5 ms·

The article says expanding capacity has not been approached by any government but I am not sure that's true, in Italy they are building hospital wings or re-ada

The article says expanding capacity has not been approached by any government but I am not sure that's true, in Italy they are building hospital wings or re-adapting abandoned hospitals in many places. Rome has 4 planned covid hospitals as of now. Also, the Italian government plans to hire a ton of medical and paramedical staff, money has been earmarked. I am quite sure other governments are doing the same.

dhosek 7y ago
I know one national government which has delegated all the work to the regional governments.
seemslegit 7y ago
> Also, the Italian government plans to hire a ton of medical and paramedical staff, money has been earmarked. Where will this staff be coming from ? Are there medical professionals currently unemployed in Italy or working in other jobs ?
- merpnderp 7y ago
  Likely retirees and early graduation from students.
- dboreham 7y ago
  I watched an interview with one of the Italian Drs. He said they were using retired medical staff and also cancelling routine procedures which frees up staff, and they are remote training staff from other specialities.
  - eecc 7y ago
    They’re also handing out IKEA leaflets to orthopedists about how ICU and ventilators work; and sending them to production. It’s insane. It’s trench warfare
    - Recursing 7y ago
      The source for that is a random tweet that contained a lot of misinformation and false statement. No Italian friend working in the medical sector was able to confirm that it even makes any sense, and there are no official sources for that
- mgreenleaf 7y ago
  The UK is planning to re-train other medical staff to deal with respiratory illness. I think that probably includes things like psychologists, etc. who have medical experience and can quickly be brought up to speed. Might be something like that.
  - seemslegit 7y ago
    > "I think that probably includes things like psychologists, etc. who have medical experience and can quickly be brought up to speed. Might be something like that. Uh, psychologists have zero medical training or experience - maybe they could explain the patients their respiratory failure is a symptom of insecure attachment patterns. If you mean psychiatrists, there aren't that many of them to move the needle.
    - harvey9 7y ago
      No need to be harsh. What is moving the needle is postponing elective surgery. There are a lot of anaesthetists and they are medics who can manage patients on ventilators.
- fma 7y ago
  And the equipment...my understanding is that ventilators are critical for those who have severe cases. Can't just magically wish for tens of thousands of ventilators....
  - yulaow 7y ago
    In italy one and the only factory of ventilators which was selling worldwide 250 units per month is now producing 500-600 per month exclusively for the italian hospitals (and past orders not yet sent abroad were blocked bt the government and redirected to italian hospitals) for the next ten months. https://youtu.be/7Iz5tWb9f8A https://youtu.be/7Iz5tWb9f8A [hoping the english subtitles work]
    - maxerickson 7y ago
      The translated subtitles seem reasonable. I had to go in and switch it to translating to English.
  - raphaelj 7y ago
    Most hospitalised people will only need non invasive respiratory support and surveillance. I guess these cases could be handled by purposely trained health workers.
  - gpm 7y ago
    But we can just build them. At least we could if we weren't instead shutting down our economies. Look at the manufacturing ramp up that occurred during WWII for example.
    - jeremyjh 7y ago
      Do you actually believe there is a ventilator factory somewhere that has been shutdown?
      - nicoburns 7y ago
        How difficult can it be to build one? Ok, we're not going to have one tomorrow. But how about in 3 months time? 6 months?
- yulaow 7y ago
  Yes, for example ~10000 people holding a degree in medicine were still awaiting to pass an abilitation exam which was removed today, allowing them to now work in the hospitals without it [ https://www.corriere.it/scuola/universita/20_marzo_13/coronavirus-proposta-medici-abilitati-senza-esame-9c0e87fa-654f-11ea-86da-7c7313c791fe.shtml https://www.corriere.it/scuola/universita/20_marzo_13/corona... ] A lot others already holding that certificaton were not working yet because positions in public hospitals where not accessible yet because of the turnover blocks put in place in the last decade while the government was trying to cut healthcare expenses.
