CAN WE AUDIOPHILES DO OUR PART?

I can't believe I'm about to do this on an audiophile thread. I'm a sucker for punishment, it seems. Here we go. I'm an inpatient internal medicine physician in a badly hit hospital on the east coast. We had less than 20 covid positive or rule outs on the day the lock downs started I'm our area. We peaked at just shy of 200 in hospital(that is total admitted at that moment in time, not total positives. People die or get discharged. Hundreds died. Fortunately, hundreds more have been discharged)with respiratory failure with covid. The peak was about 20 days after the lockdowns started and have slowly but steadily declined after a plateau of about a week(average time to death or discharge is 16 to 18 days). This is pretty much right in line with how you would expect it to go in relation to a lock down and the timeline as it pertains to covid-19 illness. Numbers played out similarly in the surrounding hospitals. 

In hard hit areas, I'm not so sure the "cure" was worse than the disease. The hospitals here were certainly not empty. We opened up 2 extra wings. We turned the same day unit into another ICU. We were still full. We weren't laying people off. We had nurses from around the country flown in to help. Same goes for physicians. Similar stories in the surrounding hospitals.

I'm very happy that in many parts of the country...it didn't play out this way. That is, after all...the point, though. The entire point. I am amazed when I see people point at the current numbers and call out that the numbers aren't that bad. "See! It's not that bad!" Yea, it's not horrible. After taking drastic measures it's not horrible. 

I'm not going to argue that things were managed properly. I won't argue that the lockdowns don't have costs of their own(of course they do, no $#!?). I won't make a claim that I know how to handle this moving forward systemically. I will say that claiming that empty hospitals during a pandemic means mistakes were made or that we've clearly screwed up isn't really a great statement in isolation. Once again...that is the point. Stop the spread of the virus. Waiting until it gets a foothold in an area before you adjust means waiting until it's too late.

I get it. As a physician, not being able to get things done for your non covid patients in an area that isn't really affected by covid is probably a horrible feeling. It's not fair to those patients. They are paying a disproportionate cost. I don't pretend to have the answer for how we should manage that. I don't think the proper pushback against that is to claim none of this is a big deal, though.

I'm also not claiming that hospitals aren't hurting financially. They are hurting in the areas that have not been touched much by the virus. I know there are layoffs. The hospitals that are the most busy with covid are also getting crushed. Despite being completely full during April with 30 admissions held in the ED and people in the hallways...revenue was down something like 60 or 70%. All the low level but high volume stuff isn't there. I don't have the answers for how to help the hospitals, but, again, I don't think the answer is to claim that covid isn't a big deal(or that it's just a political thing). 

*This was typed in a rush on a phone, and I'm not going back to proofread. I'm sure there are plenty of typos etc. Please...forgive them. 

@n80: I’ve already expressed that delayed care is an issue. A significant issue. I am not downplaying it. I don’t pretend to have the answers. I will not advocate any particular plan with steadfast conviction because I don’t have the answers. I’ll give the same response, again, about the empty hospitals. It’s a real and serious problem. People will die from the virus and people will die from the response to the virus in various numbers with any plan that is implemented. If you claim, again, that I don’t think that the negative effects of having empty hospitals is another issue, I’ll know we aren’t having a good faith discussion. I don’t know what the proper balance is. I am not downplaying it. What I can tell you from first hand experience, and plenty of second hand experience(my fiancee is a pulm/crit physician at a another larger hospital and between the two of us we have a reasonably large network of physicians to collect regional information) is that by the time you see the tip of the iceberg, assuming you haven’t been taking aggressive local measures, in many cases you are going to find out you’ve already lost. You’re going to have a really bad few months even if you lock everything down completely at that point.

It seemed pretty obvious from the beginning that any adequate response in regards to the virus would later be met with significant push back as people made claims like: "See! The numbers aren’t even that bad!" Right, they aren’t that bad in the setting of dramatic measures taken to stop the further spread of the virus. That is not the same as saying they never would have been that bad. I suppose this is my biggest point. Don’t use the fact that things didn’t explode in the setting of drastic measures being taken to downplay the seriousness of the situation.

Btw, the response to the pandemic is not central and general. There are guidelines and some central programs etc, but the states are the ones imposing the shelter in place orders etc. Did I miss something? Seriously, if I did let me know. Maybe you mean central in terms of California state making a "central" decision? That’s not really the proper terminology in this context, but ok. Maybe that means California is too big? It is bigger and more heavily population that most countries. Sure. I don’t know. I’m not very knowledgeable about California. For the record, I agree we need to worry about erosion of liberty. We always do. It’s a very real and obvious concern. That concern needs to be discussed in the setting of proper information, though. This is addressed more generally(as in not really at you N80, others are making the next claim I’m about to address), but this is not the flu. This is significantly more deadly and causes significantly more morbidity. True, we don’t know EXACTLY how deadly yet...but I’ve never seen a relatively healthy sub 40 year old(zero or one well controlled comorbidity) die of hypoxic respiratory failure. I’ve seen more than a few already in that group die from Covid-19 pnuemonia. I’ve seen a lot more of them stuck in the hospital for weeks or even more than a month on varying levels of oxygen support. Many go home on home oxygen(at least they did, it takes like a week to get it now because supply is low). Never seen that with the flu. It’s not the flu. I’ve never seen refrigerator trucks behind the hospital because the morgue is full during flu season. At least one hospital I know of in the area needed a second truck because the first was full.

I’m done though. I can’t waste any more of my day off on this. Have fun all. Enjoy your music. Stay safe(whatever that means to you). For those of you hurting with businesses. I wish you the best of luck. I’m sorry you have to go through this. I hope we can get everyone back to work as soon as possible in an intelligent way. My vote would be for reliable antibody testing(we just need to work on that reliable part first), but I’m open to whatever works.

@n80 

Wait...there were predictive models early on that predicted a may or whatever peak...we locked down the country...and about 3 weeks after the lock downs we had a peak...instead of May...aaaaaand you're arguing there is no evidence the lockdowns had an effect? You're sticking with that...because some people on tv are speaking non-sense?

Enjoy.