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Oxygen and laying prone is not exclusive to hospitals. I'm wondering if we can get oxygen tanks ready for home use. Reduce hospital load, reduce healthcare cos

Oxygen and laying prone is not exclusive to hospitals. I'm wondering if we can get oxygen tanks ready for home use. Reduce hospital load, reduce healthcare costs, get rid of the need to flatten the curve. (Waiting for a my job to begin, waiting for my son to get his surgery)

maxerickson 6y ago
You are proposing slowly letting it run until there is herd immunity, which would likely kill tens of millions of people worldwide. We should aim to do better than that.
e40 6y ago
Coworker of mine who happens to be Chinese bought portable oxygen for use in this situation. She bought it in February, after looking at videos about what was going on in Wuhan. We all thought she was kind of crazy. Doesn’t look so crazy now.
misja111 6y ago
>> get rid of the need to flatten the curve. This. A policy of flattening the curve will probably have to last for one or two years until either a vaccine is found or there is enough herd immunity. This will not only destroy our economy but the isolation will be a psychological challenge for many as well. We have to take one step back and think why we wanted to flatten the curve in the first place. And that is because our hospitals don't have enough capacity. So why don't we do something about that? IMO that, in combination with some moderate curve flattening, is the only acceptable solution in the long term.
- barkingcat 6y ago
  conceptually, flattening the curve is meant to turn an exponential infection curve into something more manageable. We are flattening the curve, yes, initially because hospitals don't have capacity, but the root of this issue is the exponential nature of infection transmission. If we have the ability to build hospitals at a rate to match O(2^n) time then we can let everyone out and declare quarantine over! But as you know, an O(2^n) algorithm is extraordinarily hard to keep up with once n approaches any large number. That's the curve we're trying to flatten - by changing the approach, changing the "algorithm" so to speak, by not allowing people to interact so they have less chance of infection. If you are able to build a new hospital in a week, and then continue building a new hospital every day after that and then one every hour after that, and then a new hospital every few seconds after that, then you have a chance to keep up with an exponential curve (well, until the virus runs out of people to infect, so until it reaches 100% of the global population).
  - misja111 6y ago
    I was writing that we should both create hospital capacity and have some moderate flattening of the curve. Of course we shouldn't let the virus run free. But unless you are hoping for a vaccine to be invented soon, which would of course be wonderful, you have to face the other scenario and that is that we have to slowly build up herd immunity. Herd immunity means that people have to get infected and a percentage of that will have to go to the hospital. No matter how you manage it, bigger hospital capacity simply means that you are able to reach herd immunity more quickly.
    - DanBC 6y ago
      > Herd immunity What does her immunity actually mean though? What other diseases do we try to tackle using herd immunity? How many deaths would make herd immunity acceptable or not acceptable? There are 350m people in the US. We need to get about 60% of them to have had covid-19. That's 210m people. We don't know how fatal covid-19 is yet, so here are some lower numbers: 0.1% = 210,000 deaths 0.2% = 420,000 deaths 0.5% = 1,050,000 deaths And once we've killed off all these people what have we achieved? Covid-19 would be in the population and will come back every year as a seasonal respiratory illness, killing off more people every year until we get a vaccine.
      - misja111 6y ago
        There are ways to limit the number of deaths and still reach herd immunity. For instance by keeping elderly and sick people isolated but the healthier part not, until herd immunity is reached. This disease has to be handled with intelligence and common sense, not with rethorics and dogma's.
      - lftl 6y ago
        > Covid-19 would be in the population and will come back every year as a seasonal respiratory illness, killing off more people every year until we get a vaccine. Do you have any evidence to support that it would keep coming back? As far as I know there's only very small anecdotal evidence of people getting reinfected and we simply have no way of knowing yet whether the average person's immunity will last weeks, months or years.
- maxerickson 6y ago
