Some math on SARS-CoV-2
94,837 ICU beds in the USA. They normally operate at around 70% occupancy. Canada has 3170 ICU beds, and those operate normally at near 100% occupancy.
If only 30% of US citizens get SARS-CoV-2, that is 96 million people. If 70% of US citizens get it, that is 224 million people.
Now, if we assume that the epidemic lasts for just 2 more months, then there may be a lower limit to it that could be as low as 70 million. Let’s call the bottom end 50 million infected. But the most recent doubling figure was 2 days here in the USA. Can we slow it down? That’s a good question. So, I’ll do the rest of my calculations based on a rock bottom minimum of 50 million total cases.
[Update: USA has the steepest curve of any nation now. We will not be rock-bottom. We are number 1, but not in a good way.]
If we have the lowest possible rate of ventilators needed, just 1% of cases, we will need at least 500,000 ventilator beds (50 million cases) for roughly 2 weeks per case. I’ll set the midrange at 960,000 ventilator beds (96 million cases). (High end minimum = 2.24 million ventilators. ) And it is likely to be 5%, which would need 2.5 million (50 MM cases) to 4.8 million (96 MM cases) ventilator beds in the next 2 months. (High end high ventilator demand = 11.2 million.)
In the USA we have, on hand, 160,000 ventilators. So, we could set up tents and requisition space to provide that many ventilator beds. Do we have enough ventilator consumables? I don’t know. How many of those ventilators will break down? I don’t know.
[Update: I advise physicians to not throw away consumables for ventilators, and to use bleach spray and alcohol (or some other suitable sterilizing method such as ethylene oxide, chlorine dioxide, etc.) on them, then store these consumables for later in case they are needed. I suspect they will be needed.]
If we assume best case, that the cases come in evenly over 2 months, then that gives us 640,000 ventilator-periods worth of capacity for our minimum 500,0000 or midrange 960,000 people. At the high end there will be 11,200,000 people competing for those 640,000 ventilator-periods. (We have a worse per-capita situation than Italy does.)
Note that I am presuming that we will have all of those ventilators available, when normally about 30% are available. So the reality is we probably have 192,000 ventilator periods available for these SARS-CoV-2 cases. What this means is that we should prepare for at least hundreds of thousands of unnecessary deaths.
To make things worse, it won’t be the best case distribution. There will be surges in one region, followed by surges in another region. So that says it will have to be handled with triage like a battlefield. Mostly older people will be needing ventilators.
Just like Italy, I think USA ERs will choose to triage by age to save the young. We may even take an old person off of a ventilator to save a young one.
I can’t find out how much of the various drugs we have on hand. But I think we may run out. I do know that my Ribavirin order has been held up since January. I presume that is because the Chinese manufacturer got their inventory requisitioned by the government, which is the way it should be.
With fewer medications, the pandemic should get worse than it otherwise would be. Physicians who are aware of alternatives not listed by CDC may be able to save their patients when others cannot.
