# HSE Respirators



## Daddy Ireland (14 Mar 2020)

Anyone know how many respirators we currently have in Ireland ?


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## SPC100 (14 Mar 2020)

Hopefullly some journalist will pose your question (and Ask about ECMOs)

ECMOs are apparently the machines that are needed when your own heart and lungs are not functioning well enuough. i.e. would be needed after in cases where ventilators are not enough.

I have heard people say we have 1-2 ECMO machines, from a quick google It appears we have at least 4.

Our Lady’s Children’s Hospital, Crumlin has three ECMO machines
Mater is the only place in Ireland that provides ECMO to adult patients


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## SPC100 (17 Mar 2020)

Had anyone heard any numbers on number of ventilators we can operate in Ireland?

This is and will be a very important number, the sooner it is in the public domain and being actively managed the better.


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## DeeKie (17 Mar 2020)

I see the uk calling for more to be bought and manufactured. Medtronic manufactures them here. Very little talk about assts on air.


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## SPC100 (18 Mar 2020)

It is said we have 6 ventilators per 100k people. (I don't have source)

4.9 million people = 49 sets of 100k = about 300 ventilators although I assume some are lost/broken.

When we are at about 3000 active infections we are at capacity, assuming ten percent need ventilators.

We are doubling every two or so days, so we might go 300, 600, 1200, 2400. That gives us about six to eight days till we are above capacity.


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## odyssey06 (18 Mar 2020)

800 ventilators with HSE.
500 with private hospitals.
Procuring 100 per week.









						Ireland to add 100 ventilators a week as coronavirus cases hit 292
					

DUBLIN (Reuters) - Ireland's health service is finalising contracts to add 100 ventilators per week to meet the demand from coronavirus cases that the country's prime minister has forecast could reach 15,000 by the end of the month.




					www.thestar.com.my


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## SPC100 (18 Mar 2020)

Thanks! let call it 1500 within two weeks. So capacity of 15k active cases.

And given 4800,9600,19200, we might be there in 12-14 days.

hopefully the lock down and stronger messaging will slow the rate of growth.


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## Fidgety (19 Mar 2020)

Prime Time suggests that we have 1029 ventilators in Public Hospitals, 200 in Private Hospitals and a further 900 ordered.
No health service can cope with what Italy and China have endured according to Dr. Catherine Motherway of UHL.


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## mathepac (20 Mar 2020)

As I suggested in another thread :- https://www.independent.ie/business...s-247-to-meet-ventilator-demand-39059876.html


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## odyssey06 (20 Mar 2020)

Fidgety said:


> Prime Time suggests that we have 1029 ventilators in Public Hospitals, 200 in Private Hospitals and a further 900 ordered.
> No health service can cope with what Italy and China have endured according to Dr. Catherine Motherway of UHL.



RTE news article has further details:








						900 ventilators ordered for use in Covid-19 pandemic
					

The Health Service Executive has said 900 new ventilators have been ordered for use with patients with Covid-19 and some of those will be delivered by the end of the month.




					www.rte.ie
				




The Health Service Executive has said that *900 new ventilators* have been ordered for use with patients with Covid-19 and some of those will be delivered by the end of the month. That is *in addition to the 1,229 machines* currently available in the country.
Following concerns expressed by senior doctors about the availability of intensive care unit beds (ICU), the HSE told RTÉ's Prime Time there is a current capacity of *255 ICU beds *in the country, while *a further 51 critical care beds have been approved* by Government.
A study commissioned by the HSE more than a decade ago recommended more than 500 intensive care beds were needed. 

On Personal Protection Equipment (PPE), the HSE said there are challenges in a volatile market, with export bans and export limits in place in many countries. It said it has secured continuity of supply through an agreement with an international supplier. Millions of face masks, goggles and face shields will begin arriving in the next two weeks. Chief Clinical Officer at the HSE Dr Colm Henry said the the Department of Health has secured a "steady stream" of PPE for healthcare workers. This includes *6.5 million face masks, 4.5 million respiratory masks and over one million goggles*. 
He said this was done through a company in China with the assistance of the Chinese authorities.


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## PaddyBloggit (21 Mar 2020)

This doctor in Canada has come up with a way of doubling use:

https://www.cp24.com/news/ontario-d...ntilator-capacity-in-rural-hospital-1.4858285


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## mathepac (21 Mar 2020)

In relation to the scarcity of ventilators globally, could I ask what members think having read this artice from RTE’s News web-site?  If you can avoid the temptation, please don’t follow any of the embedded links and just post the impression you are left with.