  We have to smash the curve so that we don't need the hospital capacity. It turns out that getting the number of infected down close to zero would also be good for the economy. I don't understand why so many people think that the best possible plan is for everyone to get infected. The best possibilities involve a few percentage points of the global population getting infected, no where near everyone.
  - irq11 6y ago
    This simply isn’t possible, and it’s a maddeningly irresponsible shifting of the goalposts. The public was sold these extreme tactics on the basis of preventing excess deaths, not locking down society for years on end until the virus (hopefully) goes away. Respiratory viruses, once endemic, have never been completely suppressed. Even China is seeing a resurgence in cases. What we’re doing now isn’t sustainable or ethical, and we have to move on to smarter tactics soon.
    - maxerickson 6y ago
      The lockdowns are a necessary step to smarter tactics working. My point is that if we move forward as if letting lots of people get infected is a 'smarter tactic', it's going to be worse in all ways. More death, more economic damage.
      - lobotryas 6y ago
        No, not “lots of people”, I don’t see anyone saying that. Given that it’s factually impossible to lock down the economy for a very long time we need conditions where the hospital system retains enough capacity to handle the really sick people. Since it looks like we’re close to this (even in places like NYC that are sitting on a vent stockpile) we can start loosening the economy back.
      - irq11 6y ago
        No, you’re still shifting the goalposts. The point of “flattening the curve” is not — and was never — to reduce the area under the curve. This is a contagious respiratory virus, and it’s going to spread until there is herd immunity. Maybe there will be a vaccine in 12-18 months. Maybe not. But regardless, we can’t go on for that long with over 30% of society out of work. Most people are going to get this virus. If you don’t understand that, you are scientifically illiterate. You are pushing on the ocean to prevent the tide. Trying to forestall the inevitable by keeping us all locked in our homes will inflict such massive economic and social collateral damage that it’s simply unthinkable. We won’t stop the virus, and we’ll burn down our society trying.
- tathougies 6y ago
  But our hospitals do have enough capacity. So far we have not seen widespread hospital overruns as predicted. Army field hospitals were set up and then taken down with no one treated. New York wanted 40000 ventilators but only needed 5000. Surely we should increase availability, but the original predictions that inspired this level of lockdown have not come to pass and with the information we have now, we know they are just delaying the inevitable.
  - maxerickson 6y ago
    At any given moment, the appropriate way to look at a fast spreading infectious disease is to consider the more likely range of potential outcomes, work for the best one and plan for the worst one. When the work pays off with a better outcome, it's foolish to look back and criticize the planning for worse outcomes, especially when the tools to manage the infection are pretty limited (social distance works well, but it's a brutal tool, so you want to use it only as necessary).
  - acqq 6y ago
    > the original predictions that inspired this level of lockdown have not come to pass The predictions of what would have happened had no lockdown been introduced then haven't materialized precisely because the lockdown have been executed. That is no argument that the lockdown haven't been needed.
    - tathougies 6y ago
      No, my claim is that the models that were used with the lockdown were wrong. Cuomo claimed to need 40k ventilators after the lockdown was put in place. He ended up needing only a fraction of that. Obviously, without the lockdown, there would likely be more needed. Of course, modeling has errors, but this is an extremely large error, and one that has direct policy implications. Had the model's predictions been more accurate we could have found a better middle ground when it comes to lockdown. Every job saved and individual financially secure is one more person who can contribute to the community's well-being. I think it's pretty safe to say in retrospect that the lockdowns need not have been as draconian as they were. We had the hospital capacity to have less severe lockdowns and we should have done that. While we can't change the past, we can certainly look at how our models failed and rework our approach in the future. Anything else is irresponsible.
- osteele 6y ago
  Hospital capacity is one motivation for flattening the curve. The other is to move infections later in time, when there will be more effective treatments and therefore lower rates of fatality and permanent disability.

