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In China and Italy, five per cent or more of those known infected with COVID-19 require intensive care. Among all infected people, the death rate is hovering at around one to three per cent, but among the critically ill, it climbs as high as 62 per cent. Most deaths are due to hypoxia, an insufficient supply of oxygen to the body’s tissues, or multi-organ collapse.

There are currently about 3,200 ICU beds in the country. “So maybe you double that by throwing everything you’ve got at it,” Kumar said. “You increase your bed capacity by an additional 3,000 beds or maybe 4,000 beds.”

In the U.S., 20 per cent of the population was infected with H1N1 in the first year of the outbreak. One-third of the world’s population became infected with the 1918 pandemic virus. If one-quarter of the Canadian population is infected with COVID-19 in the first year, “that’s roughly 10 million people,” he said.

If five per cent require ICU support that could mean 500,000 people requiring intensive care.

Now the chickens may well come home to roost

If mitigation strategies can stretch the outbreak over a substantial period of time — “and I’m talking a year, two years, assuming a vaccine doesn’t become available,” Kumar said — then we might not exceed the threshold of what the system can handle.

More unnerving would be the scenes unfolding in Italy, where hospital staff have been forced to practice “catastrophe medicine,” where even the young and healthy with no underlying medical problems have ended up “vented” — tethered to a mechanical ventilator — or dead, and where Italy’s Association of Anaesthesia, Analgesia, Resuscitation and Intensive Care has published new guidance on which patients should be intubated or considered “deserving of intensive care” should their situation deteriorate and provided the resources are even available, according to an unofficial English translation after the criteria were first published in The Atlantic.