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Thread: Why is mortality from Covid-19 higher in Italy?

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    I am posting the order per mortality
    and the order per spread
    The difference among Italy and Swiss is mortality,
    while share simmilar spread,

    COUNTRY Population /1000 Confirmed infected deaths upon confirmed Confirmed infected /1000 people Current Mortality of conf. Mortality 3 APR










    1 Italy 60318 135586 17127 2,2479 0,1263 0,1207
    1 San Marino 33 279 34 8,4545 0,1219 0,1224
    2 UK 67547 55242 6159 0,8178 0,1115 0,0866
    3 Netherlands 17425 19580 2101 1,1237 0,1073 0,0911
    4 Spain 46733 141942 14045 3,0373 0,0989 0,0923
    5 France 67022 109069 10328 1,6274 0,0947 0,0911
    6 Belgium 11516 22194 2035 1,9272 0,0917 0,0659
    7 EU 449507 608750 49990 1,3543 0,0821 0,0756
    8 sweden 10303 7693 591 0,7467 0,0768 0,0553
    9 Hungary 9773 817 47 0,0836 0,0575 0,0417
    10 Albania 2877 383 22 0,1331 0,0574 0,0578
    11 Hubei 58500 67803 3213 1,1590 0,0474 -
    12 Romania 19402 4417 197 0,2277 0,0446 0,0424
    13 Greece 10768 1832 81 0,1701 0,0442 0,0343
    14 Severna Mac 2077 599 26 0,2884 0,0434 0,0286
    15 Bosnia 3511 764 33 0,2176 0,0432 0,0295
    16 Andora 76 545 22 7,1711 0,0404 0,0280
    17 mainland China 1427648 82751 3337 0,0580 0,0403 0,0403
    18 Denmark 5823 5071 203 0,8709 0,0400 0,0363
    19 Bulgaria 7000 577 23 0,0824 0,0399 0,0252
    20 Swiss 8570 22253 821 2,5966 0,0369 0,0285



    and here is after spread

    COUNTRY Population /1000 Confirmed infected deaths upon confirmed recover Active % Confirmed infected /1000 people Current Mortality of conf. Mortality 3 APR current Recover of conf. Recover 3 APR deaths per 10 000 population Estimated mortality up lim Estimated mortality low lim estimated deaths *






























    1 San Marino 33 279 34 40 73,48 8,4545 0,1219 0,1224 0,1434 0,0857 10,3030


    2 Andora 76 545 22 39 88,81 7,1711 0,0404 0,0280 0,0716 0,0234 2,8947


    3 Luxenbourg 614 2970 44 500 81,68 4,8371 0,0148 0,0121 0,1684 0,0322 0,7166


    4 Iceland 364 1586 6 559 64,38 4,3571 0,0038 0,0030 0,3525 0,2153 0,1648


    5 Feroe isls 52 184 0 120 34,78 3,5385 0,0000 0,0000 0,6522 0,5084 0,0000


    6 Spain 46733 141942 14045 43208 59,66 3,0373 0,0989 0,0923 0,3044 0,2386 3,0054


    7 Swiss 8570 22253 821 8704 57,20 2,5966 0,0369 0,0285 0,3911 0,2132 0,9580


    8 Italy 60318 135586 17127 24392 69,38 2,2479 0,1263 0,1207 0,1799 0,1586 2,8395


    9 Liechtenstein 39 78 1 55 28,21 2,0000 0,0128 0,0000 0,7051 0,0000 0,2564


    10 Belgium 11516 22194 2035 4157 72,10 1,9272 0,0917 0,0659 0,1873 0,1626 1,7671


    11 France 67022 109069 10328 19337 72,80 1,6274 0,0947 0,0911 0,1773 0,2103 1,5410


    12 Austria 8903 12639 243 4046 66,07 1,4196 0,0192 0,0141 0,3201 0,1562 0,2729


    13 EU 449507 608750 49990 135808 69,48 1,3543 0,0821 0,0756 0,3021 0,1905 1,1121


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    So if tuberculosis vaccine can not give an aswer,
    the last I can imagine is the image described by 2 doctors, at TV
    one in Bergamo, and one in Barcelona,
    'Anaesthesiologists choose who will live and who will die'
    sometimes above 65 could mean no breath support

    comparing with nextby to Italy, Swiss and Austria,
    Can the high mortality be a result of 'overcrowded' hospitals, crash of system?
    bigger demand for the apropriate beds

