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Intensive care beds at the hospitals will be full,
not enough health professionals and equipment.
People will be left in aisles at the hospitals on the floor and other temporary
solutions like tents or expo are setup as contingency,
temporary hospitals.
Doctors will have to make the tough decision to decide whom to give a respirator
and make them live and who else instead will not get it.
Like this clip from Spain.
In the world we had 100,000 cases of Covid-19 (Coronavirus) in 67 days.
It took only 11 days to get to 200,000 to double it and then in only four days
it tripled to 300,000 so how did we get there? And most of all, what can we do?
What can you do to avoid the your country to get in that situation?
This is the first episode of a three parts of series,
called the "when your country collapses",
(if it collapses and let's try to avoid it).
The first one is going to be about health.
The second one about economic and the third about social.
For this exercise I'm going to use three countries,
very different from one another,
but you can apply the same concept for any other country.
The three countries are the United States, the United Kingdom and South Africa.
I made this video to help people contain the virus and the pandemic.
There is no fake news in this video because there is no news at all.
This is just my thoughts to try to help people based on data that are available
publicly. Link in the description below. My name is Simone Zanetti.
Welcome to The Digital Rainmaker.
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How do you evaluate when the health system of a country is about to collapse,
before it happens. ICU beds, the critical care beds,
are limited for each country.
They 're usually mainly used for short term treatments like accidents,
critical illness and stuff like that.
So usually they are occupied for a few hours doing surgery or after surgery,
or if it is a critical illness for a few days.
With Covid-19 for every single patient, they are occupied for a number of weeks
and it is a big difference in a big problem.
So the more patients come in quickly
because the curve of infection goes high very quickly,
the more beds remain occupied for a long period of time until the person gets
better or dies. Also,
these occupied beds now they are not available for normal illness
like accidents and so on.
So what happens when you have this critical mass of people needing intense care
and ICU beds?
You have a number of patients critically ill that need respirators and they need
critical care that they just cannot cater for a space in the bed or personnel to
attend them. And the quicker the infection spreads,
the more people will be waiting for beds that are not available.
As we showed in that shocking footage at the beginning
when the system is saturated,
people are left without respirators and care and a number of them die.
What happens if doctors and health professional will get sick from coronavirus
(because it happens)? Stay until the end and I'll show you what happens.
Of course,
according to recent statistics 80% of the population have mild symptoms so they
don't need to go to the hospital. Some of them,
they can still infect other people.
20% of them will need admission to the hospital and 5% of them will be critical.
So keep this in mind when you do your calculations for your country.
Every country has got a certain number of ICU beds.
These ones that you see on screen now are the one that are available in the
three countries that we are considering for this exercise.
So I plotted here three scenarios, when it comes to the spread of the virus.
The red line is the number of ICU beds available in a specific country.
In the first scenario, the yellow one is the best case.
So there is a good containment of the virus and the growing of the infection and
the getting better after getting infected follows a curve that never reaches the
red line. The second scenario is the average cases.
So there is some containment, so a lockdown,
people are behaving correctly somehow, but not all of them.
There are still people going around.
The part in red is the number of population that cannot receive medical care
because the health system has collapsed.
There are not enough beds or equipment or health professionals.
The third and worst scenario is when there is no containment like it happened
the UK, at the beginning and in many countries unfortunately,
until they took serious precautions. So let's start with the first country:
United States.
Yesterday in the US was recorded 160,000+
official cases.
And in the country there are over 100,000 ICU beds,
which is a good ratio for the population.
Remember that the real cases in the country can be up to 20 to 50 times the ones
that are recorded,
especially in the early stage because not everybody is tested:
both people that are sick and they're spreading the virus and also people that
die for other causes,
which they have also the virus and they are not tested and therefore not
recorded.
So in this chart you see the acceleration curve where I've put in day one,
all the countries when they had 100 cases.
