Adonis Diaries

Posts Tagged ‘mortality rate

There are two problems with this question.

  1. It neglects the law of large numbers; and
  2. It assumes that one of two things happen: you die or you’re 100% fine.

The US has a population of 328,200,000. If 1% of the population dies, that’s 3,282,000 people dead.

Three million people dead would monkey wrench the economy no matter what.

That more than doubles the number of annual deaths all at once.

The second bit is people keep talking about deaths.

Deaths, deaths, deaths. Only one percent die! Just one percent! One is a small number! No big deal, right?

What about the people who survive the affliction?

For every one person who dies:

  • 19 more require hospitalization.
  • 18 of those will have permanent heart damage for the rest of their lives.
  • 10 will have permanent lung damage.
  • 3 will have strokes.
  • 2 will have neurological damage that leads to chronic weakness and loss of coordination.
  • 2 will have neurological damage that leads to loss of cognitive function.

So now all of a sudden, that “but it’s only 1% fatal!” becomes:

  • 3,282,000 people dead.
  • 62,358,000 hospitalized.
  • 59,076,000 people with permanent heart damage.
  • 32,820,000 people with permanent lung damage.
  • 9,846,000 people with strokes.
  • 6,564,000 people with muscle weakness.
  • 6,564,000 people with loss of cognitive function.

That’s the thing that the folks who keep going on about “only 1% dead, what’s the big deal?” don’t get.

The choice is not “ruin the economy to save 1%.”

If we reopen the economy, it will be destroyed anyway. The US economy cannot survive everyone getting COVID-19.

Edited to add:

Wow, this answer has really blown up. Many people are asking about the sources, so here’s the basic rundown:

This model assumes that the question’s hypothetical is correct and the fatality rate is 1%.

It also assumes for the sake of argument 100% infection.

(In reality, neither of these is a perfect match to reality. The infection rate will never hit 100%, but the fatality rate in a widespread infection is likely to be greater than 1%, because health care services will be overwhelmed.)

The statistics I used in this answer were compiled from a number of different sources.

I spent quite a bit of time writing the answer. Unfortunately, I don’t have my search history in front of me, so I’ll attempt to re-compile them.

Some of the sources include:

What we know (so far) about the long-term health effects of Covid-19

Physicians have also reported an increase in inflammation of and damage to the heart muscle in Covid-19 patients. One study published in March found that out of 416 hospitalized Covid-19 patients, 19% showed signs of heart damage.

Another study from Wuhan published in January found 12% of Covid-19 patients showed signs of cardiovascular damage. Other studies have since found evidence of myocarditis, inflammation of the heart muscle that can cause scarring, and heart failure in Covid-19 patients.

Now, physicians warn that Covid-19 survivors may experience long-lasting cardiac damage and cardiovascular problems, which could increase their risk for heart attack and stroke. Doctors also warn Covid-19 could worsen existing heart problems.

What We Know About the Long-Term Effects of COVID-19

“Some of the data that we’re getting now from the China studies, one study that was just published in JAMA Neurology showed that 36.4% of patients had neurologic issues,” said Dr. Sheri Dewan, neurosurgeon at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois. “One of the review articles that came out at the end of February discussed the possibility of virus traveling into the olfactory neurons, through the olfactory bulb, and into the brain.”

Lifelong Lung Damage: A Serious COVID-19 Complication?

“Holes in the lung likely refers to an entity that has been dubbed ‘post-COVID fibrosis,’ otherwise known as post-ARDS [acute respiratory distress syndrome] fibrosis,” said Dr. Lori Shah, transplant pulmonologist at New York-Presbyterian/Columbia University Irving Medical Center.

ARDS occurs when fluid builds up in tiny air sacs in the lungs called alveoli. This reduces oxygen in the bloodstream and deprives the organs of oxygen which can lead to organ failure.

Post-COVID fibrosis, according to Shah, is defined as lung damage that’s irreversible and can result in severe functional limitations from patients, such as cough, shortness of breath, and need for oxygen. […]

According to The Lancet, in a piece titled, “Pulmonary fibrosis secondary to COVID-19: A call to arms?,” the first series of hospitalized patients in Wuhan, China showed that 26% required intensive care and 61% of that subset developed ARDS.

What we know (so far) about the long-term health effects of Covid-19

Physicians report that patients hospitalized for Covid-19 are experiencing high rates of blood clots that can cause strokes, heart attacks, lung blockages, and other complications, Parshley reports.

For instance, physicians are seeing an uptick in strokes among young patients with Covid-19.

The blood clots also can travel to other organs, leading to ongoing health problems.

For instance, pulmonary embolisms, which occur when the clots block circulation to the lungs, can cause ongoing “functional limitations,” like fatigue, shortness of breath, heart palpitations, and discomfort when performing physical activity, Parshley reports.

Similarly, blood clots in the kidneys can cause renal failure, which can cause life-long complications.

