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> Nursing homes should be able to practice basic infection control; after all, they have flu season to manage every year. What is seems more important than wha

> Nursing homes should be able to practice basic infection control; after all, they have flu season to manage every year. What is seems more important than what should be. Also, applying science, logic, and epistemology at the layer where decisions are made that affect multiple downstream organizations (who may not have the in-house expertise to make optimum decisions) seems like a sub-optimal approach to me. If nursing homes "should" be able to make such decisions competently, is it not fair to ask that those higher up the chain should be able to do the same? What is the best way to manage risk in scenarios such as this? Noteworthy is the wide variability of reporting in the media about the degree to which Cuomo did a good job on covid.

ceejayoz 6y ago
As I noted, it's likely this order was issued because NYC hospitals were filling up, and testing was very limited. On March 25, NY saw 5,146 new cases, and 12,209 tests. (https://covidtracking.com/data/state/new-york; https://covidtracking.com/data/state/new-york; click "full range) They didn't have the testing capacity to test stable nursing home patients before sending them home, and they didn't have enough hospital beds to let them sit around for weeks for that to change. Having them convalesce back at the nursing homes seems like a reasonable move given that. March in NY was "which of these bad options kills the least people" time.
- __blockcipher__ 6y ago
  They had giant medical tents which were constructed and then ended up being quickly torn down. They had the USS comfort. The predicted hospital overrun scenario never happened. One hospital in NY would be full to the brim, but a nearby hospital would be at 50% capacity. It was a shuffling problem at best. No, what happened here was the hysteria got so severe that irrational decisions were made to try to mitigate a problem that didn’t truly exist.
  - ceejayoz 6y ago
    > They had giant medical tents which were constructed and then ended up being quickly torn down. Staffing was a problem. Tents don't magically make doctors and nurses arrive. Travel nurses were being offered $10k/week to come. https://nurse.org/articles/new-york-travel-nurse-jobs-covid19-incentives/ https://nurse.org/articles/new-york-travel-nurse-jobs-covid1... > They had the USS comfort. https://www.nytimes.com/2020/04/02/nyregion/ny-coronavirus-usns-comfort.html https://www.nytimes.com/2020/04/02/nyregion/ny-coronavirus-u... "On top of its strict rules preventing people infected with the virus from coming on board, the Navy is also refusing to treat a host of other conditions. Guidelines disseminated to hospitals included a list of 49 medical conditions that would exclude a patient from admittance to the ship." "Ambulances cannot take patients directly to the Comfort; they must first deliver patients to a city hospital for a lengthy evaluation — including a test for the virus — and then pick them up again for transport to the ship." That's in early April. They later changed tack on those restrictions, but as of the order, those restrictions were still in place. https://nypost.com/2020/04/07/officials-underestimated-issues-facing-usns-comfort-to-fight-coronavirus/ https://nypost.com/2020/04/07/officials-underestimated-issue... “The ship is fitted out for battlefield injuries — it was not designed for dealing with a highly infectious and highly transmissible outbreak.” The USS Theodore Roosevelt later demonstrated just how bad the tight quarters of a ship can be for infection control. > The predicted hospital overrun scenario never happened. On March 25th, knowing that would've required time travel. The peak was still weeks away, and it was reasonable to worry about it; Italy hit that point in areas.
  - cm2187 6y ago
    And I think when people were talking about hospitals being full, they were referring to ICUs. The rest of the hospital was essentially empty as every elective procedures had been cancelled, the mayo clinic was even furloughing workers.
- mistermann 6y ago
  > March in NY was "which of these bad options kills the least people" time. They seem to have calculated wrong. But via the magic of the media to bend people's perception of reality, have been reputationally rewarded for it. These decisions and their portrayal in the media is what passes for expertise in medicine, science, politics, journalism, and authority in 2020, and people seem to genuinely wonder why we have so many conspiracy theorists.
  - ceejayoz 6y ago
    > They seem to have calculated wrong. But via the magic of the media to bend people's perception of reality, have been reputationally rewarded for it. The magic of media, or the relatively favorable comparison to the federal response at the time, which was largely "lalala can't hear you"? Folks are more inclined to accept "we tried stuff, and some of it wound up being unnecessary in hindsight" than denial.
    - mistermann 6y ago
      I'm referring to Cuomo's decision on sending covid infected people into nursing homes, and the apparently counter-intuitive public opinion of his performance. However... > the federal response at the time, which was largely "lalala can't hear you"? ...is actually a good example of how how media coverage can shape even intelligent people's perception of reality - Trump's response was indeed characterized as resembling "lalala can't hear you", which you'd think would immediately fail the sniff test truth filter of any reasonable person...but perhaps the human mind doesn't work quite how we think it does.
      - ceejayoz 6y ago
        https://www.cbsnews.com/news/timeline-president-donald-trump-changing-statements-on-coronavirus/ https://www.cbsnews.com/news/timeline-president-donald-trump... Feb 26: "And again, when you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that's a pretty good job we've done." Mar 6: "Anybody that wants a test can get a test. ... The tests are all perfect, like the letter was perfect, the transcription was perfect, right?" Mar 13: "We have 40 people right now. Forty. Compare that with other countries that have many, many times that amount. And one of the reasons we have 40 and others have — and, again, that number is going up, just so you understand. And a number of cases, which are very small, relatively speaking — it's going up. But we've done a great job because we acted quickly. We acted early. And there's nothing we could have done that was better than closing our borders to highly infected areas." Mar 24: "I think Easter Sunday — you'll have packed churches all over our country." Mar 24: "We begin to see the light at the end of the tunnel." What about these quotes imply "we're taking this seriously"? He's still mocking folks for wearing masks and is holding public rallies where people aren't wearing masks or distancing to this day.