maxerickson 6y ago

You are proposing slowly letting it run until there is herd immunity, which would likely kill tens of millions of people worldwide. We should aim to do better than that.

e40 6y ago

Coworker of mine who happens to be Chinese bought portable oxygen for use in this situation. She bought it in February, after looking at videos about what was going on in Wuhan. We all thought she was kind of crazy. Doesn’t look so crazy now.

misja111 6y ago

>> get rid of the need to flatten the curve. This. A policy of flattening the curve will probably have to last for one or two years until either a vaccine is found or there is enough herd immunity. This will not only destroy our economy but the isolation will be a psychological challenge for many as well. We have to take one step back and think why we wanted to flatten the curve in the first place. And that is because our hospitals don't have enough capacity. So why don't we do something about that? IMO that, in combination with some moderate curve flattening, is the only acceptable solution in the long term.

barkingcat 6y ago
conceptually, flattening the curve is meant to turn an exponential infection curve into something more manageable. We are flattening the curve, yes, initially because hospitals don't have capacity, but the root of this issue is the exponential nature of infection transmission. If we have the ability to build hospitals at a rate to match O(2^n) time then we can let everyone out and declare quarantine over! But as you know, an O(2^n) algorithm is extraordinarily hard to keep up with once n approaches any large number. That's the curve we're trying to flatten - by changing the approach, changing the "algorithm" so to speak, by not allowing people to interact so they have less chance of infection. If you are able to build a new hospital in a week, and then continue building a new hospital every day after that and then one every hour after that, and then a new hospital every few seconds after that, then you have a chance to keep up with an exponential curve (well, until the virus runs out of people to infect, so until it reaches 100% of the global population).
- misja111 6y ago
  I was writing that we should both create hospital capacity and have some moderate flattening of the curve. Of course we shouldn't let the virus run free. But unless you are hoping for a vaccine to be invented soon, which would of course be wonderful, you have to face the other scenario and that is that we have to slowly build up herd immunity. Herd immunity means that people have to get infected and a percentage of that will have to go to the hospital. No matter how you manage it, bigger hospital capacity simply means that you are able to reach herd immunity more quickly.
  - DanBC 6y ago
    > Herd immunity What does her immunity actually mean though? What other diseases do we try to tackle using herd immunity? How many deaths would make herd immunity acceptable or not acceptable? There are 350m people in the US. We need to get about 60% of them to have had covid-19. That's 210m people. We don't know how fatal covid-19 is yet, so here are some lower numbers: 0.1% = 210,000 deaths 0.2% = 420,000 deaths 0.5% = 1,050,000 deaths And once we've killed off all these people what have we achieved? Covid-19 would be in the population and will come back every year as a seasonal respiratory illness, killing off more people every year until we get a vaccine.
    - misja111 6y ago
      There are ways to limit the number of deaths and still reach herd immunity. For instance by keeping elderly and sick people isolated but the healthier part not, until herd immunity is reached. This disease has to be handled with intelligence and common sense, not with rethorics and dogma's.
    - lftl 6y ago
      > Covid-19 would be in the population and will come back every year as a seasonal respiratory illness, killing off more people every year until we get a vaccine. Do you have any evidence to support that it would keep coming back? As far as I know there's only very small anecdotal evidence of people getting reinfected and we simply have no way of knowing yet whether the average person's immunity will last weeks, months or years.
maxerickson 6y ago
We have to smash the curve so that we don't need the hospital capacity. It turns out that getting the number of infected down close to zero would also be good for the economy. I don't understand why so many people think that the best possible plan is for everyone to get infected. The best possibilities involve a few percentage points of the global population getting infected, no where near everyone.
- irq11 6y ago
  This simply isn’t possible, and it’s a maddeningly irresponsible shifting of the goalposts. The public was sold these extreme tactics on the basis of preventing excess deaths, not locking down society for years on end until the virus (hopefully) goes away. Respiratory viruses, once endemic, have never been completely suppressed. Even China is seeing a resurgence in cases. What we’re doing now isn’t sustainable or ethical, and we have to move on to smarter tactics soon.
  - maxerickson 6y ago
    The lockdowns are a necessary step to smarter tactics working. My point is that if we move forward as if letting lots of people get infected is a 'smarter tactic', it's going to be worse in all ways. More death, more economic damage.
    - lobotryas 6y ago
      No, not “lots of people”, I don’t see anyone saying that. Given that it’s factually impossible to lock down the economy for a very long time we need conditions where the hospital system retains enough capacity to handle the really sick people. Since it looks like we’re close to this (even in places like NYC that are sitting on a vent stockpile) we can start loosening the economy back.
    - irq11 6y ago
      No, you’re still shifting the goalposts. The point of “flattening the curve” is not — and was never — to reduce the area under the curve. This is a contagious respiratory virus, and it’s going to spread until there is herd immunity. Maybe there will be a vaccine in 12-18 months. Maybe not. But regardless, we can’t go on for that long with over 30% of society out of work. Most people are going to get this virus. If you don’t understand that, you are scientifically illiterate. You are pushing on the ocean to prevent the tide. Trying to forestall the inevitable by keeping us all locked in our homes will inflict such massive economic and social collateral damage that it’s simply unthinkable. We won’t stop the virus, and we’ll burn down our society trying.
tathougies 6y ago
But our hospitals do have enough capacity. So far we have not seen widespread hospital overruns as predicted. Army field hospitals were set up and then taken down with no one treated. New York wanted 40000 ventilators but only needed 5000. Surely we should increase availability, but the original predictions that inspired this level of lockdown have not come to pass and with the information we have now, we know they are just delaying the inevitable.
- maxerickson 6y ago
  At any given moment, the appropriate way to look at a fast spreading infectious disease is to consider the more likely range of potential outcomes, work for the best one and plan for the worst one. When the work pays off with a better outcome, it's foolish to look back and criticize the planning for worse outcomes, especially when the tools to manage the infection are pretty limited (social distance works well, but it's a brutal tool, so you want to use it only as necessary).
- acqq 6y ago
  > the original predictions that inspired this level of lockdown have not come to pass The predictions of what would have happened had no lockdown been introduced then haven't materialized precisely because the lockdown have been executed. That is no argument that the lockdown haven't been needed.
  - tathougies 6y ago
    No, my claim is that the models that were used with the lockdown were wrong. Cuomo claimed to need 40k ventilators after the lockdown was put in place. He ended up needing only a fraction of that. Obviously, without the lockdown, there would likely be more needed. Of course, modeling has errors, but this is an extremely large error, and one that has direct policy implications. Had the model's predictions been more accurate we could have found a better middle ground when it comes to lockdown. Every job saved and individual financially secure is one more person who can contribute to the community's well-being. I think it's pretty safe to say in retrospect that the lockdowns need not have been as draconian as they were. We had the hospital capacity to have less severe lockdowns and we should have done that. While we can't change the past, we can certainly look at how our models failed and rework our approach in the future. Anything else is irresponsible.
osteele 6y ago
Hospital capacity is one motivation for flattening the curve. The other is to move infections later in time, when there will be more effective treatments and therefore lower rates of fatality and permanent disability.