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    Quote Originally Posted by Yetos View Post
    So if tuberculosis vaccine can not give an aswer,
    the last I can imagine is the image described by 2 doctors, at TV
    one in Bergamo, and one in Barcelona,
    'Anaesthesiologists choose who will live and who will die'
    sometimes above 65 could mean no breath support

    comparing with nextby to Italy, Swiss and Austria,
    Can the high mortality be a result of 'overcrowded' hospitals, crash of system?
    bigger demand for the apropriate beds
    Being on a ventilator is not a guarantee of survival. In fact, most of the people who have died so far were in ICU with ventilators.
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    Quote Originally Posted by Maciamo View Post
    Being on a ventilator is not a guarantee of survival. In fact, most of the people who have died so far were in ICU with ventilators.
    as a matter of facts it's quite scary
    most of them are put asleep
    and when you ask whether you'll wake up again, no reply

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    Quote Originally Posted by Maciamo View Post
    Being on a ventilator is not a guarantee of survival. In fact, most of the people who have died so far were in ICU with ventilators.
    indeed but if 1 man survive out of 100 when being on a ventilator,
    changes numbers and statistics.
    the mortality distance from other EU countries could not be so high, (matrix bellow)
    and Italy's high mortality could be just a normal point.

    the possibily of age,
    comparing the 22,6 % of Italy with 21,8% of Greece and 21,4% of Finland and with Japan,
    would not make so much difference, except if most aged ones were in the epicenter of spread,

    and Greeks are more fat and more smokers than Italians, (even some others)
    so we may exclude the 2 above.

    other vaccinations and immunities like tuberculosis or thalassaemia,
    they don't seem to make such differnce when compared with other countries like France as it mentioned before.

    that is the last (for now) someone may think.


    offcourse the high mortality point, could be the random extraordinary statistical point,
    the one in Greek we say 'εξαιρεση που επιβαιβεωνει τον κανονα', the exception that is needed to certify the normality
    but observing UK stats and tense, the extraordinary high mortality point of Italy soon may be just a normal point.

    Italy 0,1263
    UK 0,1115
    Netherlands 0,1073
    Spain 0,0989
    France 0,0947
    Belgium 0,0917

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    ... imo, the title of the thread is debatable.

    Every country has its own standard of assigning causes of death.

    In Italy the dead with pre-existing conditions positive with Covid-19 are included in the list,
    (unlike some other countries).

    Statistics are worthless without a standardized data conformity between Countries.

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    Quote Originally Posted by Salento View Post
    ... imo, the title of the thread is debatable.

    Every country has its own standard of assigning causes of death.

    In Italy the dead with pre-existing conditions positive with Covid-19 are included in the list,
    (unlike some other countries).

    Confirmed cases have only 2 results, Death or Recovery,
    if you write pneumonia, then you must find another body, or ressurect someone else
    otherwise the hoax is visual M+R= Confirmed

    as for Greece, 1rst degree relatives must sign an information papper of Covid-19 death in family,
    so the body to be delivered for funeral.
    and is tranfered by special organised for the occasion team and vechicle, with Police company,


    Only Lazaros and Jesus ressurect.

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    Quote Originally Posted by Yetos View Post

    Confirmed cases have only 2 results, Death or Recovery,
    if you write pneumonia, then you must find another body, or ressurect someone else
    otherwise the hoax is visual M+R= Confirmed

    as for Greece, 1rst degree relatives must sign an information papper of Covid-19 death in family,
    so the body to be delivered for funeral.
    and is tranfered by special organised for the occasion team and vechicle, with Police company,


    Only Lazaros and Jesus ressurect.
    and where the ... is Jesus ?

