The problem is not yet getting better. Here's the latest US graph of number of infections as of two days ago:
I'm listening to today's Cuomo press conference about the situation in New York. I'll try to avoid repeating information provided in previous press conferences. The epicenter is New York City, about 200 miles from here.
He reported some preliminary news that is good if it holds up, that the hospitalization rate may be declining. On Sunday it was doubling every 2 days, on Monday every 3.4 days, on Tuesday every 4.7 days. It's too early to rely on this data because the average incubation period for the coronavirus is 5 days, and it seems rather soon for there to be a measurable positive effect, particularly since there has been such a huge compliance problem, particularly among young people.
Cuomo is bringing the hammer down in New York City. Congregating in parks is disallowed, as are all contact sports such as basketball. If this isn't followed parks will be closed. Some streets are being closed to vehicular traffic to make more room for pedestrians to get out.
Cuomo estimates that the maximum level of hospitalizations will occur in 21 days. He says that hospital capacity will be increased to 100,000 beds but that 140,000 are required. He believes that 140,000 people will be hospitalized simultaneously at the epidemic's apex. Since only 15% of those infected require hospitalization, doing the math says that he believes the number of infections will be north of a million people. Since the number of infected in New York is currently 30,811, Cuomo believes the number will rise by over 3000% in just three weeks. With a population of 20 million, that would mean that 5% of all of New York would be infected.
Naturally their hospital system would be far overwhelmed, even more as health workers take sick. This will affect everyone, not just coronavirus patients. A heart attack, not normally a death sentence these days, would entail longer response times and insufficient medical staff and equipment and a much higher likelihood of an adverse outcome.
Cuomo reported that yesterday in a conference call with hospital administrators he told them to increase capacity by 50%, and some 100%. The US Navy Ship Comfort has 1000 beds. All state dormitories in downstate area near New York City number 29,000, and their possible use is being explored.
They're combing the world for equipment. They have enough for present requirements, but not for further out than three weeks.
They have 4000 ventilators, federal government has supplied 4000, they've purchased 7000 more, and they're exploring splitting ventilators between two patients. They're working with federals to find more ventilators. Once the New York crisis is over the ventilators would be made available to other states. They're trying to encourage the production of more ventilators, but the need is coming up very soon, before increased production can happen, as much as major companies might want to volunteer their help.
A mental health hotline and an online capability have been set up, completely free. 6000 mental health personnel have volunteered their services.
Cuomo spoke with President Trump last night and this morning, as well as with other persons on the federal task force (Pence, Kushner, etc.) about various issues, including redeploying equipment and personnel to the next hotspot after the New York crisis is over.
The $2 trillion coronavirus assistance bill is not good for New York because its allocation is only $3.8 billion, New York City $1.3 billion, and they need well north of $15 billion.
28% of all testing nationwide has been done in New York. Testing is being done in the most dense areas. Anyone who has symptoms can get a test. Testing shows a slowing of the exponential increase in infections.
Cuomo then opened up the conference to questions, I stopped at this point, here's the video:
The two patients must have similar lung capacity and body size.
It's far more than just getting a Y-hose. My late wife was on a ventilator for three weeks in 2010. Ventilators aren't just dumb air pumps. They have parameters, such as the size of the tube in the throat. You'd have to fake those somehow. They measure lots of things such as backpressure and flow rate (and its time dependency) and use them as feedback in controlling the pumping. You'd have to set unusual high and low limits on those and maybe even change the parameters of the feedback loop (probably disallowed under normal circumstances).
I wouldn't be comfortable with hooking up another patient on my wife's ventilator other than some last resort.
quote:Officials were told that morgues in the city are expected to reach capacity next week, per the briefing. A third person familiar with the situation in New York said that some of the city’s hospital morgues hit capacity over the last seven days. And a FEMA spokesperson told POLITICO that New York has asked for emergency mortuary assistance. Hawaii and North Carolina have asked for mortuary help as well, and the disaster response agency is currently reviewing the requests, according to the spokesperson.
Kinda very, very long. I skimmed it but think I have the essence: put the hammer down now and stop all interaction that is non-essential. Implement extremely widespread testing as quickly as possible so people don't circulate in the population before they know they're infected.
It's a little over 6,000 words. You typically write more than that in a hour.
The article argues that the approach attempted until recently by countries such as Holland and the UK is doomed to cause many deaths, and may not even achieve the stated goal of herd immunity.
It further argues that given time we will be able to deal with this virus, either by finding a cure or effective treatments, or by ramping up supplies. Therefore, we need to buy time. If the virus is already spreading in a particular location, aggressive restrictions are needed to quickly bring this under control. After a few weeks; measures can be lightened and applied selectively to keep contagion below a manageable level.
The latter approach requires extensive testing and intrusive surveillance of people's lives such as is being done in Korea (intrusive surveillance is not how the article puts it, that's my interpretation).
I have to admit, although I am not fond of many of Cuomo's policies, he is being clear, concise, thoughtful, and empathic in this. He actually has reasons and a plan, and is not white washing things to make it look better.