4 ms·

Which means that if we choose to ignore the Trump aspect of the corona virus and compare the US to other countries you get the following: - no free healthcare

Which means that if we choose to ignore the Trump aspect of the corona virus and compare the US to other countries you get the following: - no free healthcare means you initially had to pay to get tested - underdeveloped healthcare system (initial wave saw NYC overwhelmed) - lack of labor laws means that you have few rights: no sick days and can easily be fired with no grace period - polarized political environment means that government help takes a lot of time and has to be executed in mammoth size packages - very large country seen as one makes it an easy target for the press (x number of people died instead of x%)

ethbr0 6y ago
> no free healthcare means you initially had to pay to get tested Varied from state to state, no? > underdeveloped healthcare system (initial wave saw NYC overwhelmed) New York City was not overwhelmed in the first wave, and had both Javits and the Mercy as unused spare capacity. > lack of labor laws means that you have few rights: no sick days and can easily be fired with no grace period Varied from employer to employer. For example, my employer at the time added Covid-quarantine-specific PTO, full PTO for high risk groups that felt uncomfortable, and bonuses for those who chose to work during the pandemic. > polarized political environment means that government help takes a lot of time and has to be executed in mammoth size packages This has always been true of the federal response. States can't typically defecit budget, by law, so the federal government typically allocates money for them in chunks.
- craftinator 6y ago
  > New York City was not overwhelmed in the first wave, and had both Javits and the Mercy as unused spare capacity. This is not in line with the facts as I understand them. Multiple health care workers I know told me in March-April that their ability to treat Covid patients were capped by constrained resources (not enough ventilators, not enough staff, not enough beds) during the first wave. Here [1] is an article that supports these anecdotes. Also, the Navy hospital ships refused to accept patient transfers, even as the hospitals were completely full [2]. "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. " and "Mr. Dowling said he has had to tear his hospitals apart, retrofitting any unused space, including lobbies and conference rooms, into hospital wards.". So no, you are incorrect. NY hospitals were absolutely overrun during the first wave. Please do not perpetuate a narrative that isn't supported by facts. 1) https://www.cnn.com/2020/03/30/us/brooklyn-hospital-coronavirus-patients-deaths/index.html https://www.cnn.com/2020/03/30/us/brooklyn-hospital-coronavi... 2) https://www.nytimes.com/2020/04/02/nyregion/ny-coronavirus-usns-comfort.html https://www.nytimes.com/2020/04/02/nyregion/ny-coronavirus-u...
  - ethbr0 6y ago
    I don't think [1] suppports that. That's a report from a single hospital. > [...] the ICU is at capacity, patient beds line the hallways of the emergency department, and the morgue is overflowing. [...] has a capacity of about 300 people at any given time They then talk about converting elective space and hallways into bed space. Which was pretty normal everywhere. And critically, NYC, as with all major metros, operates as a system of hospitals. So the data to support your assertion would be total NYC bed & ICU bed capacity & utilization. "Overwhelmed" means unable to provide care. Not busy. Not lacking in specific equipment. Not being diverted to another hospital. It means ambulances showing up with patients and being told "No, we can provide no treatment." The situation on the Comfort in NYC (swapped my coasts, oops!) was... complicated. The Navy was essentially commanded to "Send a big ship to NYC so it can be seen." Everyone I've talked to in Navy medicine thought it was idiotic, for reasons too numerous to list. However, given the order from on high, the least &@$_ed way of fulfilling it was to use the Comfort to offload non-Covid patients from local hospitals, thereby freeing capacity, thereby creating more Covid bed space. (Just to be clear, swamping an enclosed ship with large numbers of patients infected with a highly communicable virus is a terrible idea. Land-based facilities, if existent, are infinitely superior for isolation in this scenario) Only... nobody had thought about how that transfer was supposed to work. Or the legal ramifications of transferring patients from hospitals to US military care. Or any of the other minutiae. Consequently, the Comfort essentially sat there waiting for hospitals to transfer patients and... they didn't. Essentially the same story with Javits (staffed by military medical). What Javits did get tended to be folks the hospitals thought would be unable to pay, and/or Medicaid (ie capped reimbursement rates). The general feeling on the military medical side is that hospitals didn't want to lose the revenue patients represented, and so were retaining as many as possible, even as their doctors, nurses, and staff (rightly so) told the media they'd been working non-stop for weeks. Source: doctors in NYC, people who served at Javits and had colleagues on the Comfort Please see guidelines for HN commenting. Specifically, "Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith." https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
    - craftinator 6y ago
collyw 6y ago
We have a rather good state run healthcare system where I am and we also had the first two problems you describe. - You can't get free tests easily. - almost overwhelmed hospitals - pretty much at their limit. We have pretty much the same % deaths as the US - 0.1% of the population, so less than Heart disease or cancer, but worse than an average flu.
- ethbr0 6y ago
  One thing that disappoints me most about the entire response is the shifting narrative. I'm in a technical field. I understand the fits and starts and retractions that constitute actual scientific process. But my understanding from reading earlier governmental / military pandemic wargames is that there was one overriding discovery: never hide or obscure the truth, as once public trust is lost it can never be regained. This was always participants' original sin, and again and again it failed. You need public participation and adherence, and you can't do that without their trust. So in scenarios where you have limited test kits available, don't tell people they don't need to get tested. Tell them the scenarios they should get tested in, on Day 1, and then explain that there's a shortage of tests, who they're currently going to, and what you're doing to increase the supply. A vacuum of information creates panic. Trustworthiness, even in dire circumstances, creates shared goals. (PS: I'm painfully aware the US president was leading most of this, but prefer to treat that situation like the racist uncle at Thanksgiving. Roll your eyes, dig a steak knife into your own leg, ignore what he said, and get on with the business of talking to other adults)
  - collyw 6y ago
    Agree. I used to respect and defend the scientific establishment. In the days of Covid it seems more of an appeal to authority on what some scientist says rather than actual science. And there are plenty of other experts who are ignored for going against the mainstream narrative.