    .... oops, mea culpa :)

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    1 members found this post helpful.
    Quote Originally Posted by Salento View Post
    ... imo, the title of the thread is debatable.

    Every country has its own standard of assigning causes of death.

    In Italy the dead with pre-existing conditions positive with Covid-19 are included in the list,
    (unlike some other countries).

    Statistics are worthless without a standardized data conformity between Countries.
    That's indeed the case. The issue was addressed in yesterday's briefing. It was pointed out that in the U.S. (and in Italy from what I understand), if the patient is a Covid 19 patient, either because of a Covid 19 test or because of the distinctive lung X-Ray, it's considered a "Covid fatality", which is only reasonable.

    However, as was also pointed out, there are countries which don't do that, Germany being one.

    Also, in some countries it's the hospitals which do the reporting, and they don't add in the deaths at nursing homes.

    Finally, the deaths are always a lagging indicator.

    We have great statistics for epidemics which are over. You really can't get completely accurate numbers while it's still going on. We would need randomized studies of how many people have been exposed, how many were symptomatic, not at any one point in time but for at least a month, then how many died.

    Then the availability of the machines has to be examined, the amount of protective gear the doctors had, etc. Christ, they were using machines with 3D printer parts, and scuba gear. Here, at least, ventilators were sent from California and Oregon on loan to New York because their situation wasn't as dire, and doctors came from around the country to help out.

    Last count I saw, more than 60 doctors have died in Lombardia, which echoes what was happening in China.

    You can't compare the situation there with countries with a few hundred cases; it's ridiculous.

    So, I personally see no point in continuing this discussion.


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    in germany the mortality could be this low because of several factors. i read somewhere that no other country in the world made as many corona tests as germany, relative to the population size. so maybe they were able to find more infected.
    another reason could be that most people who are infected in germany are between 20-50 years old. but maybe that is actually also the case in other countries, they just didn't test those age groups that much because they show milder symptoms.
    germany has 25'000 respirators compared to 7000 in france and 5000 in italy.


    not sure but i believe in germany everyone who dies while having corona counts as a corona fatality. it's just that they do not test someone after the person already died. their argumentation is that someone who shows severe symptoms that could lead to death is most of the time tested before he dies. according to the german officials testing after the death would make little difference. according to italians it could make a difference because people who die at home are not included.

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    I think this rather proves the point:

    "In Madrid 4260 of the 4750 people who've died in nursing and disability/mental health homes there in the last month had either contracted Covid or displayed Covid symptomsOnly 781 had been officially listed up until now".
    https://elpais.com/espana/madrid/202...ltimo-mes.html


    Same thing may be happening elsewhere, even in Italy. We just don't know, so our speculations are pretty groundless.

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    switzerland has a low mortality rate but many infected/1000 people. maybe it is also because they made more testing? the hospitals there are still fine i think. enough place for patients from other countries.

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    Quote Originally Posted by Salento View Post
    and where the ... is Jesus ?

    .... oops, mea culpa :)




    there is no official report, by Greek hospitals,
    since they were not Greeks or live in Greece



    mea culpa?
    .
    Last edited by Yetos; 08-04-20 at 19:54.

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    Quote Originally Posted by Angela View Post
    I think this rather proves the point:

    "In Madrid 4260 of the 4750 people who've died in nursing and disability/mental health homes there in the last month had either contracted Covid or displayed Covid symptomsOnly 781 had been officially listed up until now".
    https://elpais.com/espana/madrid/202...ltimo-mes.html


    Same thing may be happening elsewhere, even in Italy. We just don't know, so our speculations are pretty groundless.
    that means about 10% of these are still in 'machine', or recovered?

