John Comnenus: Hard questions

According to worldometer (at 0130 on 24 March) Australia has 1717 COVID cases that lead to 7 deaths. That’s less than .05 mortality rate on those who have tested positive. But, this is not what we are concerned about with the ‘flatten the curve’ mantra. What Governments are worried about is overloading our health system. Apparently, once again according to worldometer, there are 11 serious cases of COVID in Australia. So I assume that means 11 Intensive Care Unit (ICU) beds being occupied by COVID patients. That suggests to me that the measures adopted before the destructive measures imposed over the weekend were effective.

Before Scott Morrison, the Premiers and Chief Ministers destroy anymore businesses, careers and jobs I think they have an obligation to answer these three basic questions in simple and straight forward language:

1. How many COVID cases in ICU will overwhelm the health system?
2. How many cases are currently in ICU?
3. What are the current projections for admission to ICU?

Let’s clearly answer these questions before another persons life or livelihood is deliberately destroyed.

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62 Responses to John Comnenus: Hard questions

  1. FWIW other countries report answers to these questions daily.

    Here in France there is a nightly briefing from either the head of the Health Department or the Health Minister. The key metrics each night are cases (and new cases in last 24 hours), hospital admissions (plus change in 24 hours), ICU cases (plus change), and deaths (plus change). The number of ICU beds is well-known, and the number of new beds added each day (for example, via field hospitals erected by the army) is also announced.

    Projections are basically in relation to the experience of neighboring countries (Italy, Spain) where the tracking in France is compared to their more grave situations.

    Incredible to read here that Oz is not only not answering these questions daily but not doing so at all.

  2. It would be good to see the projections that the government are seeing, but they would not make for pretty reading. They would certainly not be of any comfort to the “but what about my ancient liberties” crowd.

  3. Petros

    It was reported somewhere that we have about 2000 ICU beds nationally. Not sure if this can be increased by using e.g. operating theatres or emergency department beds.

  4. Sean

    Our media seems more interested on clarity of whether their kids are still having to go to their exclusive private schools or not.

  5. gary

    All the politicians at state and federal level and all senior public servants and journalists should go without pay until the shutdown is over. That way they will understand the consequences of putting people out of work.

  6. MPH

    It’s a shame they couldn’t have stopped at massive overreaction, instead we have to face economic suicide. Ironically enough China benefit the most by picking up our resources, property and companies for cents on the dollar.

  7. Leo G

    The are also hard questions to be asked about the real number of active cases.
    How many active cases have no symptoms, have not been tested, and have been registered as “active” only as a result of having some close contact with a person who subsequently tested positive. I know such a person- a close relative who manages a medical clinic.
    How many other prospective active cases are inflating the numbers?

  8. dan

    It was reported somewhere that we have about 2000 ICU beds nationally. Not sure if this can be increased by using e.g. operating theatres or emergency department beds.

    It could probably be doubled. But these would be staffed by people like anaesthetists who haven’t specialised in ICU specifically. Similarly there won’t be enough specialist ICU nurses. Plus we would expect to use every bed there is. The problem with the analysis above is that it takes a good week or two to deteriorate enough to need ICU, then anything from 2 days to 6 weeks to actually die. We expected to see a dozen or so ICU patients around now based on this lag. In a week or two I would expect maybe 100 ICU cases and then it grows exponentially for quite a while. Similarly it takes a while for the number of deaths to ramp up, then goes out of control. The very sick patient in ICU expels a lot of virus, so the health care workers gradually drop out as well, further worsening outcomes.

  9. dan

    The are also hard questions to be asked about the real number of active cases.
    How many active cases have no symptoms, have not been tested, and have been registered as “active” only as a result of having some close contact with a person who subsequently tested positive. I know such a person- a close relative who manages a medical clinic.
    How many other prospective active cases are inflating the numbers?

    Unfortunately probably not all that many. The most reliable number I’ve seen is that 17% are asymptomatic. Obviously we HCWs are all looking forward to the new serological testing to confirm we had an asymptomatic case, but I’m a little pessimistic that we will be confirmed immune in large numbers.

  10. Anthony

    4% of cases are fully recovered at this point. It is still an open question as to how many of the other 2000 confirmed infected recover easily or end up needing an ICU.

  11. struth

    Monty your assumptions toward the negative with no proof show a sick mind and total gullible belief in government pure insanity.

  12. C.L.

    It would be good to see the projections that the government are seeing, but they would not make for pretty reading. They would certainly not be of any comfort to the “but what about my ancient liberties” crowd.

