Author Topic: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China  (Read 23435 times)

Offline Chemsoldier

  • Pot Stirrer
  • Global Moderator
  • Survival Veteran
  • ******
  • Posts: 5794
  • Karma: 546
Re: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China
« Reply #720 on: Yesterday at 11:15:34 AM »
An ICU nurse in the Denver metro of my acquaintance (and much closer to a former forum member) is saying that more ventilator COVID patients are living than dying nation wide according to brutally honest information sharing channels among emergency medical providers.  Her ICU has not had any ventilator patients die yet.  Other metrics of their status are not bad at all for ICU patients, they just need the vent to stay alive.  The issue is some of the patients will recover just fine but need weeks on the ventilator.

Offline LvsChant

  • Resident Master Mudder
  • Global Moderator
  • Survival Veteran
  • ******
  • Posts: 7426
  • Karma: 606
Re: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China
« Reply #721 on: Yesterday at 01:51:05 PM »
An ICU nurse in the Denver metro of my acquaintance (and much closer to a former forum member) is saying that more ventilator COVID patients are living than dying nation wide according to brutally honest information sharing channels among emergency medical providers.  Her ICU has not had any ventilator patients die yet.  Other metrics of their status are not bad at all for ICU patients, they just need the vent to stay alive.  The issue is some of the patients will recover just fine but need weeks on the ventilator.

Good information... so obviously, even if the ventilators will save lives, it will takes weeks of intensive care for each one.

Online FreeLancer

  • Global Moderator
  • Survival Veteran
  • ******
  • Posts: 6504
  • Karma: 804
Re: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China
« Reply #722 on: Yesterday at 02:00:35 PM »
Everything I have seen puts the rate of someone with Covid-19 being removed alive from ventilator intubation at less  than 20% (and those removed don't necessarily survive).   I would love to hear some positive news otherwise.

Severe COVID-19 cases develop Acute Respiratory Distress Syndrome (ARDS), which is a condition critical care specialists have considerable experience treating with mechanical ventilation in an ICU setting.  ARDS in general has a fatality rate of 30-40%.   COVID-19 appears to cause a respiratory failure that is at the severe side of the ARDS spectrum and Chinese data (not my first choice of trustworthy information these days) shows about a 50% survival rate. 

Since COVID patients are requiring 2-3+ weeks of ventilation we don't have a lot of US data yet but I would expect that it will show the overall odds of patient survival to be better than 50%.

However, this is going to be very much age dependent and whether COVID causes other organ failures that requires treatment.  A 40-something patient with only ARDS could survive >80% of the time, but a 70-something with hepatorenal failure on top of the ARDS might be <10%.



This is where NY's color-coding system for rationing ventilators comes into play.  Every day the clinical team reports the objective data on all the patient's needing a ventilator to the triage team.  Based on the severity and multitude of organ failure, the patient's chances of getting (or keeping) a ventilator rises and falls against every other patient. 

The sicker you are, or the longer you go without making progress, the less likely you are to stay on the vent.  A lot of these patients who are not making progress will be extubated so their vent can be used by a patient with better numbers.  At that point they get moved out of the ICU and placed on sufficient morphine and Ativan to reduce their air hunger and keep them comfortable until they either get better or die. 


Obviously, in a pandemic situation where resources are stretched to the limit the survival rates deteriorate, so areas of the country most impacted by this disease will have the more dismal numbers.

Online FreeLancer

  • Global Moderator
  • Survival Veteran
  • ******
  • Posts: 6504
  • Karma: 804
Re: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China
« Reply #723 on: Yesterday at 04:04:09 PM »
NYT:  ‘War Zone’: Ambulances in N.Y.C. Are Now as Busy as on Sept. 11

Quote
“I’m terrified,” said Mr. Suarez, who has been a paramedic in New York City for 26 years and had assisted in rescue efforts during the Sept. 11, 2001, terror attacks and later served in the Iraq war. “I honestly don’t know if I’m going to survive. I’m terrified of what I’ve already possibly brought home.”

Quote
Because of the volume, emergency medical workers are making life-or-death decisions about who is sick enough to take to crowded emergency rooms and who appears well enough to leave behind. They are assessing on scene which patients should receive time-consuming measures like CPR and intubation, and which patients are too far gone to save.

Quote
If the rate of growth in cases in the New York area continues, it will suffer a more severe outbreak than those experienced in Wuhan, China, or the Lombardy region of Italy.

Quote
Three weeks ago, the paramedics said, most coronavirus calls were for respiratory distress or fever. Now the same types of patients, after having been sent home from the hospital, are experiencing organ failure and cardiac arrest.

“We’re getting them at the point where they’re starting to decompensate,” said the Brooklyn paramedic, who is employed by the Fire Department. “The way that it wreaks havoc in the body is almost flying in the face of everything that we know.”

Quote
Another paramedic in Brooklyn said she had been using the same N95 mask for days. Last week, as she and her partner exited an apartment building after tending to a patient, the building’s supervisor — noticing the pair’s worn equipment — met them downstairs and shoved new N95 masks and a can of Lysol into their arms.

Quote
The growing pandemic has tested paramedics physically and mentally, said Anthony Almojera, an E.M.S. lieutenant for the Fire Department who said he cried on the job for the first time in his 17-year career.

He and his team had responded to a cardiac arrest dispatch for a middle-age woman, a health care worker, who had been infected. When paramedics arrived at her home, the woman’s husband, who was also a health care worker, said she had been sick for five days.

