(COVID/ETC CONTENT HERE) China Locks Down 11 Million in Wuhan,

Originally Posted by WillBrink

I wonder if some of that is self fulfilling. That is, media et al make a huge thing of it, many more go to ER, hospital, etc and overwhelm the system, and off you go. Where as, many people, perhaps some who probably should have seen a doc, don't go when they have/had the flu.

How much of a factor that is I don't know, but I suspect it's a component at least. I just had the flu, knew a lot of others who did too, none went to see a doc. Those numbers don't get added to the flu data base either. People are encouraged to get tested if they even suspect they have C19.

My point being, while C19 appears more virulent than common flu for those with co morbidity, I'm thinking a much higher % are also going to hospitals if they suspect they have C19 vs the flu.

Seems a lot of dynamics at play there.

I think a lot of people have, have had, or will have C19 and never get tested because they think they are going to have a cold. Or here in NC, allergies (that time of year). Even if you come to the ED, the overwhelming majority will get tested but not hospitalized. They will get the diagnosis on the back-end, a call at home saying "you have C19, stay at home, eat your fruits and veggies." I think people who get the flu, most do see a doc, most do not get admitted. The challenge is, with any illness, "you can't prove a negative", so how do we know the numbers when they aren't presenting? But in both cases (flu v. C19), most people who see a doc, are tested, and only hospitalized when warranted. I totally agree, a lot of dynamics.

I am not a big fan of the flu vs COVID-19 thing because at the end of the day, it doesn't matter. All that matters is what is in front of us. The rest is, as they say, academic.

Originally Posted by chuckman

I think a lot of people have, have had, or will have C19 and never get tested because they think they are going to have a cold. Or here in NC, allergies (that time of year). Even if you come to the ED, the overwhelming majority will get tested but not hospitalized. They will get the diagnosis on the back-end, a call at home saying "you have C19, stay at home, eat your fruits and veggies." I think people who get the flu, most do see a doc, most do not get admitted. The challenge is, with any illness, "you can't prove a negative", so how do we know the numbers when they aren't presenting? But in both cases (flu v. C19), most people who see a doc, are tested, and only hospitalized when warranted. I totally agree, a lot of dynamics.

I am not a big fan of the flu vs COVID-19 thing because at the end of the day, it doesn't matter. All that matters is what is in front of us. The rest is, as they say, academic.

Is there any data on that one? That would be interesting to know. My impression was most don't see a doc if they think they have the flu, but that could just be my subjective perceptions.

Originally Posted by chuckman

You are in the biz, so you know that a medical disaster is literally one more patient than you have resources to treat (same as a MCI). I know the numbers change based on admitted patients, bed availability, etc. We have 100ish ICU beds, maybe a dozen more (we never divert). So in our experience, the flu doesn't come even close to touching us the way C19 is touching the major med centers in Italy. It's just the math. We know social distancing flattens the curve and 'trickles' demand for resources rather than 'deluge' the system, so hopefully by getting ahead of it (instead of what Italy, et al., did) we can be more prepared. But I imagine you don't have flu patients in the hallways; nor do your docs end up with flu requiring them to be hospitalized, either.

We actually had an outbreak a few years back which we rented equipment and converted break rooms and storage rooms to ICU rooms. We even scattered out to convert progressive units into ICU beds. Our limiting factor is staff.

We’ve had several physicians and staff out for influenza.

Do you think your 100 bed ICU unit will be overwhelmed? What capacity is it running right now?

Why is Italy the model and not a number of other countries?


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Originally Posted by mack7.62

Panic is bad but saying people should not panic because it's not killing very many is not looking at the big picture. People are panicking because this type of plague is truly unprecedented in modern times, not for how serious it is but for how fast it spreads which is mainly due to how contagious it is and ease of modern travel.

You seem to WANT panic. There isn’t a reason. The US and many other nations are being quite proactive. It also appears most infected are asymptomatic.

What is the response you’re hoping for?


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Good info, another great interview bu JR.

Originally Posted by mack7.62

True but the 2009 flu was not near as disruptive as this has already turned out to be. Look you can't compare this to the flu, when has the flu ever caused major sports events to be canceled.

Perhaps it should have been? But a Democrat was in the White House and under-reacted. Big pass from media thus no panic.


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Originally Posted by Averageman

Good info, another great interview bu JR.

Posted multiple times here. Very much worth watching.

Originally Posted by WillBrink

Is there any data on that one? That would be interesting to know. My impression was most don't see a doc if they think they have the flu, but that could just be my subjective perceptions.

Most people say things like “oh I have the flu” when in fact they have coronavirus (yes one of the six types we’ve been dealing with for decades), RSV, etc. The reality is flu is much more serious than people know. When people actually have flu it hits them pretty hard.


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Originally Posted by lsllc

We actually had an outbreak a few years back which we rented equipment and converted break rooms and storage rooms to ICU rooms. We even scattered out to convert progressive units into ICU beds. Our limiting factor is staff.

We’ve had several physicians and staff out for influenza.

Do you think your 100 bed ICU unit will be overwhelmed? What capacity is it running right now?

Why is Italy the model and not a number of other countries?


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We've had people out for flu (this year more than past), but not hospitalized, and none have died.

We have 5 ICUs, and they stay somewhere between 98%-100% full, but can flex up a few dozen. At any point we can also move probably around 15% of ICU patients to step-down if we had to. Our Achilles heel has been neg pressure rooms.

I include Italy in a group of countries, not just 'the' country, on which to model. These other countries (including Italy) were very late in instituting social distancing and preventive shutdowns/closings, I thinks that's why they had the deluge. Italy just happens to be the last with the most recent data we're getting.

Originally Posted by chuckman

We've had people out for flu (this year more than past), but not hospitalized, and none have died.

We have 5 ICUs, and they stay somewhere between 98%-100% full, but can flex up a few dozen. At any point we can also move probably around 15% of ICU patients to step-down if we had to. Our Achilles heel has been neg pressure rooms.

I include Italy in a group of countries, not just 'the' country, on which to model. These other countries (including Italy) were very late in instituting social distancing and preventive shutdowns/closings, I thinks that's why they had the deluge. Italy just happens to be the last with the most recent data we're getting.

We only have six negative pressure rooms, which is what CDC recommends. Your ICU is much larger. We have three ICUs with 10 beds and overflow units to add an additional eight for a total of 38 without renting equipment.

The number of vents has been a problem this flu season.


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