Dr. Seheult, a critical care pulmonologist, shares the latest details on the COVID-19 outbreak and also some practical things Seventh-day Adventists are uniquely positioned to do in the midst of this crisis. Dr. Seheult has also been sharing extensive updates all throughout this outbreak via his MedCram YouTube channel.

<p>Dr. Seheult, a critical care pulmonologist, shares the latest details on the COVID-19 outbreak and also some practical things Seventh-day Adventists are uniquely positioned to do in the midst of this crisis. Dr. Seheult has also been sharing extensive updates all throughout this outbreak via his <a href="https://www.youtube.com/user/MEDCRAMvideos/videos">MedCram YouTube channel</a>.</p>

<p>Free sharing permitted under the Creative Commons <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/us/">BY-NC-ND 3.0 (US)</a> license.</p>

Mentone SDA Church

Roger Seheult

COVID-19 Update with Dr. Roger Seheult

I want to welcome everyone this afternoon to a special time Where we can get a covid19 update from dr.

Roger Schwelt Again, we're so thankful that you're willing to take time to give us this update and I'd like to begin with prayer asking that God will bless our time together.

So please bow your heads with me and then we'll turn the time over to him.

Heavenly Father we are thankful for your goodness and your love.

We are thankful that you are in full control of all things.

And again, we just ask that you will bless our time together as we think upon these things and how We can be helpful in this time of crisis.

Schwell, thank you again for joining us the time is yours Thank you very much rodney so, good afternoon everyone and today is March 21st and we're talking about the COVID-19, which is the disease caused by SARS-CoV-2, the RNA virus, which has literally taken the world by storm, started in late December, and now we are more than halfway through March, and we're starting to see a pandemic.

Wanted to kind of bring you up to where we talked about last week and where we are this week.

Obviously, a lot of changes have happened in the last week, and they're all related to trying to work towards reducing the amount of demand that is going to be needed on the health care system here in the United States and around the world.

And we're seeing images on our newsfeed, on our televisions about what is going around the world.

We can see here in Italy, coronavirus patients, it says, on Apocalypse Ward, gasp in bubble helmets as army move bodies.

And you can see that these patients are being hospitalized in Italy and there has been a lot of issues regarding that right now Italy has surpassed China in the number of dead at least officially and also in terms of the number of infected.

I think what we're going to, what I, the purpose of what I'm going to do today is tell you where we are right now, what the strategies are that have been employed here in this country, what is the possible things on the horizon, and what we can do.

I think 1 of the most important things to understand right now is The way we're practicing medicine is not the same as we're going to be going forward.

I think a catchphrase would be, the good is not the enemy of the perfect.

The perfect is the world that we used to know in terms of how we practice medicine.

We had enough equipment, we had enough supplies.

We didn't use medication unless we had evidence for it.

We would need to have a randomized controlled trial, a double-blinded placebo-controlled trial before the FDA would approve a medication.

Those are all very good things in a very controlled situation.

But when you have an emergency situation, and by all counts, what we have right now is an emergency situation.

I'm a pulmonary critical care physician, and I work at a hospital.

And our hospitals, both of them that I work at, are preparing for an emergency situation.

We have had the benefit in this country of seeing other countries going through what we are about to go through, and there are certain things that we need to do to prepare for that.

But I wanted to show you what really we are up against and why we're under the isolation things.

Because it's very important for you to understand.

This video, in my estimation, the information I'm about to show you in this video is probably 1 of the most important videos that you're going to see all year in terms of what to do to prepare for that.

So please, if there's anybody that's around, sit them down and watch what we're about to go through because it's extremely important for you and your family and your loved ones.

So what I'm showing you here is a PDF that was, that is a study that was published from the Imperial College in Great Britain, looking at what they are preparing for in terms of hospitalization.

You can see here is a table looking at different age groups, 0 to 9.

And what I'm gonna do is I'm gonna blow this up a little bit more so you can see it better.

