France's smoking rate, at least as measured in 2016, isn't really substantially higher than the USA, believe it or not.
https://en.wikipedia.org/wiki/List_o...ion_per_capita
both France, the Netherlands and Italy have recorded a fairly high % of patients <50 w/o comorbidities being admitted to intensive care. I think this is just the virus rearing its head in full view for us to see.
There was a comment by an Italian MD who said their first surge of patients were very old/infirm, but this was followed quickly by a younger cohort who seemed healithier. It may just be the case that we haven't gotten a full picture of this bug just yet.
Assuming that the numbers from the links are somewhat accurate...
Italy has a total number of cases around 25K, yet their entire medical system is overwhelmed. Is that an indication of the harsh nature of this virus or the crappy nature of their medical system?
Not trying to insinuate that the USA medical system wont get overwhelmed cause we are awesome, just trying too get a handle on all the apples to watermelons comparisons that are being made.
”But in the end all of these ideas just manufacture new criminals when the problem isn't a lack of criminals.” -JRB
It's very much the nature of the virus. Italy has slightly more hospital beds per capita than the US (IIRC, ~3.2 per 1k in Italy vs 2.8 per 1k in USA).
As much as we sing its praises, America's healthcare system is definitely not that great - especially in responding to large-scale public health crises like this one.
As an easy example, take a look at the average ICU room in the US:
They are fairly large, in order to accommodate both lots of equipment as well as lots of personnel (for resuscitations, rounds, etc). Because of HIPAA and the "customer first" nature of US medicine, they are built as separate rooms. However, this also means that the room is built to accommodate exactly one bed: so both O2 and negative pressure outlets from central air as well as electrical outlets, C arms and other details literally engineered into the hospital blueprints are geared around providing care for only 1 person in that room.
This means we have tons of dead space in our ICUs, and it will be basically impossible to repurpose them. On top of that, because American hospitals are fee for service, our floor and ICU bedspace is basically always at a premium. Like the airline industry, empty seats don't earn money, so our system has more or less been designed to run quasi at-capacity during a normal year. And, with aforementioned issues around hospital design, there really isn't a lot of room to expand our capacity, either.
So, while we have lots of advanced technology (MRIs and fancy new chemotherapeutics, etc) that we can bring to bear on a single patient, we are WAY under-prepared to handle massive amounts of patients with respiratory failure. Like I said before, I anticipate we will do WORSE than Italy for these reasons and many more.
There's also the issue of nursing being staffed at the state mandated minimums in order to maximize earnings.
So, even if we had more space to convert into patient beds, we don't have the nurses to work the extra patients anyways.
I don't imagine things have changed much since I worked in healthcare.....the nurses usually didn't even have time for a lunch break. Their work tempo was similar to many police departments around the country, where cops come in to work with an entire shifts-worth of calls for service stacked up waiting for someone to answer, and the idea of them being able to actually do any policing is virtually a pipe-dream.
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