						Irish project tackles global ventilator shortage
					

An Irish team is leading an international community of engineers, designers and medical professionals who are trying to develop a low-cost, easy-to-assemble ventilator to use in the battle against coronavirus.




					www.rte.ie
				




Thanks.


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## mathepac (21 Mar 2020)

PaddyBloggit said:


> This doctor in Canada has come up with a way of doubling use:


*Potentially,*  as the article states that " the idea has been studied in theory and *tried once before "*


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## Susie2017 (22 Mar 2020)

Is there a breakdown of the location of these 1000+ ventilators. How many are in each public hospital ? Can the public get a breakdown ? Any new ECMO machines planned ? How many anaesthetists are employed in each public hospital ? I have heard about delays in getting test results in the last few days. Patients and hospital consultants who have symptoms, waiting on results since Thursday. I have also heard that some patients are in isolation in hospital beds since Thursday with no results available yet. Staff are using PPE around the clock to manage these possible cases, possibly wasting PPE if they are negative. Is it anticipated that test results will be available much faster than the current turnaround time in the days ahead.  Have any journalists asked about the sensitivity of coronavirus testing ? What is the expected % of false negative tests ?


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## Leo (23 Mar 2020)

Susie2017 said:


> Staff are using PPE around the clock to manage these possible cases, possibly wasting PPE if they are negative.



With ~25% of confirmed cases in Ireland now being health care workers, are you suggesting they don't need to wear PPE when working areas with multiple potential cases?



Susie2017 said:


> What is the expected % of false negative tests ?



Varies with timing, but up to 25% false negatives if the test is performed too early in the infection cycle.


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## Susie2017 (24 Mar 2020)

No. Im stating that the delay in getting test results is leading to patients being isolated and staff using up PPE when they wouldnt otherwise need to if they had a rapid test result. They may be using up PPE that might be badly needed in the weeks ahead. Testing delays and result turnaround times are a problem. Saying that there are just 200+ cases today is not reassuring when there are inpatients in beds for days waiting for results, many people at home for days waiting on results and thousands in the community waiting to be swabbed. I know of people waiting for swab appts for 5 days.

The false negative rate seems high in the literature. The chinese used CT a lot as it shows quite specific radiological features. I think clinicians are aware that if a patient has a negative swab but an otherwise typical presentation then they should continue isolation and retest. Hope the testing can be scaled up with much faster TATs soon.


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## Purple (24 Mar 2020)

New York estimate that they will need 140,000 beds and 40,000 ICU beds.
They have twice our population so if we get the same infection rate over the same time frame we'd need 70,000 hospital beds and 20,000 ICU beds. Every one of those ICU beds will need a Ventilator.

We currently have about 14,000 hospital beds in Ireland (and they already have people in them) and around 250 ICU beds.


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## Leo (24 Mar 2020)

Susie2017 said:


> No. Im stating that the delay in getting test results is leading to patients being isolated and staff using up PPE when they wouldnt otherwise need to if they had a rapid test result. They may be using up PPE that might be badly needed in the weeks ahead. Testing delays and result turnaround times are a problem.



Are you talking about admitted patients? If so these will all be in areas which already have multiple confirmed cases present. Staff have guidance on wearing PPE in these areas, even still 25% of confirmed cases here are health care staff. If we encourage them to discard the PPE, we'll quickly get to a point where we run out of staff.


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## Susie2017 (24 Mar 2020)

Of course they should not discard PPE. The point I'm making is that testing needs to be scaled up rapidly to cope with demand, appropriate patient management and use of resources.


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## mathepac (24 Mar 2020)

Susie2017 said:


> I know of people waiting for swab appts for 5 days.


My grandson, a vulnerable member of the community, has been waiting 5+ days already and that may stretch to 10+ to be swabbed plus the time it takes to get the sample tested, plus the time to communicate the results. But of course Leo, Simon, Holohan & Co are doing a great job according to those they hold in thrall of them


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## Purple (25 Mar 2020)

mathepac said:


> My grandson, a vulnerable member of the community, has been waiting 5+ days already and that may stretch to 10+ to be swabbed plus the time it takes to get the sample tested, plus the time to communicate the results. But of course Leo, Simon, Holohan & Co are doing a great job according to those they hold in thrall of them


They have changed the criteria for qualification for testing as of yesterday in order to take this into account. People now have to have two of the symptoms, be a healthcare worker or be a member of a vulnerable group to qualify. Having a cold and no backbone is no longer good enough.
That should free up availability for people such as your grandson. 
They are making this up mas they go along, changing procedures and rules as more information becomes available.