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    Quote Originally Posted by Ailchu View Post
    in germany the mortality could be this low because of several factors. i read somewhere that no other country in the world made as many corona tests as germany, relative to the population size. so maybe they were able to find more infected.
    another reason could be that most people who are infected in germany are between 20-50 years old. but maybe that is actually also the case in other countries, they just didn't test those age groups that much because they show milder symptoms.
    germany has 25'000 respirators compared to 7000 in france and 5000 in italy.


    not sure but i believe in germany everyone who dies while having corona counts as a corona fatality. it's just that they do not test someone after the person already died. their argumentation is that someone who shows severe symptoms that could lead to death is most of the time tested before he dies. according to the german officials testing after the death would make little difference. according to italians it could make a difference because people who die at home are not included.

    that is a factor that many discuss lately,
    China and Japan had the ability to use as 8 /1000 population

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    For now it seems that Italy's extraordinary mortality was just a random, not in time with rest countries, peak,
    Britain has reach that mortality with the mistake of 3rd class number,
    which probably means that Italy's high mortality was just a temporary phaenomenon, giving false impressions
    or I said Coronavirus caught Italians on sleep, not expecting it so soon to them

    Anyway most numbers West of Alps show a better normal distribution now,
    but seems we can break the stats to 2-3 different distributions
    the West Europe,
    the SE Europe -Balkans
    the NE Europe

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    i just read that in Italy around 30% of the tested people are positive. in Germany it's only 4%.

    so what i take from this is, that in Italy tests more people based on visible symptoms, because of this they see way less infected than there really are in Italy. their mortality rate is probably not really higher than in other countries but they have way more infected people than they think. based on the number of deaths it could already be 6 millions.

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    1 members found this post helpful.
    Age is indeed a factor, I think, but it's in combination with other factors.

    As with everything else, there is a north/south skew in Italy with respect to life expectancy...



    These numbers for northern Italy seem really high to me. Air pollution in Lombardia may have pushed it down a bit, but not by all that much, it seems.

    So, let's say that the age of the population is one factor.

    Then, there's the fact, which I mentioned weeks ago, that Italians have a great deal of close contact across generational lines. Here's an article which finally highlights that fact:
    https://www.spectator.co.uk/article/...st-coronavirus

    What is often forgotten in these discussions is that the number of Coronavirus "infections" in Germany and Italy are not that dissimilar, despite all the vaunted testing, tracing, isolation, which Germany has supposedly done. The disparity which does exist could be a function of other factors as well, as I'll mention below.

    ". Italy has 143,626 confirmed coronavirus cases; Germany has 114,257." Yet, the "death rate" in Germany is 2% versus 12.7% in Italy. Why?

    One clue is in the average age of the infected. Given the known fact that it is so much more fatal in those over 70 and particularly those over 90, that accounts for a great deal of the difference.

    "
    The median age for confirmed cases of coronavirus in Italy is 63-years-old. In Germany, it is 48."

    It seems that the first infected in Germany were young, and younger people in Germany have much less contact across generational lines than do Italians.

    "
    Among Germans aged 60 or over, only 6.9 per cent live with children, while that number is 27.4 per cent for elderly Italians, according to a UN report. "

    "Italy’s elderly are encouraged to live in familial homes as opposed to seeking residential care, since 72.4 per cent of Italians own their homes. In contrast, only 51.5 per cent of Germans own theirs, so more German elderly people are separated into residential facilities. Germany also provides more pre-school services than Italy. Italy’s children under three years of age are therefore often taken care of by their grandparents when their parents are busy working."

    So, then, what about deaths in nursing homes. They're virtual death camps in other countries. Perhaps families in Germany don't visit as often?

    Age and amount of intergenerational contact are not the only factors, however.

    There is also the question of ICU/ventilator availability. I think this is more important than I initially thought. Britain has a younger population than Italy, perhaps more like Germany? Also like Germany, there is less intergenerational contact than in Italy. I'll have to wait and see the CFR for Britain, but Britain's number of ventilators is extremely low, so that may indeed be a factor.



    Then there's the issue of reporting. Germany DOES NOT count deaths OF Coronavirus if the patient had a prior co-morbidity but died WITH Coronavirus. The article calls that "scrupulous"; I call that misleading. What are the odds the patient "wasn't" impacted by the existing Coronavirus infection?

    So, as we can see, there are numerous factors which might be involved. Differing genetic susceptibility might also be a factor. That will have to be studied.