0 to 9, the number, first column is the number of symptomatic cases requiring hospitalization.

The second column is the number of hospitalized cases requiring critical care.

And the last column is the infection fatality ratio.

This is based on the current estimates based on what they had seen.

So you can see here 0 to 9, very, very low cases all the way up finally to 80 plus years of age, the percent requiring hospitalization upward of 27 percent, percent requiring critical care, 70 percent of those upward of 27% percent requiring critical care, 70% of those hospitalized patients.

And then the infection fatality ratio is about 9.3%.

All to say this is if you take and you look at the population and you look at the number of people that are deemed to be infected, the, the statistics show that about 80%, that's a very important number, 80% of the people who will come down with this infection will not, will not need to seek medical attention at the hospital, but about 20% of those patients will need some sort of hospitalization or at least medical evaluation.

And in that 20%, about a quarter of them, so about 5% of the overall population, roughly, will need critical care, critical care beds.

Now that doesn't sound like a lot, just 20%, but we're talking about tens of millions of people in just the state of California, potentially, that might get infected.

And we're talking about even more millions of people in the United States, not to even mention worldwide.

And so when you multiply that 20% by a very, very large denominator, the entire fraction becomes so large that you could potentially and will overwhelm the ability for the healthcare resources to deal with you and to take care of you.

And that is why, and so there's 2 issues to this.

There is the demand side of the equation, the demand side being the population, the percentages that need care of the equation.

That is, how many hospital beds do we have?

How many nurses, physician assistants, nurse practitioners, respiratory therapists, pharmacists, it's an all hands on deck situation.

And so they, obviously to quell or to prevent this huge surge from hitting the hospital all at the same time, which is what would happen if you had all of these people intermigrant and passing this virus, which is very infective all around.

It would be a huge tidal wave, tsunami hitting this hospital.

And so what they're trying to do is flatten out that curve.

And I'll show you here in the study as we scroll down some of the things you can see that they've done some calculations.

This is the sobering graph that I want you to understand.

Here, this black curve that's going up is the do nothing curve.

And you can see that the number of people that they're expecting over here on the far left is March 20, okay?

And as you can see here on March 20, that's where we are right now.

Many people are saying, you know, people die of the flu every year.

Why are we this is the government trying to usurp?

Power that very well may be in some situations, you know, the government is not monolithic There are a lot of people in the government But what they're doing is for a good reason because you can see if we do nothing there is a very very large tidal wave that is going to hit the healthcare system.

And so people who need that healthcare system for other things, not even COVID-19, let's say they get a pneumonia from another reason, or they have diabetic issues, or they have high blood pressure issues or they need surgery.

It's going to be so saturated that they're not going to be able to get that surgery.

Here if we close schools and universities, then we have the green curve.

So again, it's bad, but it's less bad than doing nothing.

If we did case isolation and household quarantine, this is what the yellow curve would be.

And if we did all of those case isolation, home quarantine, social distancing, a greater than 70 year olds, we could get this curve down to blue.

So there's a lot of things that we can do.

The problem is, is that this red line, which I haven't mentioned up to this point, is the capacity of our healthcare system.

At least according to this paper in the UK.

And the UK is not that much different from here in the United States.

So you can see that even though we're doing all of these things, there is going to be a huge problem.

And to bring it a little bit closer to home, I can quote what the governor of New York, Governor Cuomo said.

They anticipate that they will need to have 37, 000 ventilators at the peak of their epidemic in New York State, and they have only 3, 000.

And so we're trying to be very creative in medicine.

I'm part of a planning committee here locally about what we're going to do.

There is talk about taking ventilators and ventilating 2 people with 1 ventilator at the same time.

That way you can double the effect of a number of people while you're waiting for new ventilators to come in.

Of course, there are very famous CEOs who own very large car companies that are turning their companies over to making ventilators as quickly as they possibly can to meet this demand.

We are taking ventilators and ventilating 2 people.

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COVID-19 Update with Dr. Roger Seheult

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