. They lack machines to ventilate all those gasping for air.
Now the Italian College of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) has published guidelines for the criteria that doctors and nurses should follow in these extraordinary circumstances. The document begins by likening the moral choices facing Italian doctors to the forms of wartime triage that are required in the field of "catastrophe medicine." Instead of providing intensive care to all patients who need it, its authors suggest, it is becoming necessary to follow "the most widely shared criteria regarding distributive justice and the appropriate allocation of limited health resources."
The principle they settle upon is utilitarian. "Informed by the principle of maximizing benefits for the largest number," they suggest that "the allocation criteria need to guarantee that those patients with the highest chance of therapeutic success will retain access to intensive care."
The authors, who are medical doctors, then deduce a set of concrete recommendations for how to manage these impossible choices, including this: "It may become necessary to establish an age limit for access to intensive care."
Those who are too old to have a high likelihood of recovery, or who have too low a number of "life-years" left even if they should survive, will be left to die. This sounds cruel, but the alternative, the document argues, is no better. "In case of a total saturation of resources, maintaining the criterion of 'first come, first served' would amount to a decision to exclude late-arriving patients from access to intensive care."
In addition to age, doctors and nurses are also told to take a patient's overall state of health into account: "The presence of comorbidities needs to be carefully evaluated." This is in part because early studies of the virus seem to suggest that patients with serious preexisting health conditions are significantly more likely to die. But it is also because patients in a worse state of overall health could require a greater share of scarce resources to survive: "What might be a relatively short treatment course in healthier people could be longer and more resource-consuming in the case of older or more fragile patients."
These guidelines apply even to patients who require intensive care for reasons other than the coronavirus, because they too make demands on the same scarce medical resources. As the document clarifies, "These criteria apply to all patients in intensive care, not just those infected with CoVid-19."
My academic training is in political and moral philosophy. I have spent countless hours in fancy seminar rooms discussing abstract moral dilemmas like the so-called trolley problem. If a train is barreling toward five innocent people who are tied to the tracks, and I could divert it by pulling the lever, but at the cost of killing an innocent bystander, should I do it?
Part of the point of all those discussions was, supposedly, to help professionals make difficult moral choices in real-world circumstances. If you are an overworked nurse battling a novel disease under the most desperate circumstances, and you simply cannot treat everyone, however hard you try, whose life should you save?
Despite those years of theory, I must admit that I have no moral judgment to make about the extraordinary document published by those brave Italian doctors. I have not the first clue whether they are recommending the right or the wrong thing.
But if Italy is in an impossible position, the obligation facing the United States is very clear: To arrest the crisis before the impossible becomes necessary.
This means that our political leaders, the heads of business and private associations, and every one of us need to work together to accomplish two things: Radically expand the capacity of the country's intensive-care units. And start engaging in extreme forms of social distancing.
Socialized medicine at work.
But seriously, not a good situation.
That will be the situation here if this outbreak gets bad enough. That's the reason we are canceling so many events, companies are asking people to work from home, and schools are moving to online classes. Italy didn't take these measures before their outbreak overwhelmed the medical system and now the country has ground to a halt. Hopefully the measures being taken here will make it to where we don't have to face those same decisions here on a broad level.
Marcus Aurelius said:
Scary part of this:
Here in AL - where I practice pulmonary medicine. Where "no cases" of COVID-19 have been reported. Like our sister state of MS. Why? Terrible lack of testing. It's here. Trust me.
On call today. I just got consulted and saw a elderly man with cough, altered mental status and a fever of 103 deg. Clear chest xray. Respiratory viral panel (Flu A.B plus 5 other common cold viruses) neg. Had to be intubated for respiratory failure. No other source of infection obvious. No respiratory isolation ordered. No coronavirus testing ordered. Just a pulmonary consult. No travel / exposure risks.
HAVE to test this patient and those like him. ER, hospitalist etc not screening. Why?
Ordered coronavirus isolation, and testing. RN freaking out. Probably negative but why risk it?