    Monty would have been a conscientious objector in WWII, I’m guessing.
    The “but what about my ancient liberties” crowd are not looking for comfort.
    The “those of us with enough money to watch tele for nine months and everyone else can get fucked and starve” crowd are the ones looking for comfort.

  13. The “but what about my ancient liberties” crowd are not looking for comfort.

    Yes they are. They are renters who want everyone else to get back to work and die, if they have to, to keep rents high.

  14. dover_beach

    According to worldometer (at 0130 on 24 March) Australia has 1717 COVID cases that lead to 7 deaths. That’s less than .05 mortality rate on those who have tested positive

    No, it takes 2-8 weeks to move from diagnosis to recovery or death. Therefore, what you need to do is compare the number of cases atleast 2 weeks ago, 116, with the number of deaths so far, 8, which yields a cfr of 6.9.% My hunch is this kills about 5-6% of those that catch it, and that it disproprtionately afflicts those 50 and over. This is one of those moments when we are civilisationally caught between a rock and a hard place.

  15. Ben

    What’s been overwhelmed so far – Centrelink?
    40 people hospitalised…

  16. dover_beach

    The key metrics each night are cases (and new cases in last 24 hours), hospital admissions (plus change in 24 hours), ICU cases (plus change), and deaths (plus change). The number of ICU beds is well-known, and the number of new beds added each day (for example, via field hospitals erected by the army) is also announced.

    Would love to see these numbers for Australia.

  17. Spurgeon Monkfish III

    They are renters who want everyone else to get back to work and die, if they have to, to keep rents high.

    Thwack. Again.

  18. Sean

    Italy Stats english 23 march

    Stats from Italy. 211 deaths of people under 60 out of 5019, and they have been hit the hardest. For those over 70 and the outcomes are grim reading.

  19. Tim Neilson

    Yes they are. They are renters who want everyone else to get back to work and die, if they have to, to keep rents high.

    Remind me monty, what do you do for a living?

  20. Peter Finch

    There were 2,500 ICU beds in Oz in 2010 but only 1,300 with ventilators (ICUV). Best state was Tas and worst Victoria, average around 9 beds per 100,000 population. Hopefully this has increased. If the governments were honest they would tell us the number of current ICU beds with ventilators, the current number of patients requiring an ICU(V), the average stay per patient per ICU(V). Then we Joes Public could begin to understand whether we are at the precipice or not. Also an indicator to advise current ICU staff available for duty per day. Can we expect to see this? No, truth is the first casualty of any clear and present danger.

  21. Boambee John

    m0nty
    #3374169, posted on March 24, 2020 at 7:57 pm
    It would be good to see the projections that the government are seeing, but they would not make for pretty reading. They would certainly not be of any comfort to the “but what about my ancient liberties” crowd.

    What an amazing transformation, from let the economic migrants of the world come to our wealthy country to straight up bugger civil liberties fascism in less than a month!

  22. Chris M

    This is an excellent article to read from an ICU doctor at the coal face, you can understand much better the issues at stake.

    Very sobering. Essential reading for the ‘only the flu’ crowd – and for anyone that believes the Chinese numbers.

  23. Chris M

    It was reported somewhere that we have about 2000 ICU beds nationally.

    Petros, from Daily Mail (assume it’s correct) public & private ICU beds by state excluding pediatric (can’t post the graphic here):

    NSW – 874
    VIC – 476
    QLD – 413
    SA – 188
    WA – 162
    TAS – 50
    NT – 22
    ACT – 44

    Total AU = 2229 / 8.92 per 100,000
    Total NZ = 251 / 5.14 per 100,000

  24. Chris M

    So John to answer your question say 3% need ICU that would be around 70,000 sick at one time to fill all ICU beds – serious Wuhan cases can take several weeks of hospital time. Problem is the vast majority are already in use for other serious sicknesses & accidents and I don’t have info on the free ICU beds. If you assume 10% free that would be 7,000 simultaneous Wuhan virus cases which will happen early next month.

  25. Chris M

    there are 11 serious cases of COVID in Australia.

    Sorry just saw that comment, there is typically an 8-10 day window before the critical stage so the quoted 11 cases is not representative of the current sick numbers but those that became sick a week and a half ago = around 200

  26. C.L.

    You’re a morally peculiar person, Monty.
    You were laughing about people being diagnosed (who were Republicans) just last week.
    People give you a break sometimes but they shouldn’t. You’re not a serious observer.

  27. PB

    For the most part ICU’s were usually near capacity before this started. The non-Corona death toll will spike along with the Corona toll.

