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Could Covid 19 actually save lives by reducing all cause mortality?

Disasters   (1,360 Views | 16 Replies)

myoglobin has 12 years experience as a ASN, BSN, MSN and specializes in ICU, trauma, neuro.

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Here's the thing in 2018-2019 the CDC said that "regular" influenza killed about 34,000 people in the United States and caused 490,000 hospitalizations

Estimated Influenza Illnesses, Medical visits, Hospitalizations, and Deaths in the United States — 2018–2019 influenza season

Now we don't yet know how many people (anywhere let alone the United States) that Covid 19 will kill, but consider ways that it might "reduce" not only influenza, but death from regular influenza, bacterial pneumonia, and other communicable diseases:

a.  Canceled "public" events and festivals may reduce venues that would transmit these other diseases.  How many less people will go on cruises?  That has to save at least a few lives from Norwalk virus and other things people would tend to get on cruises (including sickness from excessive eating and alcohol consumption).  

b.  Increased focus on things like hand washing and not touching your face (and even wearing masks) may translate to other diseased besides Covid 19 not spreading as easily.

c.  Those people under voluntary (or involuntary) quarantine might be in less of a position to catch or spread diseases other than covid 19.

d.  Even things like food poisonings and car accidents might be affected in a positive manner by people going out less or being more prudent in their safety behaviors (for example hand washing by cooks can help prevent the spread of Hepatitis A and maybe some cooks will wash their hands more (or longer) due to Covid 19.  

e.  Attempts to "optimize" nutrition to reduce the chances of getting Covid 19 (or reduce the chances of getting really sick if you do) by doing things like taking zinc, magnesium, vitamin C, garlic and turmeric, better hydration, and more sleep might translate into fewer MI's, strokes, and other infections. Also, when people have "subtle" symptoms of MI or CVA that they might otherwise ignore they might be more prone to see a health care provider due to fears that they are "coming down with Covid-19".

We should be able to look back in six months to a year to test this hypothesis.  Of course there are other aspects of behavior due to Covid-19 such as avoiding hospitals and health care providers due to fear of being around "Covid 19 sick people" that might increase morbidity and mortality.

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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

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I think there are more factors that could actually increase morbidity and mortality.  I don't think it likely that the population on the whole will increase health-enhancing behaviours over the long term.  People get complacent.

I do think that societies are healthier when people are able to move around freely.  Self-isolating out of fear has the same result, no matter if the fear is of illness, crime or a despotic regime.  Studies have long since shown that being part of a community has health benefits; isolation is associated with morbidity.

The biggest pitfall would be the strangling of commerce.  All the things we wouldn't do anymore translates to a lot of people not working anymore.  Everyone's bottom line drops.  With fewer tax dollars being paid there will be big hits to infrastructure and social programs.  Society as a whole starts to erode from the inside out.

A few good things might inadvertently come out of a pandemic but overall I don't think there's much of an upside.

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nznurse93 has 3 years experience as a BSN and specializes in ED, med-surg, peri op.

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This is ridiculous. there are way to many negatives to say this is good thing.

people taking better care of themselves and other is short lived. After coved 19 disappears, people will go back to normal. It will have no lasting effects. Particularly to the conditioned you mentioned. 

as for cancelling events, or people isolating themselves. This is not a positive. I don’t want to live in a nanny state. I want to live my life, enjoy it, not be controlled by fear. Also why I haven’t cancelled my travel plans to Asia. 

also people being hypersensitive about Covid 19, isn’t going help. It’s going to put more stress on healthcare systems that aren’t ready for this outbreak. When the hospital is stretched, health outcomes worsen, accidents happen, preventable deaths occur, staff become burnt out. 

I can’t see anything you’ve mentioned here being a positive. 

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canoehead has 30 years experience as a BSN, RN and specializes in ER.

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Over time, mortality is 100%.

Even if the things you say occur, OP, and they improve health, you're going to get negative effects from economic factors. But a good statistician can find numbers that prove most anything. Take your shot.

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myoglobin has 12 years experience as a ASN, BSN, MSN and specializes in ICU, trauma, neuro.

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I was thinking more along the lines of “complex emergent factors” such as what the authors of Freaksnomics found when they looked at things like declining birth rates and abortion contributing to less crime during specific periods in American history (in part because males between 16 and 30 commit more crime). Again, we should be able in 2021 to look back at influenza and all cause mortality and compare the 2019-2020 numbers to previous years. I for one have increased my hand washing about 200% so Given that I’m pretty much a lazy minimalist it wouldn’t surprise me if many others have done the same.

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46 minutes ago, myoglobin said:

I was thinking more along the lines of “complex emergent factors” such as what the authors of Freaksnomics found when they looked at things like declining birth rates and abortion contributing to less crime during specific periods in American history (in part because males between 16 and 30 commit more crime). Again, we should be able in 2021 to look back at influenza and all cause mortality and compare the 2019-2020 numbers to previous years. I for one have increased my hand washing about 200% so Given that I’m pretty much a lazy minimalist it wouldn’t surprise me if many others have done the same.