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## Sunny (25 Mar 2020)

What exactly do people expect with testing? We have carried out over 18000 tests, got 14000 results and 94% of those tests have been negative. Of course every country would like to test more but people seem to think that setting up this system can be done overnight. What they have achieved and in comparison to almost every other country, our much maligned health service including much maligned managers and administrators have done a great job. 

I have heard of people ringing GP's demanding a test and exaggerating symptoms to try and get a test. We still have people refuse to adhere to social distancing guidelines. We have parents who let their teenage children out without having a clue what they are doing. We have people using public transport for non-essential travel. I know of one person is bored in NY and so instead of isolating herself, has decided to come home to Ireland to be with her family. It is the ordinary person who will delay us coming out the other side of this and will lead to worse outcomes. It won't be the health service or the politicians.


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## RichInSpirit (25 Mar 2020)

Elon Musk got his hands on 1000 ventilators for Los Angeles sourced in China. Seems they have too many in China. 








						Virus Skeptic Musk Donates Ventilators in What Governor Calls ‘Heroic Effort’
					

Elon Musk, the chief executive officer of Tesla Inc. and an outspoken skeptic of the severity of the coronavirus outbreak, donated more than 1,000 ventilators to officials in Los Angeles to meet demand as the pandemic becomes more severe.




					www.bloomberg.com


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## Leo (25 Mar 2020)

Susie2017 said:


> Of course they should not discard PPE. The point I'm making is that testing needs to be scaled up rapidly to cope with demand, appropriate patient management and use of resources.



Which is it? Wear PPE to protect themselves *AND *all the other patients they come into contact with, or stop wasting it?



Susie2017 said:


> Staff are using PPE around the clock to manage these possible cases, possibly wasting PPE if they are negative.



Remember, hospital staff will not be isolated despite regular and extended exposure to positive cases. They are being asked to check their temperature twice daily, and will only get tested themselves if they have confirmed symptoms. So you can be pretty sure some of them will be carrying the virus unaware while treating other patients.


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## Purple (25 Mar 2020)

The guidance from the FDA is that where no ICU/CCU Ventilator is available any similar device should be used. These include things such as C-PAP devices. They can be used to increase the oxygen levels in the air the ill person is breathing. If they are included the the generality of "Ventilators" then there is capacity to produce  tens of thousands a week.


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## mathepac (25 Mar 2020)

Purple said:


> They have changed the criteria for qualification for testing as of yesterday in order to take this into account.


New Testing Criteria from HSE -


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## mathepac (25 Mar 2020)

Matt Hancock UK Health Tsar has been caught out lying about the number of ventilators / respirators available to the NHS. He also lied about the progress being made by an industrial consortium including Ford, McLaren and others to create alternative sources. He said they'd be at volume production in a few days, they say they'll likely have a prototype available by the end of March and that it'll take them months to get to volume production.

Leo, Harris, Holohan would never to lie to us would they? I mean they fired O'Brien over the BreastCheck disgrace and that settled that and none of them or their counterparts were involved, were they? I mean based on their track records we'd have every faith in them? Who was the Minister for Health that over saw [Breast] CervicalCheck? Leo? Not that Leo surely?


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## Eireog007 (25 Mar 2020)

mathepac said:


> Matt Hancock UK Health Tsar has been caught out lying about the number of ventilators / respirators available to the NHS. He also lied about the progress being made by an industrial consortium including Ford, McLaren and others to create alternative sources. He said they'd be at volume production in a few days, they say they'll likely have a prototype available by the end of March and that it'll take them months to get to volume production.
> 
> Leo, Harris, Holohan would never to lie to us would they? I mean they fired O'Brien over the BreastCheck disgrace and that settled that and none of them or their counterparts were involved, were they? I mean based on their track records we'd have every faith in them? Who was the Minister for Health that over saw BreastCheck? Leo? Not that Leo surely?



Have you any facts to back up any of those statements in your second paragraph or are they merely wild speculation for speculations sake?


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## mathepac (25 Mar 2020)

Questions Bud, questions. Varadker Minister for Health 2014-2016 during the [Breast] CervicalCheck disgrace. All of paragraph one was carried in a BBC news bulletin tonight, Holohan is CMO since 2008, Harris took over from Varadker in 2016, so a long line of continuity stretching back 12/13 years, pre-dating the [Breast] CervicalCheck disgrace and covering the period when the incompetence surfaced and factual information was suppressed.  "But no-one ever told me!", hands thrown in the air dramatically by all concerned. Any other queries?