  28. dover_beach

    Sorry just saw that comment, there is typically an 8-10 day window before the critical stage so the quoted 11 cases is not representative of the current sick numbers but those that became sick a week and a half ago = around 200

    Indeed. Things typically go pear-shaped in the second week.

  29. Archivist

    According to worldometer (at 0130 on 24 March) Australia has 1717 COVID cases that lead to 7 deaths. That’s less than .05 mortality rate on those who have tested positive.

    No. If patients take about 2 weeks to die, then you need to divide the deaths today by the number of cases as of two weeks ago, which was about 30. I’ll let you do the maths from there. But it’s not .05 percent.

  30. Art Vandelay

    It was reported somewhere that we have about 2000 ICU beds nationally.

    And a majority of them are already occupied by people with other issues. Jo Nova has been crunching these numbers and many more for months already.

  31. PB

    “Incredible to read here that Oz is not only not answering these questions daily but not doing so at all.”

    Totally agree. Very frustrating, and delays the public perception of just what this is all about.

  32. dover_beach

    Total AU = 2229 / 8.92 per 100,000

    Good to see some people actually coming to grips with the problem. Let’s say, following Chris M , that 10% are free, 223 beds, then double that capacity in response to Wuhan flu, 446 ICUs. We have 11 serious/ critical cases now and 199 confirmed cases 10 days ago which gives a 5.5% critical cases rate. Under these circumstances, we overwhelm the hospital system once we reach 8920 confirmed cases. We are on course to reach that mark within 7 days.

  33. C.L.

    We don’t anything about those 11 people, though, Dover.
    I think everybody understands the scourge of exponentiality, though, respectfully.
    There are no hold-outs on that.
    The debate has shifted to socio-economic triage.
    We know it’s bad but food riots are not going to help.
    Moreover, the trouble with shudown totalism is that it doesn’t work anyway.
    An infectious percentage remains even after months of shutdown and exponentality will start all over again.

  34. Chris M

    Been waiting for a post about the 15+ MILLION people that appear to have disappeared in China since December according to utility data. I mentioned it a couple of days ago, can’t post the data here.

    This sort of info would show why governments around the world are acting as they are – all of them – but at the same time not wanting to freak everyone out.

  35. egg_

    Grattan Institute modelling that is likely driving ScoMo:

    As more Australians get COVID-19, will we have enough hospital beds?

    Some selective quotes in the OT.

  36. MPH

    If only our governments had been building spare hospital capacity instead of all the other wank they tip tax payer money into. The response to coronavirus will cause hundreds of times more incremental deaths than the virus directly, especially for under 60s.

  37. Chris M

    John another detailed and widely read article on this exact topic by Tomas Pueyo:

    The hammer and the dance

  38. jupes

    there are 11 serious cases of COVID in Australia.

    Last week my son and his girlfriend had five jobs between them.

    Now they have none.

  39. dover_beach

    We don’t [know] anything about those 11 people, though, Dover.

    We don’t, that’s true, but the 5.5% matches well with the average of 4% globally of active cases and that number erronously, I think, uses the number of active cases now, as opposed to 10-14 days earlier. If we used that number, 140,054 ten days earlier, and divided the number of serious/ critical cases we have now, the number is 8.7% serious/ critical cases. That worsens the prognosis.

  40. Woolfe

    So someone is going to have to chose who gets the resources and who does not. Is this worth destroying our economy? We cannot slow it down, bearing in mind the 2week window, and there is no cure.

  41. DHS

    What will happen when half a million people foreclose on their mortgage?

    We are talking bank run time.

    Then there won’t be a functioning economy to pay any of our “heroic” health care workers.

    And can people stop worrying about cases of COVID?

    What matters is total respiratory disease rates.

  42. BorisG

    John another detailed and widely read article on this exact topic by Tomas Pueyo:

    The hammer and the dance

    Chris I posted this article to John last night but he wants analysis based exclusively on Australian data. But this cannot be had, for the only reliable data can be obtained after about 4-5 weeks, and 4 weeks ago we had too few cases. That is why the government is probably basing its decisions on overseas projections and modeling, such as this imperial college report, which presents comparative analysis of different mitigation strategies for the US and UK.

    https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf

  43. BorisG

    We don’t [know] anything about those 11 people, though, Dover.

    Not only that, but they are simply too few to offer reliable statistics. That’s why it is best to base your policy on overseas projections and modeling.

  44. BorisG

    Israel has only one death, and their ratio of deaths to reported cases is less than 0.1% . Yet they shut down the entire country. And Bibi is not stupid. He leads from the front.

  45. dover_beach

    Not only that, but they are simply too few to offer reliable statistics. That’s why it is best to base your policy on overseas projections and modeling.

