Friday, March 27, 2020

Larry Johnson: Cuomo's Corona Panic

Earlier this morning I referred in a comment to Cuomo's hysteria. Larry Johnson goes into that a bit, with some very informational details. It probably explains why the American public appreciates Trump's performance in this crisis, as opposed to hysterical panic mongers among the media and ruling elite. Johnson also provides some much needed details that also explain the daunting task facing our healthcare system in attempting to come to grips with this pandemic. The risk of system overload is very real.

Johnson begins Cuomo's Corona Panic by quoting Cuomo's juvenile--and deeply ignorant--tirade from yesterday:

[Cuomo] is now accusing the Feds of dragging their feet in getting NYC 30,000 ventilators. Here is the quote: 
"What are you doing sending 400 when I need 30,000 ventilators," Cuomo said. "You're missing the magnitude of the problem." 
No Cuomo, you do not understand. For starters, you do not have 10,000 patients on a ventilator now. The number of patients who test positive does not mean that all will require a ventilator. The numbers available so far indicate most who test positive for corona virus are not being hospitalized. That means the numbers for ventilators are not going to skyrocket and immediately outstrip the existing capability.
Shame on him. He has a duty to help educate his constituency. Let us start with the production reality--you cannot magically produce ventilators overnight. The existing manufacturers have limited, not UNLIMITED, capabilities to expand production.

That's good, but then Johnson digs deeper, based on his own experience as working his way through college as a Respiratory Therapy Tech and handling patients on ventilators.

Producing the machines is the easy part. It is the human infrastructure that is the problem. If there are 30,000 ventilators up and running then you need an additional 45,000 ICU qualified nurses and an additional 22,500 Respiratory Therapy Technicians. (I am assuming one ICU nurse can handle two patients per shift. There are three eight hour shifts per day. I am assuming that one Respiratory Therapy Tech can handle 8 ventilators per shift and there are three eight hour shifts per day).  
Along with the ventilators and the nurses and the respiratory techs you will also need oxygen, vacuum and forced air lines for each ventilator station. The nurses and techs also will have to put on new personal protection gear and respirators for each patient encounter (normally, a nurse assigned to a patient can last about three hours in a PPE (Personal Protection Equipment) suit and mask). There is another major complication to consider--every time the nurse goes in and out of the patient room then the nurse (or tech) must put on and then take off the personal protection gear. This can be time consuming if done properly. 
... The ventilators require regular changes of the tubing that connects the patient to the machine. And there are also medications sometimes administered via the ventilator as an aerosol. Getting a trained, certified Respiratory Therapy Tech requires about two years of school/training. Even with that basic training the new Tech is not ready to handle ventilators. That requires additional training. 
Getting a qualified ICU nurse is more daunting and more concerning. Ideally the nurse has a four year degree. But there are very sound ICU nurses now on the job with only two years of post-high school education. But to become qualified to work effectively in an ICU a nurse will have to have a minimum of one month of training.

If Republicans are Deplorables, how does one characterize Liberals based on their performance thus far? The Despicables?


  1. Cuomo's full quote demonstrates a problem with simple arithmetic, forget whether his assertions have any validity...

    -->“FEMA says we're sending 400 ventilators. Really? What am I going to do with 400 ventilators when I need 30,000? You pick the 26,000 people who are going to die because you only sent 400 ventilators,” the governor said.<--

    1. That would be on top of his most fundamental problem--a lack of simple human decency.

  2. A lack of human decency, coupled with basically the fact that he is an idiot, coupled with his megaphone, makes for a dangerous combination for those for whom he is responsible.

  3. For all those in or interested in politics...

    A registered NY Democrat has clearly demonstrated that party designation only means for partisan party objectives no matter the cost to Americans.

  4. A comment to Larry's post:

    I do not like Andrew Cuomo. He is corrupt hack, that should have been set to jail based on the "Buffalo Billion" grifter scheme (along with his top aide Todd Howe, the SUNY-Tech president and Cuomo's benefactors).

