2/ Porque las cifras oficiales cuentan como UCI cualquier cama donde se puede instalar un respirador:
quirófanos, salas reanimación postquirúrgica, unidad coronaria, UCI pediátrica...
Y no cuentan que el 70-75% de UCIs de verdad suelen están ocupadas en periodos no pandémicos.
3/ Así que el número de personas ingresadas en UCI por #COVID19 en Madrid es mayor que el número de camas reales de UCI en cada hospital.
Por ejemplo:
"La Paz" tiene 30 camas de UCI y 31 ingresados por COVID-19
"12 de Octubre" tiene 24 camas de UCI y 34
ingresados pr COVID-19
New York and Madrid had similar epidemics until they spectacularly diverged.
In March, both cities were caught by surprise and shut down because of #COVID19.
In September, the situation is under control in NY and alarming in Madrid.
Why?
2/ Let’s start with the similarities: two big, dense cities with a large network of public transit and lots of visitors.
An explosive outbreak of #SARSCOV2 overwhelmed their contact tracing system and their hospitals. A lockdown was required to reduce the public health disaster.
3/ By June, both places had succeeded in bringing down the number of new cases. That's precisely what lockdowns do.
In July, new cases started to increase in Madrid until reaching one of the highest incidences in Europe.
New York has not seen any increase in new cases yet.
2/ No country has explicitly adopted a #stratifiedlockdown, but many have implicitly defaulted into some version of it.
That is, governments haven't ordered older people and their cohabitants to stay home, but they do recommend those in vulnerable groups to be extremely careful.
3/ As a result:
Many older people have chosen to live in a soft lockdown: no venturing into public spaces unless strictly necessary, few visits with relatives, regular use of face masks.
Many young people, feeling at low risk, have reverted to pre-pandemic social interactions.
BREAKING: Risk of #COVID19 hospitalization in 77,590 persons with #HIV by antiretroviral type:
TDF/FTC: 10.5
TAF/FTC: 20.3
ABC/3TC: 23.4
Other: 20.0
per 10,000 (Febr-April 2020)
WANTED: Randomized trials of TDF/FTC (Tenofovir/Emtricitabine)
That is, individuals on TDF/FTC had about half the risk of #COVID19 hospitalization than those on TAF/FTC or ABC/3TC.
Rate ratio 0.53 (95% CI 0.29, 0.95) journals.lww.com/epidem/Citatio…
Any reasonable person should be concerned about confounding, so we did the following 3 things
👇
1) We restricted the analysis to individuals younger than 60 years, who have the lowest prevalence of comorbidities.
Rate ratio of #COVID19 hospitalization: 0.55 (0.29–1.04) for TDF/FTC compared with TAF/FTC.
Confounding by comorbidities appears less likely now.
Europe and US in total or partial lockdown to mitigate #COVID19.
Soon more hundreds of millions will be confined to their homes. Huge personal sacrifices. Staggering economic losses.
Ok, we accept the price for the common good. But how does this end? Here are some strategies:
1) Develop a vaccine and vaccinate.
If a sufficiently high % of the population is vaccinated and becomes somewhat immune, this “herd immunity” lowers the probability of transmission to a susceptible person until the epidemic dies out.
Ideal but unlikely to happen soon enough.
2) Lift lockdown (after curve flattens) and let the epidemic run its natural course without protective measures.
This brings back the scenario that lockdowns are trying to avoid: millions of people dying without adequate medical attention in overrun health systems.