Corona-V,, what is "being prepared"?

[JJ_BPK]

My daughter and family live in London UK. so I spend time watching various UK news.
They have some of the most outlandish rags in the English speaking world, Nuff said..

BBC London hospitals facing 'tsunami' of coronavirus cases, Nick Triggle, Health correspondent @nicktriggle on Twitter


https://www.bbc.com/news/health-51714498

So, this BBC article this AM gets me thinking.

What is the correct number of medical anything(masks, ventilators) that a nation should have and be prepared to deploy for emergency??

What concerns me is the number of confirmed cases in the UK, based on the total population seem very small and their concern problematic.

Population: 66,440,000 (England, Wales, Scotland, N Ireland)
Confirmed cases: 9529

9529/66,440,000 gives a incident of 1.44e-4, or 00.0144 % of the population.

And they are calling it a tsunami

The USA numbers are slightly higher.

Population: 330,000,000
Confirmed cases: 69,179
incident of 2.06e-4, or 00.0206%

World lower
Population: 7,800,000,000
Confirmed cases: 487,648
incident of 6.251897435897436e-5, or 00.00625%

How does the World medical community plan for "tsunamis"?
With an incidence rate of less the 2/100 of 1%, it sure seems like someone missed the bus

Granted, someone will say what if the numbers double, Tripple, go up 10 fold??

10 fold is 2/10 of 1% of the US population???

Mumblings of a VFOG..

[Ret10Echo]

I'll leave the real comments and feedback from the medical professionals and logisticians.

My thought is that there are some challenges with expiration dates for stocked items and maintaining that stock of items through rotation etc.

If nothing else the current state of affairs brings to light a number of things some of which are

1. We don't "learn" from our plans (2005 - 2006 Pandemic flu planning?????)
2. The bureaucracy is not designed to respond to real world events (USDA approvals, surge medical practitioner licensing)
3. We don't make much here and have a supply chain that is dependent upon "frenemies" and politics.
4. Socialized medecine would not improve anything

[JJ_BPK]

I will add, I am talking about items that are universally used, eg masks & ventilators, not vaccines and cures for something not invented yet.

[mugwump]

Originally Posted by JJ_BPK

I will add, I am talking about items that are universally used, eg masks & ventilators, not vaccines and cures for something not invented yet.

Tough, very tough. No one figured on a 30 day hospital course for some folks in a pandemic before COVID, which affects PPE needs.

I’d look at Singapore, the gold standard, and say “At least that many PPE sets.”

Estimate the CFR that crashes the grid, and back off from that because no point if the grid is down. Figure worse case stay, attack rate, and expected protocol for PPE use.

Everything is so different though. Vents were expected to be less use in H5N1 than this disease, for example. But that flu's CFR was apocalyptic so...

It’s going to be cheap insurance whatever the cost.

[Flagg]

Originally Posted by JJ_BPK

My daughter and family live in London UK. so I spend time watching various UK news.
They have some of the most outlandish rags in the English speaking world, Nuff said..



So, this BBC article this AM gets me thinking.

What is the correct number of medical anything(masks, ventilators) that a nation should have and be prepared to deploy for emergency??

What concerns me is the number of confirmed cases in the UK, based on the total population seem very small and their concern problematic.

Population: 66,440,000 (England, Wales, Scotland, N Ireland)
Confirmed cases: 9529

9529/66,440,000 gives a incident of 1.44e-4, or 00.0144 % of the population.

And they are calling it a tsunami

The USA numbers are slightly higher.

Population: 330,000,000
Confirmed cases: 69,179
incident of 2.06e-4, or 00.0206%

World lower
Population: 7,800,000,000
Confirmed cases: 487,648
incident of 6.251897435897436e-5, or 00.00625%

How does the World medical community plan for "tsunamis"?
With an incidence rate of less the 2/100 of 1%, it sure seems like someone missed the bus

Granted, someone will say what if the numbers double, Tripple, go up 10 fold??