    Having said that, COVID-19 in NYC is doubling every 3 days. Of those who test positive, 15-20% will need hospitalization (half below age 50) and a smaller fraction on ventilators. There were 25,000+ infections this morning statewide, 15,000 in the city and much of the non-city state total is in NYC suburbs (my county, Onondaga, has 60 cases this evening). Of course the hospitals are not overwhelmed... yet.

    But do the Math, Larry. If infections continue at the same rate, there are a million in 2 weeks. Even if social distancing and the partial economic shut down slows transmission, there will still be hundreds of thousands positives and hospital admissions. And it won't die out until there is "herd immunity".

    It bothers me that you can post yesterday about individual deaths being tragedies. Surely they are -- I have an elderly mom and in-laws, all very vulnerable.

    But it isn't it a Stalinist mentality the "One death is a tragedy but a million deaths are a statistic". Isn't it?

    COVID isn't a political problem, it is a public health problem. Unfortunately there isn't a dime's bit of difference between the two parties in politicizing this very serious matter. The US will prove to the world that it is utterly incapable of managing this pandemic. We're #1! USA!USA!

    Posted by: upstater | 24 March 2020 at 06:30 PM

    Are flattening curves elsewhere due to herd immunity? Doubtful.

    1. I hadn't seen his post yesterday. My view is we don't have enough information for him to express himself with that degree of certitude.

  5. Many are throwing the term “herd immunity” around while having little, if any, knowledge of what it means - and, more specifically, what it might mean in relation to COVID-19. So…bring on an expert:

    COVID-19 science: Understanding the basics of 'herd immunity’

    Recently I heard a medical "expert" on the news incorrectly define the term "herd immunity." It's a new phrase for many people, but we're hearing about it more and more, so it's important to understand exactly what it is.

    First, let's discuss how immunity works for individuals. A person can become immune (or resistant) after exposure to a disease-causing agent, such as the coronavirus causing COVID-19 in this case. The process of becoming immune includes the production of antibodies specific to the virus for future protection.

    This production typically happens when a person develops the symptoms of the viral disease, but also may occur without symptoms. Irrespective of the symptoms, after significant exposure and time to develop the antibodies, a person becomes immune to that specific virus. In other words, the person is naturally "protected."

    If a large group of people – the herd – is immune to a virus, then an individual in the middle of this group is unlikely to become infected. The virus has a very hard time getting through the herd. Herd immunity, then, happens when people in a community are protected from a virus and its associated disease to a degree that people who are not immune are still protected because of the high population immunity.

    Herd immunity can slow the spread of a contagious virus.

    More here, along with the writer’s bio:

    1. A problem with 'herd' immunity, however, has to do with how long it's good for. As I understand it, there's no guarantee for any given virus that acquired immunity is good indefinitely. In fact it might not last very long at all. A lot of people who toss the term around don't get that.

  6. Sounds like it takes a good long time to develop herd immunity to a new virus. So why are fatality curves flattening? Seasonality?

    1. Two factors. One is social distancing--the WSJ and others have pointed out that this strategy also seems to be having a limiting effect on seasonal flu.

      The other has to do with the logistic curve as opposed to the exponential curve. However, the two are closely related. Social distancing can induce an 'inflection point' that shifts exponential curves to logistic ones.

  7. Typical Democrat Cuomo, not letting a crisis go to waste, seized on this as his perfect campaign strategy… If not for 2020 (look at Biden failing - will he even make it to the convention, if there is a convention?) then certainly for 2024. My money is on his expecting to be nominated at whatever passes for a convention. Then President Trump can wallop him good… Sweet.

  8. If the Dems keep talking Trump won't have to spend a penny on ads this fall.
    Tom S.

  9. So far Trump is blessed in his enemies. Cuomo is probably too smart to jump in at this point. If Trump can continue with his performance there should be no stopping him.