Friday, March 13, 2020

Understanding "the curve" and why the number of infections is important

I heard some statements today that were weird to me. Like, "The Italian healthcare system must be bad if they can't take care of their people." And, "How can the Italian healthcare system not be equipped to deal with emergencies." Then I realized that people have faith in their system and never had to think about how it works.

This is the thing; all healthcare systems around the world are dimensioned for handling a normal influx of patients with a mix of illnesses.

There is a finite amount of hospital beds, equipment, doctors, and nurses. Many western countries have 4 hospital beds per 1,000 inhabitants. That is 0.4%. The average for the USA is lower. On any given day, most of these spaces will be occupied by people with broken bones, cancers, heart issues, respiratory issues, child births, children with tummy aches, and so on.

Let's go with Manatee County in Florida where I used to live as an example. There's Blake Medical Center with 383 beds, Manatee Memorial with 319 beds, and Lakewood Ranch Medical Center with 120 beds. (There might be some other facility I've forgotten about, but these are the big ones.)

That adds up to 822 beds. The population of Manatee County is roughly 385,600. That means 0.2% of the population can be hospitalized at the same time - and at that point, the hospitals are at capacity. (I spent many nights waiting with Mike at Blake Medical Center, because they didn't have a spot for him, so they are full from time to time.)

Now, imagine that your already full hospital with 383 beds gets another 1,000 patients with the same medical issue at the same time. There's no way to make room for them. Unfortunately, all the other hospitals in the area have the same issue. And, your staff is specialized in pediatrics, oncology, rheumatology, and other things - none of which is infectious diseases.

This is a problem with no solution - it's like trying to pour a gallon of milk into a quart size jug.

This is what has happened in Italy, and it will happen to my country and to your country if we can't "flatten the curve." That really means spreading the cases out over more time. The same amount of people fall ill, but not at exactly the same time. Instead of getting 10,000 persons over the span of two weeks you may get them over a span of three months, giving the healthcare system a chance to help everyone.

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