COVID-19 Update: Review of Peak Numbers and Immune Boosting Recommendations

Aaron Hartman, MD (April 25, 2020) presents a COVID-19 status update reviewing global and US case/death curves, arguing that US figures must be interpreted at subnational level ("US ≈ 50 countries") and noting encouraging signs that many metrics (daily cases, daily deaths, active-case growth, death rate percentage) are stabilizing or flattening. He highlights model projections (University of Washington) suggesting US deaths could peak ~68,000 by August 4, 2020, and reports that resource capacity (ventilators, beds, ICU) was not exceeded in many places; New York and Virginia are discussed as case studies. He also recommends immune-boosting and preparedness measures (vitamin C, vitamin D, hydrotherapy, HEPA filters, PPE) and urges attention to Southern Hemisphere and African outbreaks for insight into potential future waves.
Questions this video answers
About 32%
A projected peak of ~68,000 deaths, with the seasonal projection to August 4, 2020.
Initially projected up to 100,000+ (later estimates 200–300k), but the speaker said only ~15,000 ventilators were needed.
Beds needed: 984; beds available: ~6,500.
ICU beds available: 718.
Chapters
You. It's great to be with everybody again this morning. So I'd like to do another COVID 19 update. And their point of this is just to review the peak numbers and some immune boosting recommendations. So there's been a lot of changes this week and some data on drugs, but I want to kind of go back and do a few basic number evaluations because there's some actually encouraging news. So this is looking at number of cases in the world. At first glance, you see the number of cases in the United States is rising consistently and looks like the rest of the world is kind of flattening out a little bit. But when you look at the cumulative cases in the United States versus Europe, you see they're about the same. And this goes to the point that the United States and Europe are roughly the same, population wise. But that also goes to the point that the United states acts like 50 different countries. And so when you look at the United States versus Europe, it's really not quite fair. You need to look at New York versus Italy, for example, or maybe South Dakota versus Holland. And so that's the point of this graph, is to show that as we're looking at data and information, we have to remember that the United states is basically 50 countries, not one country. When we're looking at these kind of demographics, a huge country and now represents the majority of cases of this in the world. Again, when you look at the cumulative number of deaths, you do see the number of deaths are going up, and it looks like it's going up significantly. The green line represents the United States. But again, that's a little deceptive and we'll talk about that in a second. Here are the number of cases in the United States versus Europe. Again, Europe started before us, so you expect our line to be lagging, but you see ours is kind of breaking off earlier than the Europe, which actually goes to the fact that our numbers are peaking out and coming down a little quicker than European countries. If you look at countries in the world, about 32% of the world's cases are actually in the United States, which means, you know, a third of this is actually just here in the United States. I want to actually show this case timeline. This is very interesting. If you look at starting in China, we play this out, what you see is the spread across the world going to Northern Hemisphere countries. Then now, right now, what's happening the spring, south to Africa. Australia actually is entering their, their fall right now. And so they're going to be entering their peak flu season. So we should be watching what's going on. Australia, New Zealand, and this is the total cases worldwide. And again, the curve is going up, but the peak total will be coming soon. The thing about this is just. This is just the total number of cases. So if you look at the actual daily cases, this represents more the fact that worldwide the cases have flattened out and you'll see that yes, there are cases continuing to occur, but it's not escalating. It's relatively stabilized. Basically. That's the point of that. Active cases still going up, recovered, but I think infected versus newly recovered. This is another interesting one where more and more people are recovering versus new cases. And both of these are flattening out, which is again, what we would expect. Same thing with critical cases, a number of recoveries versus death. The death rate appears to be staying relatively stable. And we'll talk about this later on how the death rate actually is probably much less than originally reported. And daily deaths again, flattening out, basically. And then one other thing. I like this percentage because you look at the total deaths due to Covid, you see that initially was much higher late March, and now it's actually coming down 3%, 4%. So we see a stabilization, all these numbers. The gist is that we're actually making progress. Look at the Worldometer. This actually gives the United States and compares with the rest of the world. Again, we represent third of the cases worldwide. Now what I want to do is actually just hone in the United States a little bit and look at the total deaths and you look at where we're at on the curve from this information from University of Washington, you see we're close to the peak. If this is the peak right here, we're pretty close to that. And there's projecting maybe a peaking out in this season of 68,000 deaths. Again, this is projected to August 4th. If you look at the top right here where the pointer is, point is we're clear close to the end of the maximum number of deaths for this season that's going to end August 4th. So with that information in hand, we shouldn't expect to see a lot more deaths this season through August 4th. The question is, what should our politicians do with that information? What should we do with that information going forward to working, et cetera? I want to go up here and just look at our hospital use. We didn't meet peak utility. We actually did. We thought we're going to do we maximize hospital use. If you look at the blue number up here, which is I'm Pointing to is ventilators needed 15,000 initially, if you remember, we had 100,000. And we're going to need, you know, many more times ventilators. We boosted it up to 200, 300,000 times. We needed ventilators. Well, we only needed 15,000. So no one died. Even in New York City, the epicenter of this, no one died for lack of care. People did die in New York City, but no one did not get care. No one died from lack of a ventilator or lack of care. That's very, very important. We did flex, we did adjust, and now on the back end of things. Now, I live in Virginia, and I want to look at Virginia because Virginia is an interesting case