10 fold is 2/10 of 1% of the US population???

Mumblings of a VFOG..

I have a graphic that shows the UK # of hospital beds(all types: General, day, mental health, maternity):

300k in 1987 (56m pop)

150k in 2016 (66m pop)

58% reduction in bed spaces per person.

[JJ_BPK]

Originally Posted by Flagg

I have a graphic that shows the UK # of hospital beds(all types: General, day, mental health, maternity):

300k in 1987 (56m pop)

150k in 2016 (66m pop)

58% reduction in bed spaces per person.

Dare I say social medicine at it's finest?

Love to get a copy or source. when you get a chance..

[Flagg]

Originally Posted by JJ_BPK

Dare I say social medicine at it's finest?

Love to get a copy or source. when you get a chance..

Source: NHS England 2017

Here is a link to the graphical comparison on another forum(I couldn’t upload):

https://www.militaryimages.net/threa...970/post-81595

[JJ_BPK]

Originally Posted by Flagg

Source: NHS England 2017

Thanks, Flag (From The Land of Misfit Toys)

Using the image, I found the source(S) document.

Facts & Figures: Thirty Years of NHS Bed Numbers, Promedical, undated

The issue of NHS hospital beds – specifically the number of them available to patients – has gradually climbed the list of pressing issues for the NHS and in the media. We could say that the issue has never fully gone away, being inextricably linked with that of waiting times, and has been a mainstay on the sidelines, especially in recent times.

With rising concerns, about the budget deficit the NHS is being forced to turnaround, the long-term future of the NHS and the rise of waiting times, the number of hospital beds has quickly become a hot button issue. In a new report, published by The King’s Fund, researchers have looked at the issue of hospital bed numbers over the last 30 years and have revealed some startling information.

Here are the key points:

• The number of beds available to general and acute, mental illness, learning disability, maternity and day-only beds patients has dropped by more than half in 30 years.
• 299,000 beds available in 1987 and only 142,000 in 2017.
• Meanwhile, the number of patients using the NHS has seen a significant increase.
• While other comparable health care systems in the world have also cut numbers of beds the UK has cut more relative to its population.
• In the last thirty years the biggest reductions have come at the expense of mental health and learning disability patients.
• Since 1978/1988 beds available to general and acute patients has dropped by 43%. Meanwhile healthcare developments mean patients spend less time in hospital.
• Findings show that rate of bed number reduction has decreased in recent years.

link to source

ADDED: As the ProMedical posting above, didn't have a quote or source other than NHS UK, I did some more digging and found this KingsFound report that looks like the actual source for the data used in the chart.

https://www.kingsfund.org.uk/publica...al-bed-numbers

The King's Fund is an independent think tank in England, which is involved with work relating to the health system in England. It organises conferences and other events.

[Flagg]

That’s a massive haircut JJ.

Any idea what the # per person in the US is over a similar time range?

I’ve read stories of reducing hospital stays(such as maternity and outpatient surgery) as much as possible that would be indicators of a general trend in the west.

I wonder how much minimal access surgery has impacted on reducing the need for hospital bed/nights?

But leaving limited scope for surge capacity?

[JJ_BPK]

Not a bean counter, and would imagine trying to chart reasons would be impossible.

BUT the medical industry is trending

USA drivers
Profit (doctors, hospital, insurers)
Medicare.. with input from the above

UK
Free Medicine means taxes go up or services go down.

[The Reaper]

Originally Posted by JJ_BPK

UK
Free Medicine means taxes go up or services go down.

Or both.

TR

[Badger52]

Originally Posted by The Reaper

Or both.

