https://www.medpagetoday.com/infectiousdisease/covid19/85741?xid=nl_mpt_investigative2020-04-08&eun=g885344d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=InvestigativeMD_040820&utm_term=NL_Gen_Int_InvestigateMD_Active

— Doctor breaks down the worst fallacy

Please forgive the basic nature of this video. I’ve enjoyed spending some time with my family finally after my quarantine expired. I wasn’t planning on making a video this weekend, but everybody’s in bed now and I felt that this was important.

I have done a few interviews recently and I’ve been asked the same question every time, which is what is the worst piece of misinformation you’ve heard about coronavirus. The first time I answered I said one of those conspiracy theories that we’ve all heard, but I quickly realized actually that isn’t the most damaging misconception about the current virus at all. The most harmful perception about COVID-19 is that it’s a disease that only affects the very old or the infirm.

The Intensive Care National Audit and Research Centre is a body that collects information from all the intensive care units in the U.K. and they’ve been publishing data about the COVID-19 patients here. I briefly mentioned one of their results in a previous video and I’ve been posting updates on Twitter. The most recent, which is about the first 775 patients admitted with COVID-19 to intensive care units in the U.K., came out a couple of days ago. I put it up on Twitter and it got quite a lot of attention, and so I felt it was useful to talk about that here as well.

The European Society of Intensive Care Medicine (ESICM) has published some preliminary results — I don’t have the full data set yet — for an even bigger group of patients — I think something like 1,800 patients. But from what I have seen, the results are very comparable.

The first headline is that the average age of patients admitted is 60 years old. Now, that doesn’t mean the average age of people getting coronavirus is 60. It’s just that out of the patients admitted to intensive care units with COVID-19 in the U.K., the average age — both mean and median — is around 60. The reason I say it like that is because admissions to ITU [intensive treatment unit] are prioritized for those that have the best chance of survival.

The right-hand column is quite useful here. It shows results for admissions to ITU over the last couple of years in the U.K. for patients with non-COVID viral pneumonia to act as a comparator. We can see immediately that in comparison to the usual viral pneumonia admissions, COVID admissions have a better baseline in that 91% are fully independent compared to 73% normally and fewer have pre-existing comorbidities or medical problems.

You can also see they are much more likely to be mechanically ventilated — i.e., intubated on a breathing machine, a ventilator — which is reflective of the profound hypoxia or low oxygen levels that we’re seeing in COVID-19 and the guidance that these patients deteriorate fast, and so doctors should intubate early.

An interesting pattern that’s emerged from every country’s cohorts is that men are more affected by this than women; 70% of severe infections requiring ITU are male, and perhaps most sobering is that out of all the patients admitted to ITU so far in the U.K., almost half have died — 48%. Comparing that with the usual admissions we see in ICU for viral pneumonia, like say influenza, only 22% of those died. If it needs to be repeated again, this is not “just like the flu.”

If you look at just 16- to 49-year-olds, although numbers are low at the moment, a quarter of them admitted to ITU have died. It remains true that 80% of people that get COVID-19 will have a self-limiting illness, the way I did, that does not require hospital admission. Your risk goes up with increasing age and the pre-existence of medical conditions.

However, overall one in five people that get this will have a severe infection, perhaps requiring hospital admission. Out of that, a quarter will require admission to intensive care. As these figures show, the average age for that subgroup is only 60, and half of those patients die.

Something that’s not captured in these figures is that death is just one marker. If you spend a week on a ventilator and 2 weeks in the hospital overall and then go home alive, that’s hardly what I’d call a mild infection. As I’ve said before, the main risk for most of us is not from the virus itself, but the effect that it’ll have on how healthcare functions in our respective countries.

On the subjects of healthcare, we’ve now seen three doctors here in the U.K., several in America, and 51 in Italy lose their lives directly because of COVID-19 — many or perhaps even most of whom were fit and well beforehand. To my sisters and brothers in healthcare, especially those going into battle like this without the appropriate armor — which is something that I just cannot believe is happening in developed countries, it shouldn’t be happening — I salute you.

That’s it. That’s the video. This isn’t aimed at any particular age group nor political affiliation. I find it remarkable I even have to say that second point because somehow this has become a partisan issue, which again I can’t understand.

Perhaps, if this does have an intended audience, it’s the middle-aged politicians who maybe also think that they’re too young for this disease and promote this appalling fallacy that COVID-19 is only killing patients who would have died sooner or later otherwise. Just stop f**king around.