Italians are in general healthier then Americans. They have a significantly longer life span. Comorbidities for poor outcome include obesity, cardiovascular disease, DM and chronic pulmonary disease, hardly rare in the US.
IIlness lags infection, hospitalization lags illness, and need for ICU care lags hospitalization. This is why I believe the ERs are going to be absolutely slammed in 2 weeks.
We have no reason to believe we are not on the exact same trajectory as Italy,and now Spain and France.
The presidents action closing us to travel from China bought us 6 weeks we wasted thanks to the CDC. Now the cats out of the bag and there's not much we can do to mitigate this. Your opinion is its not going to be a big deal. All the evidence I can find (including the actions of the White House, watch what they do not what they say) indicate to me we are about to see something unprecedented in our lifetimes. One of us is going to be right and I hope to God it's you.
Thanks for the facts. We have a common point to discuss starting with this. Italy which has a regional hotspot has a mean age over 65. It is the second oldest region in the EU. Additionally the smoking rates are well in excess of 60%. Literature suggests that the greater comorbidity is long term smoking. HTN has been on and off the list. It I understand it is more the predisposition of using ACEi than the actually condition. Correct me if I am incorrect
As for transmission time. At first was the doomsday two weeks. Recent literature show mean incubation 3-7 days with five being the central tendency both mean median and modal. What else is unclear is what is the shedding period. If asymptomatic cases exist then we can surmise it would be hard to determine if there was a presymptom shedding. Hard to tell as most cases are mild or self limited (85-90%).
As for timeline. Symptoms to hospital +1.2 days. To ICU if necessary + 2 days. I also think that some of this may have previously been managed on the floor with NIPPV however with the panic I think we are possibly intubating more than under ordinary circumstance would have required ETT. This may be skewing the icu cases. In my experience thus far it looks like routine ARDS. Not seeing anything all that different both in terms of course and severity. I haven’t really seen any Pa/Fi gradients <100:1. Most are in the 150 range.
Assuming am incubation as described on the literature the time is at hand in the US. I don’t think our CoVId population is like the Italian population with CoVId. We shall see.