TR

Yup. Here's some info using one of Bernie Sanders' benchmark examples:

Danish hospitals also have high patient turnover rates. These rates are partly the result of improved treatment modalities such as noninvasive ventilation of patients with chronic obstructive pulmonary disease and invasive cardiac procedures that result in quicker patient recovery. However, they have also been driven by a steady reduction in the number of hospital beds during the past three decades, even as the number of admissions has remained relatively constant. The combination of high patient turnover, fewer beds, and improved treatments has resulted in a decrease in the average length-of-stay in Denmark’s hospitals. That length-of-stay was 6.0 days in 2003, down from 7.4 days in 1998.
.....
Emergency medicine in Denmark is organized in a way that contrasts with the system in the United States. Until recently, there have been no EDs in Danish hospitals. Instead, patients are admitted directly to the indicated hospital department, which strains those departments’ capacity. Hospital departments cannot deny admission to patients. In the United States, EDs in hospitals tend to experience crowding, since patients arrive in EDs seeking acute care and cannot legally be turned away.

Emergency medicine is not yet a specialty in Denmark, and EDs comparable to those in North America have been introduced only recently. In Denmark, acute care is organized as a three-level system in which general practitioners take care of the majority of patients on a twenty-four-hour basis.

The article (from back in 2014) isn't Coronavirus-specific but was examining bed occupancy rates as a factor in patient mortality. Thought it interesting as the Socialists seem to like to hold this one up as a way things should work.

Theory doesn't seem to prepare one for a cataclysm however. Not meant to derail from the ongoing discussion but thought their approach interesting in its contrast.

[Flagg]

Originally Posted by JJ_BPK

Not a bean counter, and would imagine trying to chart reasons would be impossible.

BUT the medical industry is trending

USA drivers
Profit (doctors, hospital, insurers)
Medicare.. with input from the above

UK
Free Medicine means taxes go up or services go down.

https://en.wikipedia.org/wiki/List_o..._hospital_beds

Not sure if correlation is causation, but....

South Korea & Japan seem to be weathering COVID-19 better or much better than the average.

I wonder what role hospital beds per capita plays in that?

But I’m aware not every hospital bed-type is the same.

[JJ_BPK]

Originally Posted by Flagg

https://en.wikipedia.org/wiki/List_o..._hospital_beds

Not sure if correlation is causation, but....

South Korea & Japan seem to be weathering COVID-19 better or much better than the average.

I wonder what role hospital beds per capita plays in that?

But I’m aware not every hospital bed-type is the same.

1)A lot of variables, The major one is the Eastern mindset when it comes to family, especially senior members. They don't use DNR squads

2)Japan is similar to the USA, in that most are privately insured, costs shared between employer & employee. And universal for all the rest. Although it looks like students are responsible for their own insurance. (link 1)

link 1

3)Japan is at the top of the list of beds per 1k, while the USA is 32nd. Curiously, the USA is marginally better than several countries with universal health. Beds per 100k may not be a useful marker? (link 2)

link 2

[Flagg]

Originally Posted by JJ_BPK

1)A lot of variables, The major one is the Eastern mindset when it comes to family, especially senior members. They don't use DNR squads

2)Japan is similar to the USA, in that most are privately insured, costs shared between employer & employee. And universal for all the rest. Although it looks like students are responsible for their own insurance. (link 1)

link 1

3)Japan is at the top of the list of beds per 1k, while the USA is 32nd. Curiously, the USA is marginally better than several countries with universal health. Beds per 100k may not be a useful marker? (link 2)

link 2

Cheers!

Yes, it was interesting to see US & NZ ranked next to each other in hospital beds per capita.

We have a 2 tier health care system.

Universal with a private layer on top for those who want to pay for additional coverage.

Universal care is broken up by regions/districts here.

And we have a similar mix of dense urban, suburban, and rural.

So I think there will be relevant and potentially useful comparisons to be made, but mindful that less than useful comparison are often made to suit agendas.

We are on Day 4 of a 4 week(minimum) mandatory lockdown.

If I had to guess, NZ will be fine from a public health perspective.

But this isn’t just a pandemic, it’s another global financial crisis that has to be remedied concurrently,