- DoofusOfDeath 7y ago
  AFAIK, physicians in the U.S. are vexed by how many hours per day they spend dealing with insurers rather than patients. I wonder how many clinic-hours we could add to our capacity by some kind of moratorium on that level of paperwork.
  - baq 7y ago
    there won't be any paperwork because there won't be any insurance. even your congress and senate realizes this by now. it's an unworkable proposition - you either bankrupt the 10-20% patients which require hospitalization or you bankrupt insurers. you're in for a revolution in healthcare.
    - kazagistar 7y ago
      Congress just had to add a ton of exemptions to a bill to guarantee paid sick leave for CORVID, making it meaningless for a vast majority of americans, because of republican pushback. Never underestimate the greed and corruption baked into the influence channels in the USA.
      - zaroth 7y ago
        The problem with the House bill is that it puts employers on the hook for making the payments. You’re just ushering small businesses faster off the cliff of insolvency if you legally require them to pay workers while they are also legally required to be shut down. If the government is forcing a company to shut its doors, the government should be prepared to pay the employees “quarantine leave”.
    - nradov 7y ago
      The majority of patients who will require hospital care are already Medicare beneficiaries. And for many others, the insurers don't really bear any financial risk because they just process claims and pass the costs on to group buyers.
- giovan-ni 7y ago
  Mostly by fast tracking newly graduated, who normally have to attend a 2 to 6 year long specialty school. This would amount to around 10 000 new hires, according to the Ministry of University.
  - seemslegit 7y ago
    This makes sense. I guess I expected it to have already happened, probably should tap into senior-year med and nursing students as well.
devy 7y ago
> but I am not sure that's true, in Italy they are building hospital wings or re-adapting abandoned hospitals in many places. Rome has 4 planned covid hospitals as of now. True. But those are being done after the fact. It's too late already for Italy. By comparison, the U.S. still has time now before the curve shot straight up to the max - then no amount of measures are going to be able to keep up with the viral infection rate (and death counts)
- lawn 7y ago
  > By comparison, the U.S. still has time now before the curve shot straight up to the max How much time do you think there is? Until recently there have been very little testing, so we don't even know where the US is on the curve. Even if we assume it's early, that's still just a couple of weeks if time.
- bad_user 7y ago
  The US, like most other countries, is only a couple of days behind Italy. Italy had 100 total cases only ~20 days ago. The problem with this virus is that it goes from 1 case to hell in only a couple of weeks. If you already have 100 confirmed cases, it's too late to stop what's coming.
  - aksss 7y ago
    So conversely if US hasn’t gone to hell in a couple weeks, it indicates we’ve been doing something right?
    - bad_user 7y ago
      Sadly that's not a possibility. According to mathematical models the capacity of your hospitals will be exceeded by more than 30 times. Give it another week or two. https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s...
      - 7y ago
lbeltrame 7y ago
> Rome has 4 planned covid hospitals as of now. Unfortunately not where it matters most, that is in Lombardia (where I live, and the hardest-hit of all regions). In fact the regional government took the matter into its own hands to attempt to convert a number of buildings in an old exposition area (not the 2015 expo area, FTR) into places to treat patients (there are still many "ifs" to see whether this will get done or not, though).
gentleman11 7y ago
My government told us today that they have excess capacity and will not run out. They have been preparing for this crisis for “over a month now” In fact, they are still going ahead with cutting doctors pay in the midst of it all. Maybe we deserve it for electing a nut job who only cares about budgets (Alberta)
- rwmurrayVT 7y ago
  When I was in Edmonton and Calgary it always seemed like Alberta was hellbent on moving the exact opposite direction of the other provinces.
tathougies 7y ago
The United States waived requirements for inspection for new hospital beds (thus allowing hospitals to increase bed count) and has ordered more ventilators and other equipment.

