I wanted to give a little insight into the what worries physicians about Covid-19. I see many complaining about how Influenza kills many more than this virus. That had been totally true. Our response today will determine what the future will hold. The problem is ICU overload.

Hospitals often run at max capacity nearly every day. When a patient in the ED gets admitted to the hospital, they sometimes wait 2-4 hours (sometimes a lot more) in the ED, until a bed becomes available. I've cared for patients "admitted" to the hospital for days in the ED because there is no place for them to go, no hospital bed.

This, then, is the problem. I have heard stats about 15-20 day length of stays in the ICU for the ARDS caused by this in Italy. That, in hospital length of stays, is an eternity. If my ICU only has 10 beds, and I usually have a 3 day length of stay, that means we can care for about 20-25 a week or so. If my ICU has a length of stay of 20 days, all the sudden I can only care for 10 patients in 3 weeks, instead of 60-75 patients. Where do those other 50-65 patients go? They die. Are you one of the unlucky patients to need emergency heart surgery? Well, guess what, there are no ICU beds left, so you get suboptimal care, and you die. Stroke? Well, you might get put on the medical floor after a clot buster, and who knows how you will do. This is the issue that is happening in Italy.

We can handle pandemics, we have done it before. What we can't handle is the overloading of ICU beds in a very short period of time. Spread it out over 6-12 months, and we can improve upon the death rate.

Carry on.