With our last podcast discussing some of the key facts of COVID-19, it is worth discussing another important component: resource utilization. One of the scarier projections with a large outbreak is how resources can be used to their maximum capacity very quickly. We break down how COVID-19 is one example that can have disastrous consequences.
UPDATED POST ON 3/17/20 (quoted directly from Chip Lange's Facebook Post):
Some things that have me particularly annoyed with society right now regarding COVID-19 and I will explain why: 1. STOP comparing this to the flu. This is not like influenza. Sure, the numbers are lower in comparison in the USA right now, but there are multiple reasons why. Some of these are how early we are into the disease here, the lack of tests to confirm cases, and the misinterpreted data as a result. 2. STOP making this political. This is not a political crisis. This is a HUMAN crisis. Politics are not helping this situation. What will help is being united in our efforts to stop the progression and save lives. 3. STOP hoarding resources and panic buying. Not only do you limit access to those that truly need it but it puts further stress on infrastructure. Many of those too poor to buy mass quantities and have to live paycheck to paycheck are now without some of the essential goods they need. You also further help promoting the spread of infection when people cannot buy what they need to care for themselves and protect themselves from infection. 4. STOP sharing misinformation. Those magic remedies are just that: magic. Sharing memes that do not come from factual and well cited sources only hurt. Do not share them. This is propaganda and you become a part of the problem. 5. STOP going out and being in group settings. Infections like to spread between people and when we are close together we help promote the spread. Social distancing helps flatten the curve. More on that in a minute but also check the link below. 6. STOP saying everything will be fine and continue about your lives normally. Everything is not going to be “just fine” unless we do something about it first. At the rate the infection is spreading in the USA we share the same trajectory as Italy where more people die every day. Read the first hand accounts of well cited sources and they tell you that they acted the same way we are acting right now. 7. STOP thinking that you are “safe” and this does not matter. Our medical resources can not handle the strain of a full on pandemic. Those young and otherwise healthy have been dying right along with the elderly. Even those with little to no symptoms can cause the spread of the disease. People will die and more of them will if we do not follow the proper guidance and directions from trusted resources. Again, look at the link to see how quickly we can use up those resources. 8. STOP going to hospitals and clinics unnecessarily. These resources are strained right now and will be where the sickest patients go for care. Only come for true emergencies and realize that wait times may be even longer than normal. This also can sometimes lead to further spread of the infection as well as other infections such as influenza. 9. STOP and call before you go for testing. Your health department, clinics, and hospitals can give you information about where to go for testing without ever having to visit them. By seeing them in person you are exposing people unnecessarily and when they must be quarantined there are now fewer people who can help as this progresses. Check your local resources and call before going anywhere for testing. 10. STOP ignoring the scientists. If things go according to plan, you probably won’t realize how well this all worked and think this was overkill. Thank epidemiologists, public health servants, medical professionals, and scientists who have been working tirelessly to help come up with the best solutions. I hope we can take this seriously and move forward united. Please listen to this advice from someone who works in emergency medicine and has already had colleagues become seriously ill. I don’t want to lose my friends and family and I don’t want you to lose your friends or family either. ORIGINAL POST By now, many of us are aware of resource shortages: masks, hand sanitizer, and now even toilet paper. The panicked buying has led to finite resources being used up with little to none of it remaining. Now, imagine that in the medical setting. Not just the personal protective equipment (PPE) but even more importantly hospital beds and ventilators. If you work in the medical field, ask yourself how many critical care beds, ventilators, and other key life-saving equipment you have on hand. Then think about the number of people your community serves. At what percentage of that population getting infected will you be out of those resources? Here is an example:
Currently, we are seeing an exponential curve in growth in the United States. There are resources that can demonstrate how quickly this disease can spread through a population, but one clever version comes from the Washington Post that explains different scenarios. Going back to Janus General Community Hospital, even if this is spread out over the course of months, this hospital will be overwhelmed by patients. We could be conservative in saying that patients only need critical care beds for a week when they require ICU care. If there are 25 critical care beds and even only 1,000 patients that need that level of care, they would need to be spread out over 40 weeks to not overwhelm resources (1,000/25=40). That would also not factor in the usual patients who occupy those beds: those with sepsis from other causes, major heart attacks and strokes, trauma, and more. What happens when these people are all sick in the matter of weeks? This is why we have to flatten the curve. There are simply not enough resources for the patients who may need them most. Yes, many people will do well but there are also quite a few who will die if we do not respond appropriately. Many of these deaths can be prevented if the resources are not overwhelmed. It becomes an ethical nightmare that is often discussed with utilitarianism. For those of you having a hard time remembering this theory, remember the train that can go one of two directions. The train may kill 10 people or just one person stuck on the tracks. Here is where we can help. We can flatten that curve. The exponential growth curve does not have to be that way. There are already many organizations that are contributing. Schools, restaurants, beaches, and other public places are closing to help avoid the spread. The common goal is to help promote social distancing. By flattening the curve, even with more cases developing the rate will significantly drop overall and we can avoid the exponential growth curve continuing. What exactly is social distancing? It is the idea of avoiding close contact with other individuals. The idea is to help stop or at least slow down the spread of disease. While a quarantine may work, this relies on prompt identification and containment. With limited testing in many parts of the United States and other locations throughout the world, this becomes an even more difficult challenge. Add in the issues of patients with minimal to no symptoms and they can further contribute to the spread. By creating social distancing and limiting gatherings, those infected (known or unknown) are not able to spread the infection as quickly. This does not necessarily mean that all businesses need to close. Many schools are using virtual classrooms and people who can are working from home. It is an incredible effort that is being performed by groups big and small with the common goal of saving lives. While many of us have not seen this in our lifetime, this is something we should all help in. Flatten the curve and save lives. More resources for COVID-19 are available with the CDC, World Health Organization (WHO), and certain reputable online resources such as IBCC can all help as this continues to evolve. We encourage you to follow local and national guidelines. Let us know what you think by giving us feedback here in the comments section or contacting us on Twitter or Facebook. Remember to look us up on Libsyn and on iTunes. If you have any questions you can also comment below, email at [email protected], or send a message from the page. We hope to talk to everyone again soon. Until then, continue to provide total care everywhere. 
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