Bhutan hospital room

[Manfred M]

A few years ago, shortly after my wife and I retired, we spent a couple of months traveling through South Asia.

My wife got quite ill from some local food, likely a the hotel we were staying at, and ended up in hospital a couple of times. This is the room she was in in Bhutan.

I post this to remind folks of how well equipped our health care systems are when compared to developing countries. In my wife's case, her treatment went well and in spite of the inconvenience of having to seek medical attention, what struck me recently is how vulnerable the developing world is to pandemics like COVID-19.

This is a fairly high-end hospital, when compared to what the general public experiences in developing countries. The doctors we saw in Bhutan were educated in India. In India, the medical professionals we saw in private hospitals or clinics were educated in the USA, Australian, the UK, etc. The ones in public hospitals were staffed by locally trained medical staff. I suspect that they were as competent and knowledgeable as the Bhutanese doctors, but suspect that the quality of the facilities was lower.




COVID-19 is impacting all of us. I sincerely hope that the medical resources in less well off places are capable of coping, but when I read of what is happening in Europe and the USA, I am worried that there will be problems....

[LePetomane]

Manfred, one of the problems is that a pandemic like this overwhelms the system. It is impossible to have the resources necessary for every patient that comes along. People show up at hospitals with no symptoms or exposure and demand to be tested. We have a medical system that has been abused so much. Now we are seeing limited resources for the ones in need. The other thing is that we are in an election year and some see this as an opportunity to politicize this. A member of the Obama administration once said, "You never let a serious crisis go to waste." That is the mindset we are dealing with.

[Manfred M]

Manfred, one of the problems is that a pandemic like this overwhelms the system. It is impossible to have the resources necessary for every patient that comes along. People show up at hospitals with no symptoms or exposure and demand to be tested. We have a medical system that has been abused so much. Now we are seeing limited resources for the ones in need. The other thing is that we are in an election year and some see this as an opportunity to politicize this. A member of the Obama administration once said, "You never let a serious crisis go to waste." That is the mindset we are dealing with.

I fully understand this. The whole concept of "social distancing" has little to do with ensuring that one is not infected (although if this is the outcome, great), but rather to ensure that the health care systems are not overloaded. When I hear what is happening in Europe, especially in Italy and Spain, I am certainly concerned that the situation here in Canada is going to get far worse, before it gets better. As I am in a higher risk demographic (i.e. over the age of 60), I am going to be careful to ensure I do not have a lot of contact with large groups and am sticking around the house unless I have to get out (grocery shopping, for example).

My daughter and her family, who are based in Hong Kong, have been living this for the past few months. She "bailed" to Japan with her husband who deals with ex-pat Japanese with medical issues in Hong Kong. Japan is experiencing issues, especially in Hokaido, but the issues in Aichi Prefecture where my daughterand my young grandson are staying appears to be relatively low risk right now. We have a friend, a Japanese MD, a specialist in pumanonology at the Yokohama City University Hospital, who had been treating patients from the Diamond Princess cruise ship in Yokohama; has told us some of the local issues she is facing .. She was planning to visit us this week, but delayed her visit until things settle down, hopefully by the summer.

Unfortunately, some countries seem to be more interested in playing politics than dealing with the issue. This is unfortunate, as the virus does not respect national borders. I hope that Canada has responded well as schools and public events and facilites have been shut down and / or cancelled. I am the chair of the largest photography club in the city and got tired of the dithering of some of the other club executives and shut down our activities, in spite of objections from some members. Better safe than sorry...

With a bit of luck, this will be behind us in a few months (I hope).

[billtils]

The whole concept of "social distancing" has little to do with ensuring that one is not infected (although if this is the outcome, great), but rather to ensure that the health care systems are not overloaded.

Social distancing is to minimise person-to-person contact and transfer of the virus. Hong Kong, Singapore and some other densely populated Asian countries stand out as having lower incidences of Covid-19 and the common factor is that they were at or near the epicentre of the SARS epidemic and immediately went into containment based on their SARS experiences.

The "higher risk demographic" of which you and I are members relates not to the chance of being infected but to to the severity of the consequences if you do indeed become infected. It could be argued that the real high risk demographic in regard to transmission is the young and healthy as it seems that many in the group show little or no signs of infection but are nonetheless carriers and capable of passing on the virus.

So yes, trying not to overload the healthcare services is an issue, but in this as in any disease, the old" adage "prevention is better than cure" must not be forgotten.

[Antonio Correia]

Allow me to post a link to my son's analysis among others available on the web.

As you probably know we just arrived from India where we have been two weeks among forests and animals.
So far so good. However, the cases in Portugal will be increasing soon as the government is slow to take measures. A shame indeed !
We are staying home as much as we can.
Cheers !

[davidedric]

Thanks for the image and thoughts. We are in close touch with a young man in Zambia, and although there seem to be very few cases at the moment there is no way their medical resources will really cope. Fortunately, he has his own property in a fairly rural area - it's the crowded slums that will suffer.

The uk has an interesting approach. Basically, we have no natural immunity and a vaccine is unlikely to be available for many months. Therefore, assume 80% of the population will become infected and plan how to manage that load

[DanK]

The uk has an interesting approach. Basically, we have no natural immunity and a vaccine is unlikely to be available for many months. Therefore, assume 80% of the population will become infected and plan how to manage that load

This is true everywhere, although some of the credible estimates are a tad lower. That's the reason for social distancing: to try to keep the number of cases below the maximum that the system can handle. Italy has failed to do this--they imposed social distancing too late--and that is leading to a high death rate.

The health system in the US is chaotic, not really a system at all, but one thing that might help a bit is that hospitals here have an incentive to invest in the facilities for which they can charge the most. The number of ICU beds per 1,000 people is therefore a little higher than in many countries. However, this small advantage may be overwhelmed by a number of other factors: a fragmented and badly underfunded public health infrastructure, a dire shortage of tests, and a craven political leadership that is seemingly all to willing to place the public at risk for short-term political advantage. This is not limited to the people at the top. For example, there are members of Congress urging their constituents not to participate in social distancing. If you think I am exaggerating, read this from this morning's Washington Post. And then we have the right-wing media, which for the most part--with a few exceptions--has been downplaying the seriousness of the epidemic, even claiming in some instances that it is a left-wing plot to discredit Trump. People will die needlessly because of this craven garbage.

[Wavelength]

I personally feel that "social distancing" is an improper usage, because while using that every body is blaming an irresponsible society outside. Be sick or otherwise everybody is a part of the social community. Social network is so intricate that it is difficult to say by which path the pathogens reach us. "Non gathering" would have been a better term.