by Karl Denninger, Market Ticker:

CNBC is at it again with the “oh no, the hospitals will overload!”

Folks, here are the facts in the US:

1. About 15% of the tested are positive.  To be tested you must be symptomatic (or have a lot of money and/or power)  Note that the test has a roughly 30% false negative rate (you’re positive, it misses it) so none of these cases wind up being considered for admission as Coronavirus cases.  These presumably all recover without admission, plus all those who are true negatives.

2. Of that 15% which test positive 12% (CDC numbers) meet criteria to be hospitialized.  Note that of these exactly zero require an actual hospital bed at that stage; oral medication and monitoring every few hours can be done anywhere, by anyone.

3. Of the 12% about one quarter wind up requiring an ICU.  Now we’re truly in the “hospital required” category.  Invasive procedures (vent, whether positive pressure mask or intubation) or critical monitoring (e.g. heartbeat, SpO2 on an “always-on” rather than spot-check basis, etc) This is also where artificial feeding and hydration come into it because you literally have no choice; with a positive pressure vent required to breathe or a tube down your throat you can neither eat or drink so a tube for that goes SOMEWHERE.

4. Of those who went on vents in Wuhan 95% did not survive.  That is, the “save” rate if you got there was five percent.  We do not know what it is here, but the “base” save rate for a vent in a US hospital from all causes is right at 50% to discharge and 30% one-year survival (vents invariably produce fairly serious damage to the victim and you frequently die not long after that.)  It is laughable that our hospitals can approach their “stock” 50% save rate – even if we’re twice as good as the Chinese, which isn’t implausible, our save rate is only 10%.

So of those who meet the criteria to be tested in the US today (by definition if you wind up in the hospital with KungFlu you’re going to get tested) 0.45% of those people wind up in intensive care (0.15 * 0.12 * 0.25) = 0.45%

Current estimates are that nine out of ten people do not develop symptoms sufficient to test.  Therefore, of those who contract Coronavirus the percentage of those who wind up in an ICU is 0.045%, approximately.

By the way — this clowns the “2% fatality rate” figure instantly.  Fatality is some fraction of the 0.045%, in other words.  But no, the media (obviously) cannot do multiplication — we’re talking grade school math here folks.

Everyone who does not require ICU care requires no hospital at all; we can provide drugs, we can provide at-home monitoring of SpO2, we can provide at-home monitoring of BP and heart rate and temperature and we can provide at-home supplemental oxygen.  All of these are trivial to do and cheap.  Such data can be transmitted in or care-givers can be given thresholds where transport is actually required.

Keeping people out of the hospital when no actual intensive, “always on” care is required improves outcomes; you immediately remove all the instances of hospital-acquired infections, for one, and if you’re already fighting a virus the last thing you need is an infection you acquire in the hospital on top of it.  If said person lives alone with nobody willing and able to help (e.g. nobody seropositive and thus immune) then we may well need someone for them to be, but it doesn’t have to be what you think of as a “hospital.”

Now let’s face facts: If you wind up on a vent in the ICU with this virus you are almost-certain to die.  That probability is almost-certainly less than or equal to 95% but materially greater than 50%.  The hospitals aren’t publishing those numbers (gee, I wonder why?) but you can bet the odds suck.  Let’s call it 90% failure.

Ok, so now of the cases we can change the outcome of 0.0023% of the cases by not overloading the medical system.

Because the outcome is so bad if you wind up on a vent we must be extremely aggressive in trying to prevent that.  We have evidence, but not scientific proof, that a number of said therapies (e.g. hydroxychloroquine, etc) are effective.  Exactly how beneficial is not known but avoiding the ICU, given the stats, is the key to not being dead.  We have to use what we’ve got; any improvement is better than none, and while I’m sure there is a range of effectiveness for what is being tried until something proves better you use what you got.

Let’s say that out of the 330 million people in the US 70% will eventually get the infection.  I have no reason to doubt this.  The idea that we can actually repress math is laughable.  The idea that we’re going to get a vaccine with persistent immunity is contrary to every piece of science on coronaviruses to date, both in humans and animals.  The data in fact does not support any other conclusion; either this thing is not nearly as transmissible as we think it is (unlikely), the percentage of people who have or have gotten “silent” infections is outrageously high or the range of people who cannot get it for some other reason (e.g. cross or natural immunity) or some combination of those elements has to be true.  Diamond Princess along with South Korea, Japan and Italy all demonstrate this conclusively.  Anyone arguing otherwise is arguing against all of the existing data.

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