One point that I have made before is that it really isn't the mortality rate that is so concerning about this virus. Lets say for argument's sake that it is 5%. Our best estimate is that his thing has a 60-70% attack rate. In this coungry lets say we are better off and go with half that--35%.
Thats 122 million infections. Overall consistent breakdown of case loads has been that 15-20% will need inpatient medical care of some form. Lets say that due to better hygeine, vaccinations, education and diet we can cut that in half to say 10%. That is 12.2 million cases that will require hospitalization or more intensive management such as antibiotics, fluids, supplemental oxygen, etc. Of those 12.2 million cases, roughly 10-15% will require ICU care with mechanical ventilation or ECMO. Lets go with the lower number there of 10%. 1.22 million americans would need ventilators. The existing mortality of those on vent is around 67%. Wihout vent and in ARDS That number will go to, at a minimum, 80-90%.
There are between 900,000 and 1 million hospital beds in total in the United States. Of those, roughly 80,000 are ICU beds. There are roughly 65,000 mechanical ventilators in the US.
So, using those numbers what is the impact?
You have 1/3rd of the US missing work, missing mortgage and car payements, and clogging up health care systems. 12 million of them will need intervention, be we only have beds for roughly 7-8%. Those who are not admitted will have to use oxygen at home (If it is available) and will be much more prone to infect others and experience seconary infections. The eventual rate of death of these will not be unsubstantial. Of those, 1.22 milion will need ventilators. Just short of 1 million of them will likely die because there are no ventilators available.
Why those numbers could be too optomistic:
1. The supply chain disruptions will seriously impact healthcare above and beyond the demands from Covid. Without medications, supplies, PPE the entire system will come to a stop. No surgeries, no chemotherapy, no heart medication, insulin, BP meds, etc. Not only will this cause their own, higher morbidity/mortality it will increase the attack rate and poor outcomes of those co-infected with Covid.
2. Economic problems have the potential to lead to food shortages, predatory lending, and unrest. Recent articles I have read were saying that 1/3rd of americans--regardless of income up to 200,000/year, run out of money before the end of the month. This would indicate that they have no savings/reserves and mandatory quarantine and the stop of those needed paychecks will cause shortages and defaults. This will ripple through the system.
3. Federal bailouts of the financial system will likely lead to unrest. We bailed them out in 2008. It is unlikely that if we bail them out in 2020 and a large part of population suffering without a "bailout" will simply not tolerate it.
4. The entire health system will collapse under the cost of treatment of millions. Insurers will decline payment because the infection is an "act of God" or will simply go bankrupt. The ramifications of this are clear--it will be taken over by the federal government.
5. We are only talking about Covid here. not heart disease, trauma, cancer, COPD, diabetes, etc. Those cases all need care as well.
Rationale: Although the number of intensive care unit (ICU) beds in the United States is increasing, it is unknown whether this trend is consistent across all regions.Objectives: We sought to better characterize regional variation in ICU bed changes over ...
www.ncbi.nlm.nih.gov
The number of mechanical ventilators per US population exceeds those reported by other developed countries, but there is wide variation across states in the population-adjusted supply. There are considerably more pediatric-capable ventilators than there are for adults only on a...
www.ncbi.nlm.nih.gov
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