The husband frantically explained that he had tried to stay home and tend to his ill wife, but his employer had asked him to work because their facility was overrun with coronavirus patients.

Grudgingly, the man told the medics, he went to work. When he returned home after his shift that day, he found her unconscious in their bed. For 35 minutes, Mr. Almojera’s team tried to revive the woman, but she could not be saved.

Offline iam4liberty

  • Survival Demonstrator
  • *******
  • Posts: 4412
  • Karma: 331
  • New TSP Forum member
Re: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China
« Reply #724 on: Yesterday at 04:12:28 PM »
Well, I do hope we have better success than in China where the experience was over 80% mortality.  The anti-virals have anecdotally been making a world of difference.

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30110-7/fulltext
Respiratory support for patients with COVID-19 infection

As of Feb 27, 2020, coronavirus disease 2019 (COVID-19) has affected 47 countries and territories around the world.1 Xiaobo Yang and colleagues2 described 52 of 710 patients with confirmed COVID-19 admitted to an intensive care unit (ICU) in Wuhan, China. 29 (56%) of 52 patients were given non-invasive ventilation at ICU admission, of whom 22 (76%) required further orotracheal intubation and invasive mechanical ventilation. The ICU mortality rate among those who required non-invasive ventilation was 23 (79%) of 29 and among those who required invasive mechanical ventilation was 19 (86%) of 22

Offline Chemsoldier

  • Pot Stirrer
  • Global Moderator
  • Survival Veteran
  • ******
  • Posts: 5794
  • Karma: 546
Re: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China
« Reply #725 on: Yesterday at 04:14:14 PM »
https://news.yahoo.com/8-strains-coronavirus-circling-globe-182338255.html?soc_src=social-sh&soc_trk=fb

The use of gene sequencing to trace the virus.  As it reproduces there are very small mutations occuring that let them figure out if a particular COVID case was community transmission from another known case in the area, or a strain that is common in a different area.

Offline Chemsoldier

  • Pot Stirrer
  • Global Moderator
  • Survival Veteran
  • ******
  • Posts: 5794
  • Karma: 546
Re: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China
« Reply #726 on: Yesterday at 04:28:17 PM »
USNS Comfort has put to sea enroute to NYC.  She is anticipated to arrive on Monday.  I am tracking that is 12 days from notification.  Initially she wasn't expected to even sail for 14 days from notification.  Well done Navy!  There are probably some exhausted yard dogs at Naval Station Norfolk.

https://thehill.com/homenews/administration/489998-trump-sees-usns-comfort-off-as-it-departs-for-new-york

Online FreeLancer

  • Global Moderator
  • Survival Veteran
  • ******
  • Posts: 6504
  • Karma: 804
Re: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China
« Reply #727 on: Yesterday at 06:21:27 PM »

Offline mountainmoma

  • Survival Demonstrator
  • *******
  • Posts: 4530
  • Karma: 214
  • suburban homesteader
Re: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China
« Reply #728 on: Yesterday at 07:10:45 PM »


must not tell the whole story as the New York area is hit so hard, they are blue on that map, how many beds per patient must be hard on them ?

Online FreeLancer

  • Global Moderator
  • Survival Veteran
  • ******
  • Posts: 6504
  • Karma: 804
Re: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China
« Reply #729 on: Yesterday at 07:26:51 PM »
It’s relative.

High density populations deemed predominantly healthy still have old/sick people to clog the health system. We’ll be in the same boat out here on the left coast.

The real point of the map is highlighting how rural middle America could get slammed. If a few dozen people need a ventilator in a county with one 50 bed hospital and 4 ventilators things get ugly at the local level really quick.  And with every other hospital in the state feeling the same crunch it’s not likely you can transport enough of them to the big city to gain much slack.

Offline Mr. Bill

  • Like a hot cocoa mojito
  • Administrator
  • Ultimate Survival Veteran
  • *******
  • Posts: 15012
  • Karma: 1871
  • Trained Attack Sheepdog/Troll hunter
    • Website Maintenance and Online Presence Management by Mr. Bill
Re: Coronavirus COVID-19 (a.k.a. 2019-nCoV) outbreak in China
« Reply #730 on: Yesterday at 08:36:11 PM »
https://news.yahoo.com/8-strains-coronavirus-circling-globe-182338255.html?soc_src=social-sh&soc_trk=fb

The use of gene sequencing to trace the virus.  As it reproduces there are very small mutations occuring that let them figure out if a particular COVID case was community transmission from another known case in the area, or a strain that is common in a different area.

That's a really good article, and answers a question I was wondering about.

Quote
...COVID-19 hits people differently, with some feeling only slightly under the weather for a day, others flat on their backs sick for two weeks and about 15% hospitalized. Currently, an estimated 1% of those infected die. The rate varies greatly by country and experts say it is likely tied to testing rates rather than actual mortality.

Chiu says it appears unlikely the differences are related to people being infected with different strains of the virus.

“The current virus strains are still fundamentally very similar to each other,” he said.


The COVID-19 virus does not mutate very fast. It does so eight to 10 times more slowly than the influenza virus, said Anderson, making its evolution rate similar to other coronaviruses such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS).

It’s also not expected to spontaneously evolve into a form more deadly than it already is to humans. The SARS-CoV-2 is so good at transmitting itself between human hosts, said Andersen, it is under no evolutionary pressure to evolve. ...