Heart damage

Physicians have also reported an increase in inflammation of and damage to the heart muscle in Covid-19 patients. One study published in March found that out of 416 hospitalized Covid-19 patients, 19% showed signs of heart damage.

Another study from Wuhan published in January found 12% of Covid-19 patients showed signs of cardiovascular damage. Other studies have since found evidence of myocarditis, inflammation of the heart muscle that can cause scarring, and heart failure in Covid-19 patients.

Now, physicians warn that Covid-19 survivors may experience long-lasting cardiac damage and cardiovascular problems, which could increase their risk for heart attack and stroke. Doctors also warn Covid-19 could worsen existing heart problems.

The numbers in this answer were made from extrapolations about percentages of COVID-19 long-term effects reported in a range of studies on Google Scholar, assuming a hypothetical 100% US infection rate and a 1% fatality rate.

Of course, in reality, a high infection rate would cause the mortality and comorbidity rates to skyrocket, so if anything, these numbers are conservative.

Wear your damn masks, people.

 Ebola outbreak in West Africa harvest over 1,000 lives: Epidemiologist Perspective

The current case in point is Ebola viral disease that is spreading wildly in Liberia, Sierra Leon, Guinea, Nigeria and a few cases in Saudi Arabia

There has been much ranting and raving about closing our borders to people with Ebola infection (as if that were possible), even some misinformed speculation that the virus has been intentionally released.

Much Ado About a Fist Bump Study

h1

Ebola: A Nurse Epidemiologist Puts the Outbreak in Perspective

August 6, 2014 (Selected as one of best posts for the day)

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

We have a knack for taking any newly reported issue of legitimate concern entirely out of context, foregoing all common sense as we transform it into a danger of galactic proportions.

To me as a nurse epidemiologist, though, the central questions in this tragic outbreak are the same for Ebola as for any other disease:

  • How is the organism transmitted?
  • What is the risk of protected or unprotected exposure to the infected person?

Ebola is a blood-borne pathogen.

It’s spread in the same way as HIV, hepatitis B, or hepatitis C: when blood or other body fluids contaminate another person’s non-intact skin or mucous membranes.

None of these diseases is spread by casual contact.

And unlike HIV or hep B or C, Ebola is not a chronic condition; transmission occurs during acute infection, after the fever begins and the disease progresses. It is virtually impossible to contract the virus by walking past an infected person in the airport, or sharing a bus ride, or shopping in the same grocery store. (When you have high fever you don’t travel)

Preventing transmission.

Unlike for HIV or hep B or C infection, isolation precautions are implemented to prevent transmission of Ebola.

This is because bloody secretions, vomit, and diarrhea are typical symptoms as the disease progresses. Because of the resulting probability of exposure to the patient’s blood or bloody secretions/excretions, both contact and droplet precautions are used (i.e., gown, gloves, mask, and eye protection) in order to place a barrier between the infected person’s secretions and the caregivers.

Airborne transmission has not been documented—however, because of the potential for aero-solization of blood or bloody secretions/excretions, most experts recommend airborne isolation precautions as well (negative pressure room, N95 or greater respirators), if possible.

(Here’s a CDC table with recommendations regarding transmission precautions for Ebola in various clinical situations.)

Why the rapid spread in West Africa?

News reports of unchecked spread of the virus in West Africa have fueled global fears. However, a closer look at what’s happening makes it clear that two main groups of people have been at particular risk for Ebola infection:

  • close family members of those who are already infected
  • health care workers

There are risk factors unique to these groups in this region that have contributed to transmission.

It has been reported that many family members have continued to provide close personal care to their infected loved ones, without using any kind of protective gear. (Don’t attribute this to ignorance. If your two-year-old child were gravely ill, would you be likely to gown, glove, and mask? And even if you thought about doing so, do you have a large stash of these items at home?)

The repeated exposure of close family members to blood and body fluids inevitably leads in some cases to the contamination of mucous membranes or non-intact skin.

Postmortem care is traditionally done by families, and this also involves much intimate contact. Added to prolonged, unprotected exposure are health belief systems that can further increase risk.

Reportedly, family members in some of the outbreak regions deny the possibility of Ebola infection. They see their loved one’s illness as a curse, not a virus, and believe it can only be cured by a traditional healer.

For health care workers, risk is increased by the difficulties of maintaining full isolation precautions under these particular circumstances. Have you ever complained about suiting up for isolation because the gown, mask, and gloves make you too warm, even in an air-conditioned workplace? Imagine wearing all of this gear for a prolonged period of time in a high-temperature, high-humidity environment.

Western medical professionals who have worked under these conditions have noted how easy it is to unconsciously wipe their faces with their contaminated hands, as they try to keep the sweat streaming into their eyes from blurring their vision.

It’s not that personal protective equipment doesn’t work, but that difficult conditions and a high-pressure care situation can compromise the use of personal protective equipment (PPE), sometimes unnoticed.

