REALISTIC MATHS AND COVID-19

 Key Points

• Statistics about COVID-19 or effective treatment are not yet stable
• Without everyone taking personal care up to 31% of the world's population could be infected
• Of those who contract COVID-19, the prognosis is good
• There is an immediate and increasing need for planning and triaging the management of those diagnosed as positive for the virus
• Present 'over-the-top' care is not sustainable 
• Limited or lack of resources in some countries can contribute to the world's infection rates
• It is critical that developed countries plan how to better manage/stretch medical resources, to review diagnostic and isolation protocols now to ensure those who require focused critical care can find it.

Let's Get Real 

Returning to the overall stats about COVID-19 as we know them today (see previous segment) it is important to be realistic and not panic.  

The disease may have been active as early as mid-November with no monitoring or collecting of observed behaviours of patients. 

Even today the accuracy of data is not complete (but is growing more stable) but does offer hope if we act now, take sensible, self-precautions and do not panic into a 'walking dead' mode of behaviour.

At this stage, the estimates are that COVID-19 may infect up to 30% of the world's population.  Of those infected the breakdown continues to offer hope and optimism.

• 81% - Mild Cases - of those infected will contract a mild case.  Without the diagnostic test, the infection could seem just 'the flu'. 
• 10% to 14% - Critical cases - of those infected are at risk to ultimately be infected with a serious form of the virus. 
• 7% - Death rate - out of this population of critical cases result in death.

Critical Care and Isolation

Not all hospitals are large enough to have an intensive care unit.  If they do, it is small with only a few beds because each bed represents the ultimate of care.  The beds are usually full as new patients are moved in and out.  

Typically, for each patient is assigned dedicated doctors, nurses, specialist practitioners, all responsible for identifying diagnostic and treatment requirements.

Additionally, these critical patients need heart monitors, respirators/ventilators to manage breathing, multitudes of tubes and other monitoring and testing devices, etc.  There are requirements for radiologists, lab technicians, respiratory and physical therapists, dietitians and those who maintained feeding tubes, change linens, etc. and practical nursing care.

Early Days 

These are the early days with COVID-19, so the ratio of health care providers, infrastructure and equipment is easy to provide (although the run on masks is already causing concern for those on the front line of caring for these highly infectious patients).  

Researchers do not have the full picture of COVID-19, so each infected patient is put in isolation (a room of their own).  All necessary safety protocols and procedures for a highly-contagious disease have to be in place, monitored and documented for future discovery.  

Fresh protective gear, masks, gloves and goggles need to be used for every visit with the patient.  Every time a health care provider leaves a patient's room, they must dispose of the contaminated gear.  Everything going into and taken from their room needs extra care and handling to ensure the virus does not spread and so no additional dangers are introduced.

With the need to isolate each patients for at least 14 days, consider the number of beds available within each treatment facility -- they are limited as cost utilisation initiatives have been shrinking our health care capacity for decades.

Current Procedures Won't Continue - They Can't 

Today, when someone arrives at their doctor's, a clinic or hospital emergency room who is suspected of being infected with this new virus, they are being given 'over-the-top' care.  Each infected person is sort of a 'guinea pig' to be observed and case notes taken and shared to help when the next person presents.  

Of great concern, many countries are totally unprepared for any of this and the health care infrastructure, even basic hygiene is missing.  Even the countries who take pride in their preparedness will be surprised should the virus not be contained quickly. 

Consider the Costs

Right now, with so few patients it is possible to lavish care on each individual’s diagnosis, treatment, support and confinement from the moment they are identified as being infected.  The costs per patient at this stage would be astronomical (and well worth it). 

However, as more cases are identified, the ‘quantity’ of care will, of necessity have to lower as fewer health care providers will be available per infected individual.  Also, supportive care tools, instruments and devices will be dramatically stretched.   We are in the time to prepare.

How to Help Protect Yourself and Others

Please take practical precautions.

There are still many unknowns about this new disease, that has been designated a pandemic (meaning world-wide consequences).  However, there are some things you can do to try to protect yourself and others around you.  They need to be followed consistently during this time:

1.      Avoid crowded places and public transportation – so self-quarantine when possible.

2.      Avoid touching surfaces and shaking hands.  You may wish to wear gloves when you know you will be out and about.  At this time, in Australia, non-latex gloves are available in boxes of 100 pairs and reasonably priced.  They need to be taken off and disposed properly.  (More on the use of gloves in a later post.)

3.      Wash your hands thoroughly with soap, scrubbing vigorously if you’ve been out in the public or exposed to someone suspected of having the virus.

4.      It is coincidentally flu season, so many may feel ill and more than usual may want to go to the hospital or doctors.  Try to avoid this.  If you feel you need help, call a health provider (doctor, clinic, hospital emergency room) rather than showing up and having to wait with other unwell people who may be infected and not know it.  Self-quarantine may be the best choice.  (In Australia the support of phone-based and visiting doctors is a great benefit.)

5.      Because this is a virus rather than a bacterium, the ‘virus germ’ is much smaller than a bacterium.  Additionally, because the COVID-19 virus is well protected by a barrier, unlike bacterium, it does not die easily when inadvertently deposited on a surface.

6.      Hand sanitisers (that rely on alcohol) have not been found to be effective, although they do give a sense of doing something and may be most effective in reminding you to keep your hands clean and away from your face.

7.      Face masks may be helpful, but they must be of the proper type (N-95 Mask – more in another segment of the blog on masks and proper wearing of them).  They must be worn correctly (again the virus is very small) and will slip through little cracks and porous materials.

8.      Glasses (or goggles) may also be helpful should you be exposed to someone who coughs or sneezes nearby as these droplets are small and travel through the air and may land on your face and eyes.

For Australians, this resource may be of interest:  An overview as of the 8th February by the Australian Broadcasting Corporation:  https://www.youtube.com/watch?v=pR0lgj0N2DI

HINT:  It may be good to buy a few masks now while they are available and not priced for the market value (meaning when there is a great need someone will sell the masks but at a hugely inflated price).  It may be good to also have some other basic supplies on hand, as you may find yourself quarantined.