- U.S. has 1,267 known cases of coronavirus
- Worldwide cases are doubling in every 6.4 days
- 220 million Americans could become infected
- 11 million Americans could need intensive care
- Only 924,000 hospital beds in U.S. and 65% are usually full
- All available U.S. hospital beds estimated to be filled by May
- Ventilator shortage could threaten treatment
So, when a top U.S. health official says “things will get worse than they are now”, what does that mean? It depends upon the country’s ability to contain the spread of the virus:
I can’t give you a number,” he said. “I can’t give you a realistic number until we put into the factor of how we respond. If we’re complacent and don’t do really aggressive containment and mitigation, the number could go way up and be involved in many many millions.
The COVID-19 infection in America has just begun and will be unfolding for months and months. And the numbers can go up “astronomically” according to Professor Michael Osterholm, an internationally recognized expert in infectious disease epidemiology. Osterholm predicts coronavirus will be 10-15 times worse than the seaonsal flu. He conservatively estimates 48 million hospitalizations, 96 million cases occurring, and 480,000 deaths over the coming months.
For those common core math folks at MSNBC, here’s how to crunch the potential coronavirus infection numbers.
According to Dr. Carlos del Rio, executive associate dean for Emory University School of Medicine at Grady Health System, the coronavirus outbreak is “doubling in case size every 6.4 days.” CNN reports the U.S. has 1,267 known cases of coronavirus as of March 11th.
But how many people get so sick they need to go to the hospital?
Contagion Rates: “An Epidemiological Disaster”
In Italy, an “epidemiological disaster is taking place.” Italy’s most recent numbers (4,600 cases identified with 460 in ICU) indicate ten percent of cases are serious enough to require hospitalization.
The Chinese Center for Disease Control and Prevention reported in late February five percent of those infected became critical, defined as respiratory failure or multi-organ system failure. Five percent is a conservative number. So, potentially, five percent of 220 million infected Americans means 11 million Americans may require hospitalization in intensive care units across this country.
Unless containment efforts slow the infection rate, America may need up to 11 million ventilators and 11 million hospital beds to house and care for coronavirus patients on ventilators.
How Many U.S. Hospital Beds? 924,000.
If contagion rates in America match those in Italy, “hospitals will be quickly overwhelmed with patients, and … all available beds will be filled by around May 8th” according to Dr. Liz Specht, a PhD in biology and the associate director of Science and Technology for the Good Food Institute. Due to lack of beds and supplies, doctors in Italy are already forced to choose who to treat.
In America, there are only slightly more than 924,000 total staffed hospital beds. Usual hospital bed occupancy is already 65.9% (let’s round that down to 65% for MSNBC). If 65% of the total hospital beds in America are already filled with patients, that leaves 323,400 hospital beds (35% of the total 924,000 available) for those critically ill with coronavirus. And only a fraction of those 323,400 available beds are intensive care units, and turnover for beds will be low.
China built a hospital in a week. America can quickly convert military barracks, gymnasiums, auditoriums, and stadiums across the country to expand the number of hospital beds almost overnight; however, supplying ventilators is another matter.
How Many Ventilators? Well, that’s classified.
Using China’s rates, five percent of coronavirus patients will suffer respiratory and multi-organ failure, requiring intensive respiratory care such as a ventilator which forces oxygen into the lungs. Access to ventilators throughout the United States will factor in surviving a pandemic, as Eric Toner at John Hopkins Center for Health Security explains:
In a severe pandemic, we certainly could run out of ventilators, but a hospital could just as soon run out of respiratory therapists who normally operate these devices.
Dr. Paul Biddinger, chief of the division of emergency preparedness at Massachusetts General Hospital, has also posited a worst-case ventilator scenario as reported by NBC News:
In a worst-case scenario, ventilators could become a concern. Biddinger said they are vital for patients undergoing respiratory failure including cases that might arise from the coronavirus. . . .
