Wednesday, March 11, 2020

Do Your Bit - Now, Go To Your Room

If it isn't one damn thing it's another.

Reduce your carbon footprint. Reign in needless consumption. Do this, do that and, when you're finished doing that, do this other thing. It ain't the freewheeling 80s any more.

So now we're being asked to wash our hands several times a day. Sporting events, concerts - give 'em a pass. Those who can, work from home. The Guardian has a helpful piece on how to convert that corner of your apartment for office Skype sessions. That'll come in handy when they start shutting down the schools (Seattle did that today) and somebody has to mind the kids.

It's not so much that you're going to keel over if you don't. It's that this virus business is going to put an immense strain on our healthcare system. It too is structured for optimal efficiencies. Whether it meets them or not is another matter. However it's not particularly resilient and it can break down. When it does, it's not just virus victims in jeopardy.

That was the message last week from Dr. Daniele Macchini, an Italian physician whose lengthy Facebook post was published in a local newspaper, translated into English and circulated on social media.

"And there are no more surgeons, urologists, orthopedists; we are only doctors who suddenly become part of a single team to face this tsunami that has overwhelmed us," he wrote. 
Three professors from the University of Milan also sent a letter warning doctors in the rest of Europe to "get ready," because 10 per cent of patients who test positive for COVID-19 end up needing intensive care.

"This situation is like a bomb that explodes, and you're simply overwhelmed by an incredible number of patients," another Italian physician, Dr. Giacomo Grasselli, told the CBC News Network this week.
Since we're losing the war to staunch the spread of Covid-19, the focus becomes on managing the problem, "flattening the curve."

"If you can slow it down enough and flatten the curve, so the same number of people get infected, but over a much longer period of time, then ... what you're allowing is that the capacity will not be exceeded," said Dr. Anand Kumar, a critical care physician at Winnipeg's Health Science Centre.

"And that protects the community, so that an ICU bed will be available when it's needed."
...Most healthy people will experience a mild COVID-19 infection because their immune system will protect them. But so far, the experience in Italy and China suggests that as many as 10 per cent of people infected can require critical care.

That creates an urgent need for beds in intensive care units, along with ventilation, dialysis and other life support technology. It also requires qualified health-care specialists to manage patients — excess capacity that Canadian hospitals just don't have.
You aim to modulate the population infected so that you don't have too many people in need of finite medical assistance at any one time. Covid 19 is a threat to your health but it may be an even greater threat to the resilience of Canada's healthcare system. Precautions that, at first blush, may seem excessive, even alarmist may be anything but.


Owen Gray said...

Our healthcare system is going to be pushed to its limits, Mound.

Marie Snyder said...

The Walrus has a good piece about how this virus differs from the regular flu virus despite the current low relative numbers of deaths. We often focus on the wrong data. And this Medium article has lots of graphs and math that all point towards the necessity of shutting places down after just a few confirmed cases. Waiting just an extra 24 hours can mean an exponentially larger number of cases. Hopefully those in power heed the warnings.

John B. said...

When's it going to start spreading through the hospitals? Should I be more frightened now by the hygiene horror shows I've observed over the years in most of our local facilities?

I know what we'll do. We'll contract it out to the bidder with the most disciplined approach to shareholder interests and labour cost arbitrage. Wait a minute. We already did that. Maybe there are a few more hidden gems in places we haven't looked yet and this new opportunity is likely to provide some.

The Disaffected Lib said...

For years, as the litany of global threats grew, I've been writing that the magnitude of the threats was meaningless except when in the context to our resilience. I used the example of the champion prize fighter. What made him champion was not just his punching ability or whether he could take a punch. It came down to his ability to weather a succession of blows and yet remain on his feet, capable of finishing off his opponent.

Comparisons are being made between Covid-19 and the Spanish flu of 1918. That is an apples v. oranges comparison. A century after the Spanish flu we're far less resilient.

Our economy in the neoliberal era has been honed to razor-edge margins. One example is the "just in time" inventory system in modern manufacturing that is absolutely dependent on perfect supply chains to reduce the costs of standby parts inventories. Profits are maximized until a link in that supply chain breaks which happened to the Ford F-150 when a supplier's factory was destroyed by fire.

In 1918 a death was tragic but it often meant just one less plate on the dinner table. People still had their jobs. They still knew how to grow their own food. They bounced back. Our society is not theirs, would that it were. We have no reserves, no effective resilience.

Even our healthcare system has been honed to such an optimal state that it operates in ordinary times at full capacity. We have built into it a profound vulnerability when something like a pandemic hits.

Thanks for the heads up on the Walrus thing, Marie.

The Disaffected Lib said...

John, yes, you should be more worried about the dilapidated state of some of our vital health care providers. I know full well of what you write and you'll have no argument from me.