study. We didn't get close to our maximum peak number. If you look at, let me see here, things down here, that's our death. If you look at number of beds needed and beds available, you know, we had 984 beds were needed, 6,500. We didn't get close to, to meeting our capacity in the state of Virginia, ICU beds, we got two thirds of the way through. But the point is, if you look at this graph here, you see that we're kind of flattening out. We've reached our peak. April 23rd. Today's the 24th on the day I'm recording this, our flats. We've reached our peak. Resource use. It doesn't mean that people aren't dying. It doesn't mean that there aren't sick people in the hospital. It means that for this pandemic, which this is a worldwide pandemic in the state of Virginia, we did not exceed our capacity to care for these people. That's an important caveat. If you look at total deaths, again, Virginia, same kind of graph. We're about halfway through. Again, if we repeat to the top, you expect half the deaths to be on the left side of a graph and the other half on the right side. And that's kind of what this shows. But again, August 4th. So what about September 1st, October 1st, November 1st? No one's talking about that. Australia is entering their fall right now. So I think all eyes are on Australia to see what goes on in other parts of the world. And last but not least, talk about New York, which is the epicenter. This is the worst of the worst for the United States, and they are on the back end of things again with their cumulative deaths. It's 15 days since their peak. Again, if you look at this red area, range of variance, huge projected difference from 1500 deaths per day to 166 deaths per day. They're at 608 deaths, perhaps deaths per day. They've already peaked out. If you look at the near curve is very interesting because they did kind of get close to their peak with what they actually met here. So that was kind of close to that. But then the backside. Now you look at the beds needed versus beds available. They have a bed shortage. Bed shortage does not mean lack of care. Bed shortage means like every flu season in central Virginia, people will be on gurneys in the hallways, rooms will be packed. Instead of one person per room, you might have three or four. Um, so that, that's what that means. But ultimately, ICU beds needed. This is the key. ICU beds needed. 61, 88. ICU beds available. 718. Now you have to realize, and look at this as these are beds used at any point in time. This is for the whole season. No one in New York, and this is where the data can be kind of tricky. No one in New York died for lack of a ventilator or lack of care. They were stretched. And even the governor of the state and as well as the New York says this repeatedly. And then deaths, they're kind of toward the peak of their deaths here April 24th. So the gist is we're kind of on the back end of this season. Definitely New York and Virginia. We're kind of midway. When I say this season, I mean we're going to start again in the fall. So what we should be doing now is looking towards Australia and what they're doing, what's going on in Australia. So I think that that's, that's good news. I think that means that we can start making some big different decisions about what we plan on doing. So to kind of circle things back around, things to worry about. South Africa and South African nations. Africa, which has roughly 25% of population, has HIV. Some of these countries have massive amounts of tuberculosis. What's going to happen in those countries, we don't quite know yet. People are already impoverished, people that already are going hand to mouth daily, people that already have nutrient deficiencies, and a significant number of chronic illnesses like HIV or tuberculosis. I think we should be watching what happens in these African nations, which are incredibly populated nutrients. I've talked about these before, and there'll be some articles that I'll attach below here talking about vitamin C shortening, hospital stays in the icu, improving lung function, hospitalized patients, even sepsis patients with organ failure, IV vitamin C being useful. And we're using this in the Virginia Richmond, central Virginia area as well as New York and other places across the country. Vitamin D actually shown to be help off fight off COVID 19 and helping fight off flu like illnesses and other others. I'm going to refer back to the survival guide I've put together. There'll be links below. It's available on our website for anybody to download. These are things we need to be thinking about now because as we go through and finish this season off, we have to realize that another season is coming. What can we start doing now to prepare for that? HEPA filters for our workplaces, for our houses, to filter out these micro particles, your personal PPE mask, all these things. Protective gear, other things. Hydrotherapy. Something I mentioned before and there's actually an article below talking about hydrotherapy. How can you boost your immune system in your own shower? Is that even possible? Well, actually it is and there's been previous videos we've done in the past talking about the Finnish studies and how hydrotherapy, which is basically hot, cold and a shower can actually boost your immune system in the road forward. I want to just again summarize. We've done a lot of previous videos talking about numbers. This past weekend we did one a little more in depth on some numbers as well as like where we're at. We need to be talking about this among ourselves and talking with our representatives, what our expectations are as localities, regions, states and then ultimately at a national level, Australia, I think New Zealand. These countries are now entering their fall will be instructive for us. Do they get a second peak? We're going to need more data, more information. But this kind of data information will not be forthcoming for months and so we need to kind of realize that and make decisions and move forward. Hopefully this was helpful. I think overall we have a lot of good news coming out. I will be talking later on about some new drug studies that are popping up. You know, if you want to follow us, please follow us at the follow button. Wherever you are following us like us, share this that help makes this information more available to other people and as well look at our website. We have a lot of resources there including the guide that are available for download. I hope you all take care. Have a great weekend. Be safe. Hopefully find some good resources that will help you and stick with those. I think the big thing for this week that I've been hearing a lot about is anxiety and stress related to the flurries that are going on and we'll be doing some videos about that as well, that will hopefully be available soon. Y' all take care. Have a great weekend, and be safe.
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