ceejayoz 6y ago

As I noted, it's likely this order was issued because NYC hospitals were filling up, and testing was very limited. On March 25, NY saw 5,146 new cases, and 12,209 tests. (https://covidtracking.com/data/state/new-york; https://covidtracking.com/data/state/new-york; click "full range) They didn't have the testing capacity to test stable nursing home patients before sending them home, and they didn't have enough hospital beds to let them sit around for weeks for that to change. Having them convalesce back at the nursing homes seems like a reasonable move given that. March in NY was "which of these bad options kills the least people" time.

__blockcipher__ 6y ago
They had giant medical tents which were constructed and then ended up being quickly torn down. They had the USS comfort. The predicted hospital overrun scenario never happened. One hospital in NY would be full to the brim, but a nearby hospital would be at 50% capacity. It was a shuffling problem at best. No, what happened here was the hysteria got so severe that irrational decisions were made to try to mitigate a problem that didn’t truly exist.
- ceejayoz 6y ago
  > They had giant medical tents which were constructed and then ended up being quickly torn down. Staffing was a problem. Tents don't magically make doctors and nurses arrive. Travel nurses were being offered $10k/week to come. https://nurse.org/articles/new-york-travel-nurse-jobs-covid19-incentives/ https://nurse.org/articles/new-york-travel-nurse-jobs-covid1... > They had the USS comfort. https://www.nytimes.com/2020/04/02/nyregion/ny-coronavirus-usns-comfort.html https://www.nytimes.com/2020/04/02/nyregion/ny-coronavirus-u... "On top of its strict rules preventing people infected with the virus from coming on board, the Navy is also refusing to treat a host of other conditions. Guidelines disseminated to hospitals included a list of 49 medical conditions that would exclude a patient from admittance to the ship." "Ambulances cannot take patients directly to the Comfort; they must first deliver patients to a city hospital for a lengthy evaluation — including a test for the virus — and then pick them up again for transport to the ship." That's in early April. They later changed tack on those restrictions, but as of the order, those restrictions were still in place. https://nypost.com/2020/04/07/officials-underestimated-issues-facing-usns-comfort-to-fight-coronavirus/ https://nypost.com/2020/04/07/officials-underestimated-issue... “The ship is fitted out for battlefield injuries — it was not designed for dealing with a highly infectious and highly transmissible outbreak.” The USS Theodore Roosevelt later demonstrated just how bad the tight quarters of a ship can be for infection control. > The predicted hospital overrun scenario never happened. On March 25th, knowing that would've required time travel. The peak was still weeks away, and it was reasonable to worry about it; Italy hit that point in areas.
- cm2187 6y ago
  And I think when people were talking about hospitals being full, they were referring to ICUs. The rest of the hospital was essentially empty as every elective procedures had been cancelled, the mayo clinic was even furloughing workers.
mistermann 6y ago
> March in NY was "which of these bad options kills the least people" time. They seem to have calculated wrong. But via the magic of the media to bend people's perception of reality, have been reputationally rewarded for it. These decisions and their portrayal in the media is what passes for expertise in medicine, science, politics, journalism, and authority in 2020, and people seem to genuinely wonder why we have so many conspiracy theorists.
- ceejayoz 6y ago
  > They seem to have calculated wrong. But via the magic of the media to bend people's perception of reality, have been reputationally rewarded for it. The magic of media, or the relatively favorable comparison to the federal response at the time, which was largely "lalala can't hear you"? Folks are more inclined to accept "we tried stuff, and some of it wound up being unnecessary in hindsight" than denial.
  - mistermann 6y ago
    I'm referring to Cuomo's decision on sending covid infected people into nursing homes, and the apparently counter-intuitive public opinion of his performance. However... > the federal response at the time, which was largely "lalala can't hear you"? ...is actually a good example of how how media coverage can shape even intelligent people's perception of reality - Trump's response was indeed characterized as resembling "lalala can't hear you", which you'd think would immediately fail the sniff test truth filter of any reasonable person...but perhaps the human mind doesn't work quite how we think it does.
    - ceejayoz 6y ago
      https://www.cbsnews.com/news/timeline-president-donald-trump-changing-statements-on-coronavirus/ https://www.cbsnews.com/news/timeline-president-donald-trump... Feb 26: "And again, when you have 15 people, and the 15 within a couple of days is going to be down to close to zero, that's a pretty good job we've done." Mar 6: "Anybody that wants a test can get a test. ... The tests are all perfect, like the letter was perfect, the transcription was perfect, right?" Mar 13: "We have 40 people right now. Forty. Compare that with other countries that have many, many times that amount. And one of the reasons we have 40 and others have — and, again, that number is going up, just so you understand. And a number of cases, which are very small, relatively speaking — it's going up. But we've done a great job because we acted quickly. We acted early. And there's nothing we could have done that was better than closing our borders to highly infected areas." Mar 24: "I think Easter Sunday — you'll have packed churches all over our country." Mar 24: "We begin to see the light at the end of the tunnel." What about these quotes imply "we're taking this seriously"? He's still mocking folks for wearing masks and is holding public rallies where people aren't wearing masks or distancing to this day.