I predict that in 3-4 weeks time there will be significant discussion brought to light by academic epidemiologists on Twitter about COVID-19 as a possible extinction event. I could be wrong, but let's look at the numbers. We have a contagious disease that is as deadly as the 1918 pandemic with all of modern medicine being thrown at it. In 1918, the 5% of critically ill covid-19 cases would surely have died - excluding those rare minor miracles. A higher percentage of patients requiring admission, but not intubation, would also surely pass away.
Nobody is certain that we will be able to keep up a sophisticated level of care, and in that case you're looking at a significant jump in mortality rate as critically and moderately ill patients cannot be treated due to the overwhelming surge.
COVID-19 is not showing many signs of being susceptible to weather. Hot and humid locations across our own country are seeing their own exponential outbreaks. Any flattening of the curve will only last until social distancing measures are lifted. Nobody can be absolutely certain that active immunity (antibodies made after an infection) will last long enough to prevent yearly reinfection, and so there is the possibility that we'll see this return year after year.
Unless we develop a vaccine, we will have an endemic virus that infects 50-70% of our population and has a mortality rate that is 2-5x that of the spanish flu and will cripple a healthcare system that doesn't find a way to grow itself by 3-400% whilst protecting the workers.
The birth rate is only 1.8% folks. Essentially, we'll be spending 7% our of money and only getting 1.8% back in returns. The principle won't last forever and the human race will eventually go out of business.
At this point, we don't know the prevalence of COVID, as we have not done enough testing. However, respected scientists estimate the prevalence as 10 to 100 times higher than we think. That makes the mortality a lot lower than many report. The mortality is NOT the current confirmed deaths divided by the current confirmed cases. It is you who need to understand fractions and percentages. The larger the denominator, the smaller the number!
I'm suspecting there's a bit of an echo chamber ongoing where people are repeating the (comforting) thought that since there are surely way more cases than we know of, the case fatality rate must be much lower than reported. What that line of thinking leaves out is the very likely possibility that the number of deaths attributed to covid19 is lower than the actual number. For one, many patients die without getting tested, either due to code status or disease progression. For another, it would not have been uncommon even up to a few weeks ago for patients presenting with covid along with some other illness not to be worked up or even suspected. And of course a substantial number of the patients currently positive for covid19 will in fact die from it but merely haven't yet.
Lets a assume a 1% case fatality rate, for the sake of argument. That would mean every covid19 fatality missed from the official count would balance off 100 undiagnosed cases. The problem with assuming that the case fatality rate is actually 10 times lower than what has been measured so far is that to make that assumption, we have to estimate not only that theres 10 times more cases than we know about (which isn't entirely unlikely) but also that the numerator of the case fatality equation is accurate as reported. Unfortunately, it isn't.
In a society that didn't even know where diseases came from. They didn't know about bacteria, viruses, etc. They had no good healthcare and terrible hygiene. Things are very different now. And over half a decade still gives time for the development of a vaccine and treatment, not to mention reproduction. As long as people are reproducing, there is hope for the continuation of the species.
Not that it would necessarily be so awful if we weren't here. Sounds morbid, I guess. I am just thinking about all of the really awful things humans have done. Wars for winning land or access to waterways or to obtain spices, slaves, or minerals or just for ego or for so-called racial purity or some other arrogant insanity. Who do we think we are?
Specializes in NICU, PICU, Transport, L&D, Hospice.
7 hours ago, Kooky Korky said:
Not that it would necessarily be so awful if we weren't here. Sounds morbid, I guess. I am just thinking about all of the really awful things humans have done. Wars for winning land or access to waterways or to obtain spices, slaves, or minerals or just for ego or for so-called racial purity or some other arrogant insanity. Who do we think we are?
We think that we are the only sentient beings of any value on the planet...and we even like to classify some of the humans along lines of value.
Specializes in NICU, PICU, Transport, L&D, Hospice.
There's no reason for people to get so irritable over a discussion, right?
An extinction event would be any situation where a large number or high percentage of a species dies in a short period of time, right? That could be a catastrophic volcanic event, a celestial event like a meteor, or something like what humans have done to the animal kingdom. Or it could be a viral infection...
I'm not a believer that humans will become extinct because of this virus. But a nasty virus with no effective cure and no vaccine or long term immunity in a world with dropping fertility (I think the global fertility rate has halved in my lifetime) could dramatically change what humanity's footprint looks like. If humans consider the changing climate, changes in insect populations, bird populations, marine populations and the emergence of new and deadly viruses, it's easy to wonder if humans aren't more vulnerable than we believe.
We should protect ourselves and protect each other.
Meanwhile, I think it's an interesting discussion for some of us sheltered in, don't you?
Specializes in Psychiatric and Mental Health NP (PMHNP).
