The most common mistake made in the COVID-19 response was treating contagious COVID-19 victims in the same hospitals and hospital areas as non-COVID19 patients. This happened both in Wuhan and in New York City.
Stephen McIntyre tweeted yesterday:
western nations completely ignored procedures that Western doctors use in controlling epidemics in Africa and elsewhere. An interesting and experienced doctor said that their FIRST act is to create field hospital exclusively for epidemic patients, keeping regular hospitals safe
and on April 9:
I saw interview with experienced US doctor on epidemics in Third World. They set up field hospitals for epidemic patients so that ordinary hospitals can continue without getting infected. Domestically, US did exact opposite. Allowed epidemic patients to disrupt. Worse than Third [world]
In very rare cases, like intensive care units, sharing of facilities is justified, but this is very rare. It has been documented that a significant number of COVID-19 infections have taken place in medical facilities in China, Italy, and the US. From Why hospitals and nursing homes are the likely coronavirus epicenters (NY Post, March 3):
A staggering 41 percent of coronavirus patients at a Wuhan, China, hospital contracted the virus in the hospital.
This might also be how CoV2 evolved.
The feds and state health officials, including the New York Department of Health, should focus on getting nursing homes ready. Some 2.2 million Americans live full time in these facilities, and hundreds of thousands more go for rehab after hospitalization.
New York City suffered due to a similar situation of nosocomial transmission (i.e., infection in medical facilities), exacerbated by panic.
NYC’s COVID-19 mortality has been, in large part, panic driven. Here are quotes from an article tilted (too alarming, in my opinion): NYC paramedic says coronavirus patients brought to hospitals ‘to die’ (NY Post, March 31):
City paramedic Megan Pfeiffer is on the front lines of the coronavirus pandemic in New York — and said the situation has surpassed anything she could have imagined.“It’s like battlefield triage right now,” she told The Post of the increasingly grim outlook. “We’re pretty much bringing patients to the hospital to die.”
“There are a lot of really sick people. Others are panicked, and as soon as they have symptoms, they call us. Some have fever, some have shortness of breath,” Pfeiffer said.”
“Nearly one-quarter of the city’s paramedics are out because of illness or injury amid the deadly pandemic …”
Panic caused more people to rush to hospitals, both overwhelming them and spreading the infection further.
One size does not fit all
The Covid-19 pandemic and otolaryngology: What it comes down to? (Laryngo-Rhino-Otol) Jan-Christoffer Lüers, Jens Peter Klußmann, Orlando Guntinas-Lichius
Another hypothesis formulated by virologist Christian Drosten of the Berlin Charité states that affected [younger] patients could have inhaled a high dose of virus directly into the lungs, so that the virus could multiply directly in the deeper respiratory tract without first triggering an immune reaction in the pharynx.
This may explain the case of multiple deaths linked to a church choir rehearsal. Singing would increase the amount of expelled virus and would also cause singers to inhale deeply. Thus, it creates ideal conditions for virus transmission. Since many of the singers were older, they had many COVID-19 infections, and two people in their 80’s died.
This case would suggest an increased danger during joint activities, especially those necessitating any type of deep breaths. Such activities can include not only singing, but also aerobics, gym training, and perhaps even prayer meetings, which are typically attended by older individuals. This said, authorities should communicate clearly, offering rational explanations and recommendations, rather than simply banning all services.
As the list of ages, conditions, activities, and locations associated with increased danger of heavy COVID-19 infections and/or serious outcomes becomes increasingly complete and accurate, people having none of these conditions can engage in other activities, in other locations, with higher confidence.
Published on April 12. Expanded and updated on April 13.