Visiting audio stores?

I am an ED doc in a very large urban teaching hospital (Wash U/Barnes Jewish in St Louis)
This is a serious disease. Death rate (using worldwide data) is 10x that of the flu. So using numbers given by Mrmb, that is a half million deaths. But those are only deaths by COVID-19. The crunch comes when a small percentage of sick people need ICU care or Vents. If (really when) the current numbers of those infected get sick (the 10-20%) it will exhaust medical resources. The 68 yo with an MI, will NOT have the equipment needed to save his life because it is being used by a COVID-19 patient. We simply do not have enough ICU beds or vents in the entire nation to care for the large increase in medical resources. In any large city, there are already sometimes 8-12 hour waits for an open ICU bed. All the while the critically ill patient is in the ED using up the ED resources and preventing another sick person from getting care. And most small hospital ICUs are NOT prepared to care for the really sick ICU player. These places often transfer these patients to larger medical center, sometimes with 1-2 day waits. Social distancing is vital to keep the numbers NOT DOWN, but to delay , or increase time they present over. The number of critically ill patients will be the same through the COVID-19 season, we just need to have them present to the hospitals over months, not weeks. And as draconian as it seems, look at any city, and you will see too many people ignoring the recommendations which will spread the virus faster and overwhelm the system.

From an Italian Doc: [exerpts]

Lessons Learned from the Front Line of the COVID-19 Outbreak in Northern Italy: An Emergency Physician’s Perspective:

Andrea Duca, MDEditorial Board, Emergency Medicine Practice Attending Emergency Physician, Ospedale Papa Giovanni XXIII, Bergamo, Italy

• Prepare to initially receive patients with upper airway symptoms, followed in the next days by patients with persistent fever, and finally, patients with interstitial pneumonia. The proportion of patients needing admission increases day by day. As of March 10, 2020, up to 60%-70% of patients presenting to the ED with suspected COVID-19 infection needed to be admitted, primarily for hypoxia.
• Be...
• In the first days, the critically ill patients will be mostly older than 65 with comorbidities, followed by younger patients in the days/weeks after. Do not exhaust all of your resources with the first patients. Patients will need to stay in the ICU for weeks.
• Patients come in waves, usually in late afternoon. For every 100 patients coming to the ED, expect to have 5 with severe ARDS, 10-20 with mild/moderate ARDS, and 40 patients needing oxygen to treat hypoxia.
• Do...
• Prepare in advance to have 10% of staff becoming ill. Personal protection is hard to maintain during long shifts in a busy ED, but it is feasible, and constant vigilance is mandatory.
• Most...
• In large health systems...
• Lung ultrasound...
• Tell all the...
• Prepare psychological support for the staff early. You will need it.

Look at China.  Would never trade our society for theirs, but their ability to completely lock down a region (basically house arrest) with a population that follows the orders almost to a 'T' the social isolation has stopped COVID in it's tracks.  Only 1 new case today.  

dwmaggie - prayers with you.  Stage 1 laryngeal cancer highly survivable

asvjerry - don't forget Boeing.  Great deal :)

Stay safe, all

assetmngrsc:

Yes, there are pneumonia vaccines, but they only protect one from Streptococcus pneumonia. And one specifically for H flu.  There are many types of pneumonia: bacterial, mycoplasma, fungal and other less common types. A short list of some bacterial: Streptococcal, staphylococcal, peptostreptococcal, Bacillus anthracis, Nocardia, Actinomyces, Neisseria meningitidis, Moraxella catarrhalis, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter, Burkholderia pseudomallei, Yersinia pestis, Francisella tularensis, Chlamydia pneumoniae....... And the list goes on. Then there are the different types of fungal or viral, etc. Treatment for these are not 100% in an otherwise healthy person. Take someone sick from COVID-19 with its pathology and add another infection (a pneumonia of another kind) and treatment is less effective. Vaccines and antibiotics help your body fight the infection. If your body is already weakened....

YES! Everyone under the age of 2 and over the age of 65 should be vaccinated, but is not a one and done thing.