dhosek 7y ago

I know one national government which has delegated all the work to the regional governments.

seemslegit 7y ago

> Also, the Italian government plans to hire a ton of medical and paramedical staff, money has been earmarked. Where will this staff be coming from ? Are there medical professionals currently unemployed in Italy or working in other jobs ?

merpnderp 7y ago
Likely retirees and early graduation from students.
dboreham 7y ago
I watched an interview with one of the Italian Drs. He said they were using retired medical staff and also cancelling routine procedures which frees up staff, and they are remote training staff from other specialities.
- eecc 7y ago
  They’re also handing out IKEA leaflets to orthopedists about how ICU and ventilators work; and sending them to production. It’s insane. It’s trench warfare
  - Recursing 7y ago
    The source for that is a random tweet that contained a lot of misinformation and false statement. No Italian friend working in the medical sector was able to confirm that it even makes any sense, and there are no official sources for that
mgreenleaf 7y ago
The UK is planning to re-train other medical staff to deal with respiratory illness. I think that probably includes things like psychologists, etc. who have medical experience and can quickly be brought up to speed. Might be something like that.
- seemslegit 7y ago
  > "I think that probably includes things like psychologists, etc. who have medical experience and can quickly be brought up to speed. Might be something like that. Uh, psychologists have zero medical training or experience - maybe they could explain the patients their respiratory failure is a symptom of insecure attachment patterns. If you mean psychiatrists, there aren't that many of them to move the needle.
  - harvey9 7y ago
    No need to be harsh. What is moving the needle is postponing elective surgery. There are a lot of anaesthetists and they are medics who can manage patients on ventilators.
fma 7y ago
And the equipment...my understanding is that ventilators are critical for those who have severe cases. Can't just magically wish for tens of thousands of ventilators....
- yulaow 7y ago
  In italy one and the only factory of ventilators which was selling worldwide 250 units per month is now producing 500-600 per month exclusively for the italian hospitals (and past orders not yet sent abroad were blocked bt the government and redirected to italian hospitals) for the next ten months. https://youtu.be/7Iz5tWb9f8A https://youtu.be/7Iz5tWb9f8A [hoping the english subtitles work]
  - maxerickson 7y ago
    The translated subtitles seem reasonable. I had to go in and switch it to translating to English.
- raphaelj 7y ago
  Most hospitalised people will only need non invasive respiratory support and surveillance. I guess these cases could be handled by purposely trained health workers.
- gpm 7y ago
  But we can just build them. At least we could if we weren't instead shutting down our economies. Look at the manufacturing ramp up that occurred during WWII for example.
  - jeremyjh 7y ago
    Do you actually believe there is a ventilator factory somewhere that has been shutdown?
    - nicoburns 7y ago
      How difficult can it be to build one? Ok, we're not going to have one tomorrow. But how about in 3 months time? 6 months?
yulaow 7y ago
Yes, for example ~10000 people holding a degree in medicine were still awaiting to pass an abilitation exam which was removed today, allowing them to now work in the hospitals without it [ https://www.corriere.it/scuola/universita/20_marzo_13/coronavirus-proposta-medici-abilitati-senza-esame-9c0e87fa-654f-11ea-86da-7c7313c791fe.shtml https://www.corriere.it/scuola/universita/20_marzo_13/corona... ] A lot others already holding that certificaton were not working yet because positions in public hospitals where not accessible yet because of the turnover blocks put in place in the last decade while the government was trying to cut healthcare expenses.
DoofusOfDeath 7y ago
AFAIK, physicians in the U.S. are vexed by how many hours per day they spend dealing with insurers rather than patients. I wonder how many clinic-hours we could add to our capacity by some kind of moratorium on that level of paperwork.
- baq 7y ago
  there won't be any paperwork because there won't be any insurance. even your congress and senate realizes this by now. it's an unworkable proposition - you either bankrupt the 10-20% patients which require hospitalization or you bankrupt insurers. you're in for a revolution in healthcare.
  - kazagistar 7y ago
    Congress just had to add a ton of exemptions to a bill to guarantee paid sick leave for CORVID, making it meaningless for a vast majority of americans, because of republican pushback. Never underestimate the greed and corruption baked into the influence channels in the USA.
    - zaroth 7y ago
      The problem with the House bill is that it puts employers on the hook for making the payments. You’re just ushering small businesses faster off the cliff of insolvency if you legally require them to pay workers while they are also legally required to be shut down. If the government is forcing a company to shut its doors, the government should be prepared to pay the employees “quarantine leave”.
  - nradov 7y ago
    The majority of patients who will require hospital care are already Medicare beneficiaries. And for many others, the insurers don't really bear any financial risk because they just process claims and pass the costs on to group buyers.
giovan-ni 7y ago
Mostly by fast tracking newly graduated, who normally have to attend a 2 to 6 year long specialty school. This would amount to around 10 000 new hires, according to the Ministry of University.
- seemslegit 7y ago
  This makes sense. I guess I expected it to have already happened, probably should tap into senior-year med and nursing students as well.

devy 7y ago

> but I am not sure that's true, in Italy they are building hospital wings or re-adapting abandoned hospitals in many places. Rome has 4 planned covid hospitals as of now. True. But those are being done after the fact. It's too late already for Italy. By comparison, the U.S. still has time now before the curve shot straight up to the max - then no amount of measures are going to be able to keep up with the viral infection rate (and death counts)

lawn 7y ago
> By comparison, the U.S. still has time now before the curve shot straight up to the max How much time do you think there is? Until recently there have been very little testing, so we don't even know where the US is on the curve. Even if we assume it's early, that's still just a couple of weeks if time.
bad_user 7y ago
The US, like most other countries, is only a couple of days behind Italy. Italy had 100 total cases only ~20 days ago. The problem with this virus is that it goes from 1 case to hell in only a couple of weeks. If you already have 100 confirmed cases, it's too late to stop what's coming.
- aksss 7y ago
  So conversely if US hasn’t gone to hell in a couple weeks, it indicates we’ve been doing something right?
  - bad_user 7y ago
    Sadly that's not a possibility. According to mathematical models the capacity of your hospitals will be exceeded by more than 30 times. Give it another week or two. https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-NPI-modelling-16-03-2020.pdf https://www.imperial.ac.uk/media/imperial-college/medicine/s...
    - 7y ago

lbeltrame 7y ago

> Rome has 4 planned covid hospitals as of now. Unfortunately not where it matters most, that is in Lombardia (where I live, and the hardest-hit of all regions). In fact the regional government took the matter into its own hands to attempt to convert a number of buildings in an old exposition area (not the 2015 expo area, FTR) into places to treat patients (there are still many "ifs" to see whether this will get done or not, though).

gentleman11 7y ago

My government told us today that they have excess capacity and will not run out. They have been preparing for this crisis for “over a month now” In fact, they are still going ahead with cutting doctors pay in the midst of it all. Maybe we deserve it for electing a nut job who only cares about budgets (Alberta)

rwmurrayVT 7y ago
When I was in Edmonton and Calgary it always seemed like Alberta was hellbent on moving the exact opposite direction of the other provinces.

tathougies 7y ago

The United States waived requirements for inspection for new hospital beds (thus allowing hospitals to increase bed count) and has ordered more ventilators and other equipment.