brar w wrote:This is the only option for 99.9% of the areas where you expect an apex within 7, 10 or 14 days. Hence cities all around the world, with advise from their health officials, are doing exactly this. You have to buy or build hundreds if not thousands (or tens of thousands) of ventilators and then build make shift ICU like capacity while also on boarding retired healthcare professionals to provide the service. Then you have to stratify the hospitalized population based on acuity and triage them appropriately. This is an excellent way to do that.
If this wasn't being done here, it would have been done in hospitals which are even less adequately prepared to handle it (lining up cots in hallways and other common space). It is unfortunate, but in order to minimize the number of deaths you have no other option..be it London, Paris, New York, or Wuhan. Higher level resources have to go to creating capacity to support higher acuity patients who have a higher likelihood of dying without an intervention. Very sad..but that's all that can be done in such short notice while also prioritizing other resources. Better than sending them home to die.
I think one thing which hasnt been adequately explored is using unoccupied flats and real-estate for the mildly symptomatic/asymptomatic patients and their mass quarantine.
In India at least, there are countless apartments where you can via Govt decree, take them over for a period of time, and set them up for relatively spacious quarantine. You don't need ventilators and ICU like capacity for the above category of asymptomatic or mildly-symptomatic patients - you need individual rooms and (hopefully) restrooms but at least by giving them individual rooms with open ventilation, you automatically reduce the viral load which is aerosolized/ via micro-droplets. If they use a common restroom, again, that can have a mandate for constant sanitization and then ventilation before usage by anyone else. This is anyday better than 1000 beds next to each other.
This is safe for them and safe for society.
You can follow the tent approach for negative pressure in large football field size stadiums for the highly infected patients who already have a very high viral load - if you can't fit the existing infrastructure to the standardized layout in commercial housing which has its panels already laid in and too many open spaces/vents which can't be managed. Then you move to individual tents for the high risk patients with the worst symptoms. Again centralization in one area allows you to centralize vs distributing 10 beds in each hospital, pool resources, trained personnel.
Here, you can pool the ventilators, the staff with the best PPE, the monitoring, ventilators etc.
In most countries, the general wards don't even have a negative pressure environment. Many hospitals run off a centralized AC which though anti-virus scrubbers are claimed, their efficacy isn't going to be tested at such short notice.
Put up separate beds in an ICU, you risk all the patients.
The above is an easier option but for the fact these tents and other gear are also usually meant for CBRN type scenarios and not easily available. I won't be surprised if US vendors have shifted even their production to China.
In India, CBRN gear is made locally, but capacities are of the order of 1000's per day, not millions (given the Indian population size, if the need to scale up capacity hasn't stil been realized..).