Should we be worried in the U.S.?

In this age of global travel, it is inevitable that we will eventually see cases of Ebola in the U.S. Of course the prospect is sobering; though the virus is not spread casually, the mortality rate from Ebola infection is high. (As of August 1, there had been 1603 confirmed or suspected cases in this outbreak, with 887 deaths.)

However, given the infection-control resources and expertise of hospitals and health care providers, there is very little risk of the spread of Ebola in the U.S. The take-home points for health care workers are these:

  • This is a blood-borne pathogen. It is transmitted through contact of mucous membranes or non-intact skin with blood or body fluids.
  • Transmission is most likely to occur after fever develops and as the disease progresses.
  • If infection is suspected, ALWAYS inquire about the patient’s travel history. Ebola and other diseases don’t appear out of thin air. Look for a link to outbreak areas.
  • INSTITUTE ISOLATION PRECAUTIONS IMMEDIATELY. Policy in all health care organizations should specify that any clinical staff person can initiate isolation; if your policy limits isolation “orders” to physicians, change it.
  • Wear appropriate PPE.
  • Don and remove PPE as though someone’s life depends on it. Often, someone’s does. Unfortunately, we caregivers can be careless about suiting up because in most situations, we are not the people at risk.
  • But the patient down the hall to whom you’ve just carried MRSA (because of poor hand hygiene, messy glove technique, or a sloppily tied gown) can die from MRSA bacteremia or pneumonia.
  • With a disease like Ebola, or any emerging infectious disease that has not yet been fully defined (e.g., MERS), a “gatekeeper” should be stationed outside of the closed door of the patient’s room. The gatekeeper’s role: to ensure that only essential personnel enter the room, and to supervise the meticulous donning and doffing of protective gear.

For details on the pathogenesis, clinical presentation, epidemiology, and treatment of Ebola virus, see this still very relevant AJN article from several years back, free until the end of September.

Is the process of “Natural Selection” almost over?

Resurgence of Man-Made Selective processes?

In developed countries, 9 out of 10 kids reach the age of 21.

And every one of these survivors from infantile mortality (prevalent in underdeveloped countries) can spread his “deficient” genes as never before and generate “defective progeny“: medicine and hygiene engineering are permitting asthma patients to live beyond the age of 5 and live to be 80!

In the time of Shakespeare, 1 out of 3 kids lived to be 21 years of age, and barely lived to go beyond 40.

This ratio didn’t improve substantially, even in the time of Dickens, 3 centuries later...

If you visit the graves of the rich people, you’ll notice that most of the dead were children

In the 19th century, the rich people who had homes used wet towels on windows to block the nasty smells emanating from the river Thames.

It is no surprise that Charles Darwin criteria for “natural selection” was founded on mortality rate: The better fit had higher odds to survive, long enough, to procreate and propagate “fitter genes” in these harsh conditions of living…

Only in the last 7 decades did mankind experienced living to be over 60 of years.

And the modern criteria for natural selection is: “How healthy are the sperms? And is their count high enough to fecundate the females of mankind…?”

Evidences in modern day age are showing that the sperms tend “to lose direction and not focus on the target ovary and give up too early on their unique job… Lack of energy even at that stage?”

In countries with normal sperms, at least in count, the odds are that their people will survive, regardless of how plagued they are in famine, dying from curable diseases, malnourished, antiquated civil human rights, faulty public health…

Mind you that there is a difference between the notion of natural selection and the adaptive concept of mankind to the environment. For example:

People living in high altitudes developed intricate, vast networks of larger veins and arteries to facilitate the flow of blood in these rarefied oxygen climates. Their red blood count is almost the same with people living in seashores, otherwise, they’ll be dying like flies from blood coagulation…

People in tropical climates develop resistance to diseases carried by flies: They are infected, but many survive, long enough, to procreate under “favorable” customs and traditions…

Two decades ago, with the breakthrough in genetic engineering and medicines, many rich people are selecting the genes, tailored-made, to their choices in colors of hair, skin, eyes… The specialized hospitals and clinics do not make much fuss with their clients’s demands…

The technology is here for the trans-human clubs of the rich and powerful to “improve their genes”, but they are a very tiny fraction of the 7 billion of people who are resuming their life, as if nothing has changed…

This is another story for a special article relevant to the kinds of Singularity University, Peter Diamondis, Kurtzwel….Those believing that soon, the rich billionaires,  if they will it, will live to be eternal.

Eternal billionaires conversing with eternal people, sitting tight, and watching the billion of mankind dying every day, and having a blast

The bottom line for mankind survival is: “How to rejuvenate those lazy sperms, totally disoriented and going nowhere? What are the factors that are ruining the count and health of sperms…?”

Why the Western States are the most afflicted in their “manhood”?


adonis49

adonis49

adonis49

September 2020
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