This can also be related to social media, people being more open with their sex lives, and people not having babies due to financial issues. Then there's the issue of increased suicides and changes in criminal law. Plus, crime stats have gone down in terms of numbers of crimes committed but intensity and severity of crimes have risen over the years and have been international which may skew numbers as well.

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CharleeFoxtrot has 7 years experience as a ADN, RN.

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1 hour ago, canoehead said:

Over time, mortality is 100%.

Even if the things you say occur, OP, and they improve health, you're going to get negative effects from economic factors. But a good statistician can find numbers that prove most anything. Take your shot.

Quote

Mark Twain wrote:

"There are three kinds of lies: lies, damned lies, and statistics" 

 

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KatieMI has 6 years experience as a BSN, MSN, RN and specializes in ICU, LTACH, Internal Medicine.

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COVID19, should the epidemy be let run its natural course, may decrease all-cause mortality within limited time AFTER the peak is over + some omega periods. Because of many high risk people who contact COVID19 will die as a result either in acute period or relatively short time after, there will be less of them to enter mortality stats right after epidemy is over. Omegas will cover mortality from short term complications such as vent-dependent respiratory failure. 

Omegas (standard deviation, aka time from contact to peak period as considered for standard Gaussian bell curve for "single contact" with chance for infection for susceptibles about 95%, as it is for measles) for COVID19 seems to be around 2 weeks. 

IMH(umble)O, only one positive effect of COVID19 outbreak in the USA might be full uprooting of current SNF business model. Apparently, in Seattle personnel was using positive valve bag masks which, in a sense, is a perfect thing to create heavy aerosol which the person applying mask is practically forced to breathe, because "they told us to use them" without having appropriate PPI, isolation techniques and enough trained staff. They ignored directions of firefighters who had appropriate training and knowledge. They just did what they were told to do, without any understanding, without ever thinking if what they were told made any freaking sense. 

https://www.cnn.com/2020/03/08/politics/coronavirus-washington-nursing-home-life-care-center-kirkland-cnntv/index.html

And now, I bet, someone there is sitting and thinking along the line "iwasjustdoingmyjob, iwasjustfollowingourpolicies".

This got to be stopped. 

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The virus is going to run through the population of the USA. We have already guaranteed that widespread infection with our tepid testing. Most workers in most settings are not prepared to prevent causal contamination through the course of a day on the job.  A quarter of American workers don't have paid sick time and cannot self quarantine. 

This is going to be an interesting social experiment. We are the test subjects. 

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1 hour ago, KatieMI said:

COVID19, should the epidemy be let run its natural course, may decrease all-cause mortality within limited time AFTER the peak is over + some omega periods. Because of many high risk people who contact COVID19 will die as a result either in acute period or relatively short time after, there will be less of them to enter mortality stats right after epidemy is over. Omegas will cover mortality from short term complications such as vent-dependent respiratory failure. 

 Omegas (standard deviation, aka time from contact to peak period as considered for standard Gaussian bell curve for "single contact" with chance for infection for susceptibles about 95%, as it is for measles) for COVID19 seems to be around 2 weeks. 

 IMH(umble)O, only one positive effect of COVID19 outbreak in the USA might be full uprooting of current SNF business model. Apparently, in Seattle personnel was using positive valve bag masks which, in a sense, is a perfect thing to create heavy aerosol which the person applying mask is practically forced to breathe, because "they told us to use them" without having appropriate PPI, isolation techniques and enough trained staff. They ignored directions of firefighters who had appropriate training and knowledge. They just did what they were told to do, without any understanding, without ever thinking if what they were told made any freaking sense. 

https://www.cnn.com/2020/03/08/politics/coronavirus-washington-nursing-home-life-care-center-kirkland-cnntv/index.html

And now, I bet, someone there is sitting and thinking along the line "iwasjustdoingmyjob, iwasjustfollowingourpolicies".

This got to be stopped. 

However, I also think the slow response of the CDC and Washington state department of heath plays a factor in this situation too. 

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KatieMI has 6 years experience as a BSN, MSN, RN and specializes in ICU, LTACH, Internal Medicine.

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1 minute ago, egg122 NP said:

However, I also think the slow response of the CDC and Washington state department of heath plays a factor in this situation too. 

And these, too

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I think as we are going into Spring time with warmer temps it will die out here soon.  

I'm honestly most disturbed that people don’t normally wash their hands and disinfect surfaces.  I already have tons of Clorox wipes, hand sanitizer and soap as I got to Costco once a month and stock up.  I regularly disinfect all surfaces in my house.  Door knobs, light switches, appliances.....  Now I go for my monthly stock up and it’s all gone at stores with signs that people are limited on how much they can buy.

Thankfully I still have a small stockpile until stores restock.

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