Wednesday 25 November 2020

Death

Globally, at least 59 million have been infected. At least 1.4 million have died. In Europe, almost 17 million infected, 383 thousand dead. In Poland, 876 thousand infected, 13 thousand dead. I find it difficult to believe the Polish figures, though, as positive test ratio in Poland has been well above 30% for the last two months. Some days, over 60%. Some districts, over 100% for up to a week. WHO recommends aiming for positive test ratio under 3% to maintain an overview of the situation. Any time discrepancy is found in Polish official data, it is resolved by no longer reporting unconsolidated data points. In September and October, only patients exhibiting 4 symptoms of COVID-19 simultaneously (high fever, difficulty breathing, cough, loss of taste and smell) were being tested. Asymptomatic patients, or patients with mild symptoms, are not being tested at all. Wait time for test results stands currently at 3.5 days on average. As a matter of policy, patients not diagnosed before death are not being tested. Tests made commercially are not included in public statistics. Officially, Poland is through the peak of the second wave, but this does feel like artificially generated optimism, created by severely limiting the number of tests being conducted. Excess mortality metric keeps rising fast, currently highest in Europe, at 86%.

COVID-19 mortality, across the whole world population: 0.02%. Mortality across the population of Europe: 0.05%. Mortality of confirmed COVID-19 cases aged under 40: under 0.5%. Mortality of confirmed cases, across various pre-existing health conditions: under 10%. The probability wave collapses when observing a singular point.

You develop fever, 39 °C, and shortness of breath. A day later, your partner loses the sense of smell (WHO reports: loss of smell is correlated with a milder form of the disease). Your partner tries to get a phone consultation with your registered family doctor, but it is difficult over the weekend, and neither of you manifests the full set of symptoms required to qualify for COVID-19 test. Friends hunt for available pulse oximeters online, two get delivered on Monday. At no point do they show blood oxygenation over 90%. Rescue services visit several times per day over the course of the week, suggesting auxiliary oxygen treatment at home. There are no available places at the city hospital. Someone delivers compressed oxygen canisters, someone else orders an oxygen concentrator device. Oxygen prices, both online and in pharmacies, are now at plainly absurd levels. Around mid-week, you finally get tested. 7 days from developing symptoms, SpO2 barely hovers over 80%. Oxygen inhalations provide a brief respite. On the 8th day, test results confirm COVID-19. During the night, you get admitted to A&E. Your child bursts into tears in the morning, as they did not get to say goodbye when you were taken in. Someone perished at the hospital that night, so on Saturday you get moved to the freed place in the isolation ward.

10 days from the infection is considered a threshold date - mild cases ten to recover by then. Prognosis worsens for those who don't. Your partner is still in quarantine, but feeling much better by now. You aren't.

16 days after symptoms started, you get a call from health services - they are interested in conducting a tracing interview. You tell them you are in the isolation ward, find it hard to talk, can't really talk in multiple sentences. Ask them to call when you can. Your blood oxygen saturation struggles to climb over 80% while breathing concentrated oxygen. Mortality of cases with SpO2 still under 90%, after 10 days on oxygen: 40%.

20 days since the symptoms started, SpO2 67% in the morning. You get moved to the intensive care unit. High-pressure oxygen administered.

21 days. SpO2 again critically low. Intubation. Attached to the ventilator ("respirator"). Mortality of cases on forced ventilation, best case scenario: over 90%.

When faced with a problem, I tend to look at the world through numbers. It helps me put things into perspective, develop plans, propose actions. I know the numbers. I have read the WHO reports, the relevant medical studies. There is nothing I can do. I do not tell the numbers to anyone.

My friend died from pulmonary embolism last week, shortly after intubation. The city of Zielona Góra reported no COVID-19 deaths for the whole 7 day period.

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