    That number agrees with the global stats. No need for projections or modelling.

  46. DHS

    Ok Boris. Can you provide overall respiratory deaths this year vs last year for the same time period for whichever location you think needs highlighting.

  47. DHS

    That’s why it is best to base your policy on overseas projections and modeling

    Oh yes. What could possibly go wrong?

    By the way, what evidence do you have that a single death has been caused by this virus? And remember, “some guy said so” is not evidence.

  48. BorisG

    DHS anti- vaccer, fuck off.

  49. BorisG

    Guys I plea again. Please read the report I linked to above.

    I know it is boring but it clearLy shows there is no other policy option if we want to prevent hundreds of thousands of deaths and complete collapse of the hospital system.

  50. DHS

    I know it is boring but it clearLy shows there is no other policy option if we want to prevent hundreds of thousands of deaths and complete collapse of the hospital system.

    Your report is nonsense. It assumes the tests are reliable, unambiguous and meaningful. It assumes that if a 90 year old tests positive and dies 3 weeks later that they died *because* of the virus and not because of the multitude of other health conditions they had or toxic medical treatments.

    Now, your answer to all of these ridiculous assumptions is to say “you’re an anti-vaxer”. Which just goes to show you have no answer.

    You’re completely wrong. And a fool.

  51. DHS

    Here is a CDC paragraph about results.

    “Positive [test] results are indicative of active infection with 2019-nCoV but do not rule out bacterial infection or co-infection with other viruses. The agent detected may not be the definite cause of disease. Laboratories within the United States and its territories are required to report all positive results to the appropriate public health authorities.”

  52. Iampeter

    1. How many COVID cases in ICU will overwhelm the health system?
    2. How many cases are currently in ICU?
    3. What are the current projections for admission to ICU?

    Also, why not do: 4. Increase the capacity of ICU’s?
    Everyone just wants to ration out the pie. Why is no one suggesting baking more pies?

    Of course that’s hard to do once you’ve put millions out of business and thus created the very problem you were trying to stop…

  53. Sydney Boy

    If only our governments had been building spare hospital capacity instead of all the other wank they tip tax payer money into. The response to coronavirus will cause hundreds of times more incremental deaths than the virus directly, especially for under 60s.

    Just two years ago QLD spent $500k changing the name of a hospital. I wonder how many ICU beds that would have funded?

  54. Andre Lewis

    Places in deep trouble like Italy are already triaging patients to maximise effective use of hospital resources. It has to be that way as respirators and the associated oxygen system to connect them to cannot be exponentially expanded in a short time. Someone of very advanced age with other health problems will probably be on a respirator with ICU care for a few weeks without much chance of recovery. Tough decisions must be made in desperate situations and hopefully we will get to that stage here.

  55. Tel

    If only our governments had been building spare hospital capacity instead of all the other wank they tip tax payer money into. The response to coronavirus will cause hundreds of times more incremental deaths than the virus directly, especially for under 60s.

    Adelaide: they built a new hospital, turned out to be somewhere in the top 10 most expensive buildings in the world. Delivered late of course.

    It’s not because they don’t spend enough money.

  56. Siltstone

    Qld Health wasted more than $1 billion on a payroll system that did not work.

  57. min

    Posted this on another thread . It is not the number of deaths or even the age group most threatened it is the number of beds , respirators and trained staff . All the countries where rates have increased rapidly have had this problem Why are they converting convention centres in NY into wards or why are young people lying in the floor of corridors in Cremona hospital ?

  58. Roger

    But, this is not what we are concerned about with the ‘flatten the curve’ mantra. What Governments are worried about is overloading our health system.

    That was always the issue. Health resources are stretched even in normal times, just ask anyone waiting for elective surgery in a public hospital.

  59. Iampeter

    But, this is not what we are concerned about with the ‘flatten the curve’ mantra. What Governments are worried about is overloading our health system.

    That was always the issue. Health resources are stretched even in normal times, just ask anyone waiting for elective surgery in a public hospital.

    But as we see from South Korea, proper processes can be put in place and activated in the event of an epidemic and be very effective.
    We’ve been caught with our pants down in other parts of the West and are very lucky this virus isn’t as deadly as it is infectious.

    On the other hand, our government is intent on killing us all anyway, so, whatevs…

  60. Chris M

    But as we see from South Korea, proper processes can be put in place and activated in the event of an epidemic and be very effective. We’ve been caught with our pants down in other parts of the West

    Are you referring to western Australia? South Australia has been testing at a much higher rate per pop than has South Korea for example. Pull your pants up now Peter.

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