13 hours ago, Cowboyardee said:
I'm suspecting there's a bit of an echo chamber ongoing where people are repeating the (comforting) thought that since there are surely way more cases than we know of, the case fatality rate must be much lower than reported. What that line of thinking leaves out is the very likely possibility that the number of deaths attributed to covid19 is lower than the actual number. For one, many patients die without getting tested, either due to code status or disease progression. For another, it would not have been uncommon even up to a few weeks ago for patients presenting with covid along with some other illness not to be worked up or even suspected. And of course a substantial number of the patients currently positive for covid19 will in fact die from it but merely haven't yet.
Lets a assume a 1% case fatality rate, for the sake of argument. That would mean every covid19 fatality missed from the official count would balance off 100 undiagnosed cases. The problem with assuming that the case fatality rate is actually 10 times lower than what has been measured so far is that to make that assumption, we have to estimate not only that theres 10 times more cases than we know about (which isn't entirely unlikely) but also that the numerator of the case fatality equation is accurate as reported. Unfortunately, it isn't.
I understand your point. The important thing to remember is that this is so new that there is just a lot we don't know. Germany is trying to get a good random sample of COVID testing and the data should start coming out by end of April. This will give us a lot more info, and it will be an ongoing effort. At any rate, this is not an extinction event.
This is a pandemic of chronic disease. Diabetes and COPD and other almost COMPLETELY preventable diseases. That should be what stands out to you.
You do know this disease is also taking young people without comorbids? Stats just published for the State of Michigan R/T those who have died note that while median age is 72 the range is 20 - 107 years old.
Not that it would necessarily be so awful if we weren't here. Sounds morbid, I guess. I am just thinking about all of the really awful things humans have done. Wars for winning land or access to waterways or to obtain spices, slaves, or minerals or just for ego or for so-called racial purity or some other arrogant insanity. Who do we think we are?
Very interesting thoughts and opinions. You want humanity to be wiped out because of past events? Your fatalistic fantasy is rather morbid and hopeless. Nurses have one of the highest rates of depression and are experiencing extreme stress and PTSD due to COVID-19, maybe you should go talk to someone.
You do know this disease is also taking young people without comorbids? Stats just published for the State of Michigan R/T those who have died note that while median age is 72 the range is 20 - 107 years old.
- I think it's possible there were no co-morbidities, but also quite possible they were just not known or reported. Un-diagnosed asthma, smoking / vaping / drug use.
- we know people in their 20's die from it, whether or not there are complicating factors, but based on the data now out from the state of NY someone 75+ who gets Covid-19 is 30X more likely to die from it than someone 18-44 (and actually closed to 50X since the 18-44 is less likely to get a symptomatic case in the first place.)
Specializes in Currently wound care, passion in SCI..
We cannot continuously rely on the pharmaceutical establishment like vaccines to save us from disease! Why are there no voices espousing the incredibly advanced and profoundly effective immune system? As nurses, we should know how complex, intricate, and strong the immune system is intended to be. But it needs to be built up and supported continuously.
Given the suppression of our immunity by the inadequate nutrition available in grocery stores and intensely strong advertising to each of us and our children to poor quality, devoid of nutrients edible food-like products (constructed in labs specifically to addict us - look it up) it is no surprise that this virus appears to be so menacing. Our immune systems are totally impotent in fighting. Exhausted by the constant against fight of the garbage we dump into it constantly causing chronic inflammation which we know as the first stage of healing. We need to wake up and then wake others to the right diet and lifestyle proven by science over and over to be the primary defense against all disease.
So many people claim they would eat healthy if it weren't "so expensive" while using their expensive new phones, Starbucks every day, buying fast food constantly, etc. As nurses making pretty good salaries as salaries go, we may need to re-prioritize our expenditures and be the example we are intended to be. It's time to take responsibility for our health and put our big boy and girl panties on.
Cowboyardee
472 Posts
I'm suspecting there's a bit of an echo chamber ongoing where people are repeating the (comforting) thought that since there are surely way more cases than we know of, the case fatality rate must be much lower than reported. What that line of thinking leaves out is the very likely possibility that the number of deaths attributed to covid19 is lower than the actual number. For one, many patients die without getting tested, either due to code status or disease progression. For another, it would not have been uncommon even up to a few weeks ago for patients presenting with covid along with some other illness not to be worked up or even suspected. And of course a substantial number of the patients currently positive for covid19 will in fact die from it but merely haven't yet.
Lets a assume a 1% case fatality rate, for the sake of argument. That would mean every covid19 fatality missed from the official count would balance off 100 undiagnosed cases. The problem with assuming that the case fatality rate is actually 10 times lower than what has been measured so far is that to make that assumption, we have to estimate not only that theres 10 times more cases than we know about (which isn't entirely unlikely) but also that the numerator of the case fatality equation is accurate as reported. Unfortunately, it isn't.