Absolutely -- the communicability is very concerning. Even a 0.01% mortality rate can add up if nearly ever citizen is infected. Stating that some of the actions taken are overblown does not mean that this disease isn't in any way concerning. I'm exhausted at the moment, so this may read like a random assortment of thoughts, but here are a few:
I agree with you that the mortality rates will plummet. Every state/hospital is a little different, but those 184 people tested in OK were likely stratified as "high-risk patients," and it was still a low-rate of positive tests. I'm betting that >90% of those 184 patients had viral illnesses...which just goes to show how many nonspecific viral illness are always floating around at one time. Furthermore, if we tested everybody, we would start seeing more asymptomatic/mild patients.
When a patient comes in with nonspecific signs of infection, we do a workup to rule out bacterial infection (would benefit from antibiotics). Once we've determined it's likely viral, we send them home and tell them to rest and eat/hydrate well (unless they have severe symptoms like dyspnea requiring supplemental oxygen, IV hydration secondary to nausea/vomiting, etc.). That makes me think - how many times do we miss these new strains? We don't go chasing specific causes of viral illnesses most years. What if stuff like this happens once every few years, and we just don't panic because we're not aware?
"This is different than the flu." True. It actually more closely resembles a bad strain of the common cold. The old strains of coronavirus are literally considered a variation of the common cold. But, of course, this is a worse mutation of that, so it's still apples to oranges.
Do we really need to test everybody? What does that accomplish? If they develop ARDS or need to be intubated, we don't really need to know it was COVID-19 to treat. Sure, it helps a little, but I feel it's mainly for our curiosity. I think it's reasonable for all patients with viral illnesses to self-quarantine themselves for several days. Even if it's actually the flu, that can still kill the elderly and immunocompromised. We should honestly be quarantining ourselves better than we do even in years when viral illnesses aren't that bad.
Depsite my insistence that this panic is likely an overreaction, there have been many good measures put in place. Washing hands is a wonderful thing (but this should have been done before). Those that can work from home, should work from home (this might even help businesses to innovate...anybody read 4-hour work week?). Travel from China should be restricted/screened (this should have been implented months ago). As mentioned above, self-quarantining is a very responsible thing to do, and I hope that people continue to do a better job of this even when we get past this pandemic. I also think that hospitals should be better equipped with ventilators, negative-pressure rooms, etc to handle a situation like this, but it has to be financially responsible for a hospital to actually take these steps. My hope is that this will lead to our country being better able to handle the next pandemic.
On the flip-side - as I mentioned above, this disease isn't causing healthy 25 year olds to drop dead, so why aren't we letting the NBA play? I understand the empty arenas, but at least give people something to watch while they're quarantining themselves at home, and don't cripple the economy any more than it already has been. Donovan Mitchell didn't even know he was sick from what I've heard, and it sounds like Rudy Gobert was planning to play even when his symptoms were at their worst. Also, there was talk of shutting down the NYC subway briefly (thankfully rational minds prevailed). Many people depend on that subway to put food on the table. Viruses are often easily conquered, but starvation is undefeated eventually.
I do think the ventilators is a concern, and from the sounds of it, it has already become an issue in a few of the worst areas. To that end, I think it's a great idea that many hospitals are temporarily canceling all non-emergent surgeries (freeing up more ventilators). One of my bigger worries is how quickly we are being encouraged to intubate. In a normal patient, when we have a patient with shortness of breath, there are several steps we can take before intubating. Due to the fear of aerosolizing the viral particles and thus increasing its spread, we are encouraged to avoid some of these methods and go straight to inbutation. One of those methods is high-flow nasal cannula, and I don't think the fear of its use if warranted if it can keep some people off the vent.
I had few more thoughts, but got interrupted. I'll probably stop by later today to add a little more.