And I grayed out all the other countries that are put here as a sample except
for the US and as you can see,
the US has got a very quick acceleration after day 16,
but you can see the effect of this infection only 14 days after,
after the incubation period, more or less.
And that's why it spikes and it spread so much. So considering that curv,
I think that the U S is going to be in one of these two curves is not going to
be on the low one because of the little precautions be taken at the beginning.
And also New York is already at almost critical stage.
They are setting tents in Central Park with hospital beds.
So I would put it here very close to the borderline. What do you think?
Let me know. Let's see. South Africa now, 59 million people,
1,326 cases yesterday,
30th of March and more or less 7,000 ICU
beds, intensive care beds. So the curve of South Africa:
I had to shorten the chart here because Africa is behind the curve, luckily.
And it seems that for now it is, quite contained, it's not growing very quickly.
But again, how much are they testing in South Africa? How frequently,
how long is the backlog? There is a lockdown in South Africa.
It is enforced by the government but we've seen in the news that in the informal
settlement and when there is a lot of people it's not really applied,
a lot of people gather together.
So we're going to see the results of these gatherings only in 14 days. But,
things are getting better.
We went from this...
... to today with social distancing at the shops.
This is the 1st of April and this social distancing has been enforced by the
store. Well done. So South Africa is at a very early stage.
That's why I put the marker there at the beginning and can really go in any of
these directions.
I think it's really too early to talk about if South Africa is going to hit
the critical point of collapsing the health system or if it's going to
follow the yellow line.
That depends greatly on all the citizens of South Africa if they're going to be
self contained or not. South African friends:
let me know in the comments what do you think?
The UK: this is a very special case because as you know,
the policy of the government at the beginning was to not take any precaution.
And in the next episode I'm going to go a little bit more in detail and what was
the plan or what I think was the plan from an economical perspective.
With 68 million people living in the UK,
they had on the 30th of March
22,444 official cases with 4,000 ICU beds.
The UK is very difficult to predict because they haven't been testing a lot at
the beginning and they have been gathering together a lot before they started
putting some government blocks.
So I split it here in two.
It could be that now it seems to be like a yellow line and they're going to make
it, but I foresee a spike and UK friends:
it's not trying to bring bad luck or anything,
it's just the way that it seems. But if you don't agree, let me know.
I'm open to criticism. After the peak,
because of the blocks that they've put in place now,
probably there is going to be a stabilization.
So the quicker that they contain everything,
the quicker the curve is going to stabilize and then go down.
So where do you think that you are in the curve with your country and do you
think that you're gonna hit the critical line? So there's a button up here,
you can click there and there's a poll.
Let me know if you think you're gonna hit the critical line when you get into
default of the health system in your country or not. Oh wait,
there is something more interesting that is coming now. Before we continue.
There's a lot of you that commented that are much better than me at maths and
statistics and all of that. And I know what you're going to say.
Now you're going to say that this chart is not correct because a country with
less population,
of course it's going to have less cases and it's going to show lower.
So a plotted a second chart where I divided 1 million people in terms of
population by the number of cases. So this is per capita now.
So as you can see in this chart, which is absolute numbers,
so we have the US which has got the highest number of cases and Switzerland,
which has got the lowest number of cases.
Look what happens if you plot a chart per capita. As you see now,
things went to the other way around for Switzerland and the US.
Switzerland is the country of these ones that has got the highest number of
cases per million people.
In the US it's actually the one that is at the lowest end.
So to all my American friends, please try to contain it now,
so it doesn't spread because in the US with the number of population...
It would be really a disaster otherwise. So velocity is the key.
The quicker the virus spreads,
the most critical is for the health system to put stress on the health system of
your country. We need to slow it down.
So I've done an interactive chart here to see what happens in the first two
weeks from the 100th cases and then in the second two weeks:
this is critical. So as you can see if I go in day 3, 4, 5...
up to 2 weeks, there is very little growth in the various countries.
But this is the moment where there are thousands and thousands of people that
are getting infected by other people without even knowing it.
