Sitrep: Europe

I usually write in Dutch but this information is internationally useful. What we know so far:

  1. about 10 % of confirmed infections are admitted to the ICU for assisted breathing,
  2. doubling time in Europe is about 4 days, which works out to a daily growth factor of about 1.2,
  3. The median ICU stay is 10 days,
  4. in Lombardy, Italy and Hubei, China, the medical system was overrun,
  5. Median age of ICU admissions is dropping in Italy. Likely due to older people not getting treatment.
  6. when the medical system gets overrun, CFR shoots up as proper treatment is unavailable,
  7. quarantine doesn’t stop growth, but it can slow it, which allows proper treatment of patients,
  8. Many European countries have few ICU beds.
  9. Iceland is toast
  10. Norway is toast

Take Iceland. Iceland has about thirty ICU beds. In normal operation, in most countries, about 70-90% of ICU beds are taken. that leaves 3-9 beds for treating covid-19 patients. With 10% needing an ICU bed, that leaves Iceland vulnerable if the case count goes above 30-90. Current case count: 109.

 

This situation isn’t exclusive to Iceland. All nordic countries are running low on beds.

The Netherlands isn’t far off. According to this model, ICU capacity problems are just a week away.

Why care about ICU beds?

The current CFR is based on every patient getting adequate medical care. Even in that case, the CFR is pretty high (3.5% ish). When ICU beds run out, patients cannot get the care they need. That means people die who could have lived.

With fast action we can “flatten the curve”, which means to spread the same amount of cases over a longer period of time. A coronapatient that ends up in ICU spends about 10 days there. The more of those 10 day periods you have, the more you can treat.

Why isn’t Europe acting?

Who knows? Political reasons? Economical reasons? International markets are in pretty rough shape. The first major western economic power to announce a big quarantine could be the straw that breaks the camel’s back. Recency bias may play a role. It’s tempting to think that nothing bad will every happen because nothing bad has happened in a while. There’s also some social credit to be gained if you’re the only person to keep your head cool when the situation turns out to be a “nothing burger”.

Point is, Europe should be acting. If we don’t, we’re gonna see another Italy (which was really another Wuhan) very soon.

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