    Note that I'm trying to look at CFR, not the number of infections, so when countries, or areas, closed down is not a factor.

    Note also that some of these factors play out in Spain as well. We can't analyze Greece in the same way, because there initial exposure was very small, and from only one area, and they immediately shut down, so there are too few cases to analyze properly.

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    1 members found this post helpful.
    Salento was right: fatalities aren't highest in Italy; they're highest in Spain. The same factors apply, however, as is pointed out in post #43.

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    The thing with the average age of the infected is, that with more testing it automatically decreases. if you only test people with strong symptoms the average age of the infected will be high because the old people show the strongest symptoms.

    https://www.weforum.org/agenda/2020/...virus-outbreak

    "The difference between Germany and Italy is partly statistical: Germanys rate seems so much lower because it has tested widely. Germany has carried out more than 1.3 million tests, according to the Robert Koch Institute. It is now carrying out up to 500,000 tests a week, Drosten said. Italy has conducted more than 807,000 tests since Feb. 21, according to its Civil Protection Agency. With a few local exceptions, Italy only tests people taken to hospital with clear and severe symptoms."


    also:

    We learned that we must meticulously trace chains of infection in order to interrupt them, Clemens Wendtner, the doctor who treated the Munich patients, told Reuters.

    Wendtner teamed up with some of Germanys top scientists to tackle what became known as the Munich cluster, and they advised the Bavarian government on how to respond. Bavaria led the way with the lockdowns, which went nationwide on March 22.

    Scientists including Englands Chief Medical Officer Chris Whitty have credited Germanys early, widespread testing with slowing the spread of the virus. We all know Germany got ahead in terms of its ability to do testing for the virus and theres a lot to learn from that, he said on TV earlier this week.

    Christian Drosten, the top virologist at Berlins Charite hospital, said Germany was helped by having a clear early cluster. Because we had this Munich cohort right at the start ... it became clear that with a big push we could inhibit this spreading further, he said in a daily podcast for NDR radio on the coronavirus.

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    1 members found this post helpful.
    I don't know how many more ways I can explain that the number of cases in Germany and Italy are not that dissimilar, so all that contact tracing in Germany didn't stop it from spreading. The difference is indeed the number of tests with Italy still testing a lot of people.

    Much more importantly, we've gotten studies with data from random tests of the population in hot spots in both Germany and Italy (the city with the Carnival cluster and Lombardia's hardest hit areas), and the infection rate is about the same: 15%, much lower than people expected. They're posted somewhere upthread. If you don't read everything you can be very misinformed.

    Also, if the contact tracing hasn't turned up a lot of people who are elderly it proves my point that younger Germans don't have much contact with grandparents, and perhaps not even parents. If they did, the average age of the infected would be higher.

    What is dissimilar is the death rate. That's influenced not only by age but by availability of PPE and ventilators.

    The countries which stopped the SPREAD don't include Germany. Hong Kong is the best example.

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    According to this article https://www.dailymail.co.uk/sciencet...ronavirus.html
    Italy suffers from a different strain of coronavirus than elsewhere. "Methods used to trace the prehistoric migration of ancient humans were adapted to track the spread of the SARS-CoV-2 virus, which causes COVID-19. The team have now updated their analysis to include more than 1,000 COVID-19 cases up to the end of March to provide a clearer snapshot. It has not yet been peer-reviewed."

    I wish someone could comment on how much this study could be trusted - if the predominant strain in Italy is different from other places in Europe and Americas, perhaps it is really more lethal ? On the other hand, if we take deaths per 1000 population, then Belgium is in the first place. At the same time, it is not reasonable to compare countries with different real infection rate, different progress in term of peak time, etc.


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    Quote Originally Posted by Angela View Post






    The real difference per country is about availability of ICU beds, rather than their numbers per capita. All Western and Northern European countries, apart from Germany, are doing badly, because the forecast is that there will be a shortage of ICU beds/ventilators when these are needed on peak times.
    The Eastern side of the EU, including Greece, is doing fine, because hospitals are not and will not be overburdened with COVID patients. These countries closed faster/they were less connected from the beginning and imported less virus.