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## Eireog007 (25 Mar 2020)

Not doubting the first paragraph mainly because the UK situation isn't my concern. 

Your "questions" however are simply wild speculation with nothing to back them up. I don't see them as being helpful or relevant as I don't believe that our politicians have been making any wild claims in relation to testing/supplies/figures etc.


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## mathepac (25 Mar 2020)

Minister Harris claimed it was OK for thousands of people to travel to Cheltenham and return, now positive diagnoses for the virus from at least one of the attendees.  Harris saw no need for special measures for the crowds that went.

The only predicator we have for future or current human behaviour is what happened in the past. Not perfect by any manner or means, but pretty much the only model we have. They lied about [Breast] CervicalCheck (as did the Chinese about the first signs of the virus) so they will lie again as suits their need to avoid responsibility for bad (or no) decision-making. QED.


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## SPC100 (25 Mar 2020)

SPC100 said:


> We are doubling every two or so days,



Only doubling every four days now! Presumably due to public behavior change. Hopefully not a side effect of backlog in testing.



			https://twitter.com/IrishDataViz/status/1242561656007335936?s=20
		


That plus extra beds and ventilators has gotten us some more time.


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## Purple (26 Mar 2020)

We have the lowest number of ICU beds per head of population in the EU, despite having amongst the highest spend per head. If this crisis doesn't highlight the need for major reform in the structure and day to day work practices within the public healthcare system then nothing will.


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## geri (26 Mar 2020)

Purple said:


> They have changed the criteria for qualification for testing as of yesterday in order to take this into account. People now have to have two of the symptoms, be a healthcare worker or be a member of a vulnerable group to qualify. Having a cold and no backbone is no longer good enough.
> That should free up availability for people such as your grandson.
> They are making this up mas they go along, changing procedures and rules as more information becomes available.


I dont mean to be disrespectful at all and I hope macthepac's grandson is doing well, but if he is tested and is positive what happens then? He will be advised to continue self isolation. It will make no difference to his condition. 
I sincerely hope he is doing well, and that he recovers soon.


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## mathepac (26 Mar 2020)

He will need to be admitted to a paediatric ICU and will require access to a respirator, such is the nature and degree of his vulnerability.


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## Sunny (26 Mar 2020)

mathepac said:


> He will need to be admitted to a paediatric ICU and will require access to a respirator, such is the nature and degree of his vulnerability.



You dont know that so I wouldn't panic. I have a relative with cystic fibrosis who caught it and didnt require ICU care. It was mild. Her healthy sister also had it and was admitted to intensive care. This was in the US though.  There is no simple formula of if a certain person gets it, they will get it worse than somebody else. Otherwise we would just isolate the vulnerable and let the rest of us get it.


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## odyssey06 (26 Mar 2020)

Sunny said:


> You dont know that so I wouldn't panic. I have a relative with cystic fibrosis who caught it and didnt require ICU care. It was mild. Her healthy sister also had it and was admitted to intensive care. This was in the US though.  There is no simple formula of if a certain person gets it, they will get it worse than somebody else. Otherwise we would just isolate the vulnerable and let the rest of us get it.



(I hope everyone pulls through and that was v fortunate that it didn't hit your relative harder)

Not saying it's a simple formula but the vulnerable will be asked to cocoon \ self-isolate. Your post could be read as implying that certain groups are not considered vulnerable and hish risk.

_An escalation of the lockdown will see old and vulnerable people “cocooned” in their homes for weeks on end as the emergency inevitably worsens. _








						Taoiseach confirms elderly will eventually have to 'cocoon' as COVID-19 spreads
					

He addressed all of Ireland in a rare national broadcast at 9pm on RTE and Virgin Media One




					www.dublinlive.ie


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## Sunny (26 Mar 2020)

odyssey06 said:


> (I hope everyone pulls through and that was v fortunate that it didn't hit your relative harder)
> 
> Not saying it's a simple formula but the vulnerable will be asked to cocoon \ self-isolate. Your post could be read as implying that certain groups are not considered vulnerable and hish risk.
> 
> ...



It doesn't imply that at all. Everyone knows who the vulnerable groups are. All I saying is that there is no rule saying that someone with an underlying condition will get really sick and require ICU care. That's not how it works. It is easy to cling to the worst case scenario which we all seem to do but as with everything, there are plenty of exceptions to every rule. Soneone with an underlying respiratory problem or something else is a higher risk but lets not start acting like it is a straight death sentence.


