From my new column in Taki’s Magazine:
The good news is that we actually have flattened the curve. Even in New York City, few hospitals are overwhelmed, and in much of the country, such as California, the situation is better than epidemiologists were predicting only a month ago. For example, in Los Angeles County, home to 10 million people:
Roughly 1,059 people in L.A. County are hospitalized for COVID-19, the disease caused by the coronavirus. Of those, 18% are in intensive care and 15% of those patients are on ventilators.
About 0.0016 percent of the residents of L.A. County are on ventilators: not a huge number for an immense urban area that holds 3 percent of the country’s population. In general, California hospitals are rather empty at the moment. …
Unfortunately, one of the reasons that we don’t have as much of a ventilator shortage as was expected is because ventilators aren’t working very well. The success rate of patients getting better on ventilators is depressingly low. This awareness has, in turn, relieved pressure on ICUs and hospitals in general.
Read the whole thing there.
Here’s a new NYT article on how NYC doctors are much more reluctant to intubate than they were a month ago. Instead, they first try having patients with low levels of oxygen in their blood lie face down or on a side with an oxygen mask. (This is my vague impression of Boris Johnson’s treatment.) That often works, and it’s vastly less work for the hospital staff than monitoring a patient on a ventilator.
“Intubated patients with Covid lung disease are doing very poorly, and while this may be the disease and not the mechanical ventilation, most of us believe that intubation is to be avoided until unequivocally required,” Dr. Strayer said.
This shift has lightened the load on nursing staffs and the rest of the hospital. “You put a tube into somebody,” Dr. Levitan said, “and the amount of work required not to kill that person goes up by a factor of 100,” creating a cascade that slows down laboratory results, X-rays and other care.
By committing all the resources of the hospital to highly complex care, mass mechanical ventilation of patients forms a medical Maginot line.
For heavier patients, Dr. Levitan advocates combining breathing support from a CPAP machine or regular oxygen with comfortable positioning on a pregnancy massage mattress.
It’s not clear if hospitals have managed to find a better treatment for acutely ill patients, but they have managed to figure out a better treatment for not overwhelming hospitals, which is a very good thing.