“If the peak of illness is narrow, meaning we need lots for a short time, we could run out of our traditional ventilators,” Biddinger said.
Issue of ventilator shortage known since 2006
Since at least 2006, many many people in government, in D.C. in positions of authority, and in academia knew or should have known about America’s ventilator shortage. This includes the Democratic presumptive nominee for president, the longtime Senator from Delaware and former Vice President Joe Biden.
In 2006 in a widely distributed report about the bird flu (another gift from China), The New York Times noted the U.S. had 105,000 ventilators but that the country would need seven times that to handle a pandemic:
No one knows whether an avian flu virus that is racing around the world might mutate into a strain that could cause a human pandemic, or whether such a pandemic would cause widespread illness in the United States. But if it did, public health experts and officials agree on one thing: the nation’s hospitals would not have enough ventilators, the machines that pump oxygen into sick patients’ lungs.
Right now, there are 105,000 ventilators, and even during a regular flu season, about 100,000 are in use. In a worst-case human pandemic, according to the national preparedness plan issued by President Bush in November, the country would need as many as 742,500.
To some experts, the ventilator shortage is the most glaring example of the country’s lack of readiness for a pandemic.
Also in 2006, the American Association for Respiratory Care (AARC) recommended that the U.S. Centers for Disease Control and Prevention’s Strategic National Stockpile (SNS) expand its inventory of 6,000 ventilators by 5,000 to 10,000 more.
At the time, the director of the National Center for Disaster Preparedness at Columbia University expressed frustration at the federal government’s failure to plan for such a pandemic:
“This is a life-or-death issue, and it reflects everything else that’s wrong about our pandemic planning,” said Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University. “The government puts out a 400-page plan, but we don’t have any ventilators and there isn’t much chance we’re going to get them.”
Current numbers of ventilators held by the Strategic National Stockpile (SNA) “is generally not disclosed for national security reasons.” Available data suggests the United States does not have enough ventilators to handle even 323,400 cases, much less than an estimated 11 million who may need them in the event we cannot avoid a narrow peak of illness.
If, God forbid, Americans infected with coronavirus die for lack of access to ventilators there will be plenty of blame to go around the D.C. swamp. But, as the political outsider, President Donald Trump is not on that list. Instead, he will be left to solve the crisis and clean up the mess left by Biden and his D.C. cronies.
UPDATE: How to supplement ventilator shortage
There is a way to save Americans who may need ventilators but do not have access. It is a life-saving model successfully used on the battlefield in times of war when ventilators are unavailable: manually operated respirators called ambu bags.
Ambu bags can supply the positive pressure to force air into infected lungs. They require no electricity and are reusable once sterilized with ethylene oxide. Anticipating a possible shortage of respirators, President Trump has already directed U.S. secretary of labor to increase their availability.
State militias and the army core of civil engineers in coordination with the CDC can begin converting stadiums, gymnasiums, or local auditoriums into make-shift MASH infirmaries. Lined with beds, these can house many victims monitored by one respiratory therapist who can supervise people pumping the ambu bags.
Mobilize Gen Z
Over the next six weeks, the federal government can mobilize high school and college aged students — an increasing number of whom are not in class due to quarantines — to collect and sterilizing the ambu bags America already has on hand in hospitals and nursing homes.
These same students will learn from respiratory therapists how to use the ambu bags effectively. If necessary, two or three Gen Zs per bed will take take turns pumping the ambu bags to become the ventilators for people who need treatment.
Gen Zs will get sick but they won’t die. The China CDC found fatality rate for infected people ages 10 to 39 was 0.2%. StatNews reports “Teens and people in their 20s . . . don’t seem to be contracting the disease at significant rates. . . [A]ge increases the risk that the respiratory system will basically shut down under viral assault.”
The average age of those who stormed the beaches of Normandy in Operation Overloard was 20 years old. Armed with ambu bags America’s Gen Z can be heroes by saving older Americans if the coronavirus health care battle becomes a pandemic war.