Are we doing enough, and how much is enough?

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 Toerag 20 Mar 2020

So, the Coronavirus rumbles on, and for many countries the reality of exponential growth is now starting to kick in - check the graphs here http://nrg.cs.ucl.ac.uk/mjh/covid19/ (don't get caught out by the log scales) and here https://www.worldometers.info/coronavirus/.  This new article https://medium.com/@tomaspueyo/coronavirus-the-hammer-and-the-dance-be93370... has prompted me to wonder 'are we doing enough?' and 'what is enough?'.  It also makes me sad that the world doesn't appear to be learning from China,Italy, South Korea and Singapore.  Even the best countries are experiencing 10%+ growth - case numbers doubling every ten days.  Each person coming out of hospital after ten days is going to have 2 people needing their bed. One London NHS trust is turning people away already. Most European countries are tracking at a 35% daily increase in cases, with some dropping to 22% with controls. That means cases are still doubling every 5 days or so even with controls.  The rates are still exponential, just slower.

Worldometers reckons on a global 5% serious case percentage of reported cases, and there's reputed to be 100k ICU beds in the UK. Logically, this means the UK can handle a total number of 2 million cases at any one time (assuming beds aren't needed for anything else, which we know is untrue - anyone know the bed occupancy ratio? In winter they're 50% full with normal flu patients).  The UK are at ~3250 as I write this and increasing at what is probably 35% per day (under-testing maskign the true figure).  At 35% growth that gives the UK a month from today until the NHS is overwhelmed. If we drop to the 22% rate it's 50 days, and at 10% its 100 days.  The critical thing is that it's still going to happen even at that low rate unless we can increase the NHS' capacity.  China locked down on the 23rd January and only now have their cases stopped rising. Numerous countries are beyond the point at which China locked down already.  I'm pretty sure we can't bolster the NHS sufficiently in 50 days, so we have to do what's required to hit the 10% rate to have any chance of not overloading the NHS. and we're not doing that .

Post edited at 12:48
In reply to Toerag:

>  Most European countries are tracking at a 35% daily increase in cases, with some dropping to 22% with controls. That means cases are still doubling every 5 days or so even with controls.  The rates are still exponential, just slower.

There's also a lag because of incubation time.  So we wouldn't expect the controls to show through immediately. 

It's concerning that the Chinese Red Cross guy who was sent to Italy is saying their controls are nothing like strict enough compared to what worked in Wuhan, and UK controls are even worse.

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Deadeye 20 Mar 2020
In reply to Toerag:

There's nowhere near 100000 ITU beds in the UK. You're out by a factor of 10 or more

Sorry

 DaveHK 20 Mar 2020
In reply to Deadeye:

> There's nowhere near 100000 ITU beds in the UK. You're out by a factor of 10 or more

> Sorry

Factor of 20 more like. There's about 5000 unless we're talking about something different?

OP Toerag 20 Mar 2020
In reply to Toerag:

Ah, it was 'overnight acute beds' in the link I found. Just found 4k 'critical care' in another page.

So, revised estimate:-

Worldometers reckons on a global 5% serious case percentage of reported cases, and there's reputed to be 4k ICU beds in the UK (let's round it up to 5k). Logically, this means the UK can handle a total number of 100,000 cases at any one time (assuming beds aren't needed for anything else, which we know is untrue - anyone know the bed occupancy ratio? In winter they're 50% full with normal flu patients).  The UK are at ~3250 as I write this and increasing at what is probably 35% per day (under-testing masking the true figure).  At 35% growth that gives the UK 2 weeks from today until the NHS is overwhelmed. If we drop to the 22% rate it's 25 days, and at 10% its 50 days.  The critical thing is that it's still going to happen even at that low rate unless we can increase the NHS' capacity. 

Post edited at 14:44
Deadeye 20 Mar 2020
In reply to Toerag:

> Worldometers reckons on a global 5% serious case percentage of reported cases, and there's reputed to be 4k ICU beds in the UK (let's round it up to 5k). Logically, this means the UK can handle a total number of 100,000 cases at any one time (assuming beds aren't needed for anything else, which we know is untrue - anyone know the bed occupancy ratio? In winter they're 50% full with normal flu patients).  The UK are at ~3250 as I write this and increasing at what is probably 35% per day (under-testing masking the true figure).  At 35% growth that gives the UK 2 weeks from today until the NHS is overwhelmed. If we drop to the 22% rate it's 25 days, and at 10% its 50 days.  The critical thing is that it's still going to happen even at that low rate unless we can increase the NHS' capacity. 

You really need to stop spewing out ficticious numbers.  Winter beds are not "50% full with 'flu patients".  Winter bed occupancy is typically 90-105%.


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