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## johnwilliams (26 Mar 2020)

a stupid question 
am i understanding correctly the ppe equipment is being reused, what would be used to clean them completely of this bug ,microwaves or just standard disinfectants ?


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## Leo (27 Mar 2020)

johnwilliams said:


> a stupid question
> am i understanding correctly the ppe equipment is being reused, what would be used to clean them completely of this bug ,microwaves or just standard disinfectants ?



It varies depending on the make up of the equipment, and they're still just figuring out what works. Much of the PPE they wear was designed to be disposable to reduce the risk of contagion, so it was never designed to be reusable or washable. They're seeing guidance from manufacturers on what's effective without compromising the protection.


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## Purple (27 Mar 2020)

Visors/ goggles etc can be reused. Masks gloves etc can't.


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## settlement (27 Mar 2020)

mathepac said:


> He will need to be admitted to a paediatric ICU and will require access to a respirator, such is the nature and degree of his vulnerability.



Please stop spreading panic and misinformation. No children have died from this. Almost all patients with moderate and severe cases have been adults


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## allaround (27 Mar 2020)

having ventilators is one thing, though I'd be focused more on whether we have the desired number of appropriately trained staff to operate these


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## Purple (27 Mar 2020)

allaround said:


> having ventilators is one thing, though I'd be focused more on whether we have the desired number of appropriately trained staff to operate these


There's not much to using them.


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## Thirsty (27 Mar 2020)

@Purple - for someone with training, I assume you mean?


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## Leo (27 Mar 2020)

Manual for one system  for anyone else curious enough.


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## mathepac (27 Mar 2020)

settlement said:


> Please stop spreading panic and misinformation. No children have died from this. Almost all patients with moderate and severe cases have been adults


I'm writing about a specific child known to me, a child with a partial trisomy-9p and a partial monosomy-10q with both a compromised immune system and an impaired respiratory system as well as other complications. If readers are stupid enough to extrapolate from a specific child to the population in general and panic, then that is hardly my fault.


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## Purple (27 Mar 2020)

Thirsty said:


> @Purple - for someone with training, I assume you mean?


Every ICU nurse should be trained on them anyway. Putting a patient on one doesn't take a huge amount of time and then it's a case of monitoring the outputs. Personnelle won't be the issue, machines will be.


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## Thirsty (27 Mar 2020)

Leo said:


> Manual for one system  for anyone else curious enough.


Not planning to have a go!


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## Leo (27 Mar 2020)

Thirsty said:


> Not planning to have a go!



Oh, same here! I'm very thankful I don't work in that environment right now.


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## odyssey06 (27 Mar 2020)

settlement said:


> Please stop spreading panic and misinformation. No children have died from this. Almost all patients with moderate and severe cases have been adults



You have made a very strong claim there that no children have died from this, please provide some official currently valid support for it or you should retract your statement. It is hardly spreading panic to express concern that children - especialy those with underlying conditions - could die from this. There are news reports of deaths of children in the US and Iran.

_new study, which was published online in the journal Pediatrics, looked at 2,143 cases of children with confirmed or suspected COVID-19 that were reported to the Chinese Centers for Disease Control and Prevention between Jan. 16 and Feb. 8. More than 90% of the cases were asymptomatic, mild or moderate cases. However, *nearly 6% of the children’s cases were severe or critical*, compared with 18.5% for adults. _








						WHO warns some children develop 'severe' or 'critical' disease from coronavirus
					

Nearly 6% of the children's cases were severe or critical, compared with 18.5% for adults, according to the new study.




					www.cnbc.com


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## Purple (30 Mar 2020)

mathepac said:


> He will need to be admitted to a paediatric ICU and will require access to a respirator, such is the nature and degree of his vulnerability.


The good news is that there are plenty of respirators. It's Ventilators that they are short of.


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## losttheplot (2 Apr 2020)

Poorest countries will really be hit by this. South Sudan has 2 ventilators for 12 million people.


[broken link removed]


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## odyssey06 (7 Apr 2020)

Strange case in the High Court... A DUBLIN-BASED company has claimed before the High Court that the HSE has failed to honour a contract for the provision of 350 medical ventilators to treat those who contract the Covid-19 virus.








						HSE has failed to honour a contract to pay for medical ventilators, court hears
					

Narooma claims the HSE has failed to comply with the contract and has not paid it the money it says it is owed.




					www.thejournal.ie


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