    Sweden has really messed up with their open politics http://covid19.healthdata.org/sweden compared to Finland http://covid19.healthdata.org/finland (with only 3 ICU bed shortage, or Lithuania, which had at most 6 deaths per day during the peak time, and no shortage of ICU beds at all).
    The situation looks pretty bad in case of the UK, the Netherlands or Belgium. Of course, this is just mathematical forecasting, however, it is pretty much accurate in case of Italy where during the peak, which was at the end of March, they have ended up with about 4,500 ICU beds shortage or Spain with 5,500 ICU beds shortage.

    At the same time, it might be that death rate is higher in those countries where a lot of patients cannot received medical help when it is needed. Of course, the rate of survival of critical cases in ICU is not very high in case of patients with underlying conditions, too. Nevertheless, even Boris Johnson said that he owns his life to St Thomas Hospital and their ICU.

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    Quote Originally Posted by Dagne View Post
    The real difference per country is about availability of ICU beds, rather than their numbers per capita. All Western and Northern European countries, apart from Germany, are doing badly, because the forecast is that there will be a shortage of ICU beds/ventilators when these are needed on peak times.
    The Eastern side of the EU, including Greece, is doing fine, because hospitals are not and will not be overburdened with COVID patients. These countries closed faster/they were less connected from the beginning and imported less virus.


    Sweden has really messed up with their open politics http://covid19.healthdata.org/sweden compared to Finland http://covid19.healthdata.org/finland (with only 3 ICU bed shortage, or Lithuania, which had at most 6 deaths per day during the peak time, and no shortage of ICU beds at all).
    The situation looks pretty bad in case of the UK, the Netherlands or Belgium. Of course, this is just mathematical forecasting, however, it is pretty much accurate in case of Italy where during the peak, which was at the end of March, they have ended up with about 4,500 ICU beds shortage or Spain with 5,500 ICU beds shortage.

    At the same time, it might be that death rate is higher in those countries where a lot of patients cannot received medical help when it is needed. Of course, the rate of survival of critical cases in ICU is not very high in case of patients with underlying conditions, too. Nevertheless, even Boris Johnson said that he owns his life to St Thomas Hospital and their ICU.
    Yes, that's why I said the following:
    What is dissimilar is the death rate. That's influenced not only by age but by availability of PPE and ventilators.
    Of course, the number of ICU units is going to be a factor in that, but only a factor.

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    Quote Originally Posted by Dagne View Post
    The real difference per country is about availability of ICU beds, rather than their numbers per capita. All Western and Northern European countries, apart from Germany, are doing badly, because the forecast is that there will be a shortage of ICU beds/ventilators when these are needed on peak times.
    The Eastern side of the EU, including Greece, is doing fine, because hospitals are not and will not be overburdened with COVID patients. These countries closed faster/they were less connected from the beginning and imported less virus.


    Sweden has really messed up with their open politics http://covid19.healthdata.org/sweden compared to Finland http://covid19.healthdata.org/finland (with only 3 ICU bed shortage, or Lithuania, which had at most 6 deaths per day during the peak time, and no shortage of ICU beds at all).
    The situation looks pretty bad in case of the UK, the Netherlands or Belgium. Of course, this is just mathematical forecasting, however, it is pretty much accurate in case of Italy where during the peak, which was at the end of March, they have ended up with about 4,500 ICU beds shortage or Spain with 5,500 ICU beds shortage.

    At the same time, it might be that death rate is higher in those countries where a lot of patients cannot received medical help when it is needed. Of course, the rate of survival of critical cases in ICU is not very high in case of patients with underlying conditions, too. Nevertheless, even Boris Johnson said that he owns his life to St Thomas Hospital and their ICU.
    What we may not underestimate is that an ICU may save a live, but you can question the quality of life afterwards......Many with corona that have used an ICU have severe after effects.....

    https://en.wikipedia.org/wiki/Post-i..._care_syndrome

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