And see what happens when a move the chart in the 3rd and the 4th week:
see the acceleration, it's unbelievable.
These are all the people that got infected the two weeks before.
That's why if you look that everything is fine and you don't think you're not
going to get affected, that is not the case. You need to take precaution.
So if the acceleration of the curve is the most critical part,
the containment is the most critical factor to avoid to default to the health
system of your country. So I have a friend in Italy,
Francesca ciao Francesca that is a health professional and she deals with Coronavirus patients.
[NOTE: Francesca is a professional nurse operating in an emergency surgery theatre in Italy, where now - due to the coronavirus spread - she has to deal with suspected and confirmed cases of Covid-19]
[NOTE: Francesca is a registered nurse operating in an emergency surgery theatre in Italy, where now - due to the coronavirus spread - she has to deal with suspected and confirmed cases of Covid-19]
an hour and a half with her to ask tons of question that I had.
And found out a number of things that I didn't think about. For example, yes,
the respirators are critical,
but one thing that is becoming critical now in Italy (that is ahead of the
curve) is the oxygen tanks.
There aren't enough oxygen tanks that need to be of course refilled or the
supply that they require because these people are always on oxygen and it's not
oxygen at 40% because they are so critical and the lungs have so low capacity,
they are at 100% oxygen the whole day.
She told me also some dramatic stories like patients that were so
critical in a medic three hours they get so quickly bad that they just had the
time to do a video call with their relatives (because they couldn't see them
face to face because of the infection) and then they've been sedated and
intubated.
And then it comes the point of a health professionals getting sick.
It does happen.
They are in contact all the time with sick patients and no matter how much
precaution they take with masks and gloves and all of that, they do get sick.
Now the problem is that these people besides the doctor that of course they have
a degree in experience, but even the nurses, especially the high care nurses,
that know how to operate the ventilators and all the high care equipment in the
bed, they are highly specialized.
They cannot be substituted by somebody else with less experience.
So when you start having one and then two and then four and then six of these
professionals getting sick,
what happens is that people attending these beds start becoming less and less.
So you might have the equipment,
but you put even more stress now on health professionals that need to look after
more than one bed.
And so this gets worse and worse and worse as the time goes by. And again,
it depends on the amount of people that comes to the hospital.
So lowering the curve is the priority number one.
So I'm not saying that the default of the health system is going to happen to
your country and I really hope that that is not that this is happening today in
countries like Spain and Italy. So what do you,
what do we need to do to keep our countries below the critical line?
First of all: Stay at home as much as you can. Lock-down or not lock-down,
try to self isolate yourself and your family.
If you go out because you need to buy food or you need to go to the pharmacy
wear a mask and gloves if you can. Disinfect or wash your hands very frequently.
One thing that I heard that I found it very visual and easy to understand is:
imagine that you cut some very hot chili with your hands so they are dirty with
chili and then you need to touch your eyes like to put contact lenses.
How well would you wash your hands in that case?
That's how well you should wash them. Stay two meters from everybody else.
Cover your mouth like this if you cough or sneeze,
not with your hands because then otherwise you can infect (if you're infected)
other objects and surfaces and then people get infected touching those surfaces.
Basically you need to assume that everybody's infected in every surface is
infected.
I'd like to thank everybody for the overwhelming number of positive comments
that I received in the previous videos.
I will continue making videos to keep people informed.
The most important part is the one that you play. Liking this video, sharing it,
commenting and all of that. This spreads,
these kind of communication that I hope will help people.
So let's spread information rather than the virus.
And remember to subscribe so you know when I come out with episode 2 and 3 and
also I was thinking to do an interview with Francesca, what do you think?
I think she's got really great information and insights from the frontline
fighting everyday with Coronavirus. Thank you for watching. And guys,
this is the data that I have available in the description box and on video I've
put all my sources. If you find discrepancies incongruences or any mistakes,
let me know. It's not a problem. If you have better information, please send it.
Share it.