ethbr0 6y ago

> no free healthcare means you initially had to pay to get tested Varied from state to state, no? > underdeveloped healthcare system (initial wave saw NYC overwhelmed) New York City was not overwhelmed in the first wave, and had both Javits and the Mercy as unused spare capacity. > lack of labor laws means that you have few rights: no sick days and can easily be fired with no grace period Varied from employer to employer. For example, my employer at the time added Covid-quarantine-specific PTO, full PTO for high risk groups that felt uncomfortable, and bonuses for those who chose to work during the pandemic. > polarized political environment means that government help takes a lot of time and has to be executed in mammoth size packages This has always been true of the federal response. States can't typically defecit budget, by law, so the federal government typically allocates money for them in chunks.

craftinator 6y ago
> New York City was not overwhelmed in the first wave, and had both Javits and the Mercy as unused spare capacity. This is not in line with the facts as I understand them. Multiple health care workers I know told me in March-April that their ability to treat Covid patients were capped by constrained resources (not enough ventilators, not enough staff, not enough beds) during the first wave. Here [1] is an article that supports these anecdotes. Also, the Navy hospital ships refused to accept patient transfers, even as the hospitals were completely full [2]. "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. " and "Mr. Dowling said he has had to tear his hospitals apart, retrofitting any unused space, including lobbies and conference rooms, into hospital wards.". So no, you are incorrect. NY hospitals were absolutely overrun during the first wave. Please do not perpetuate a narrative that isn't supported by facts. 1) https://www.cnn.com/2020/03/30/us/brooklyn-hospital-coronavirus-patients-deaths/index.html https://www.cnn.com/2020/03/30/us/brooklyn-hospital-coronavi... 2) https://www.nytimes.com/2020/04/02/nyregion/ny-coronavirus-usns-comfort.html https://www.nytimes.com/2020/04/02/nyregion/ny-coronavirus-u...
- ethbr0 6y ago
  I don't think [1] suppports that. That's a report from a single hospital. > [...] the ICU is at capacity, patient beds line the hallways of the emergency department, and the morgue is overflowing. [...] has a capacity of about 300 people at any given time They then talk about converting elective space and hallways into bed space. Which was pretty normal everywhere. And critically, NYC, as with all major metros, operates as a system of hospitals. So the data to support your assertion would be total NYC bed & ICU bed capacity & utilization. "Overwhelmed" means unable to provide care. Not busy. Not lacking in specific equipment. Not being diverted to another hospital. It means ambulances showing up with patients and being told "No, we can provide no treatment." The situation on the Comfort in NYC (swapped my coasts, oops!) was... complicated. The Navy was essentially commanded to "Send a big ship to NYC so it can be seen." Everyone I've talked to in Navy medicine thought it was idiotic, for reasons too numerous to list. However, given the order from on high, the least &@$_ed way of fulfilling it was to use the Comfort to offload non-Covid patients from local hospitals, thereby freeing capacity, thereby creating more Covid bed space. (Just to be clear, swamping an enclosed ship with large numbers of patients infected with a highly communicable virus is a terrible idea. Land-based facilities, if existent, are infinitely superior for isolation in this scenario) Only... nobody had thought about how that transfer was supposed to work. Or the legal ramifications of transferring patients from hospitals to US military care. Or any of the other minutiae. Consequently, the Comfort essentially sat there waiting for hospitals to transfer patients and... they didn't. Essentially the same story with Javits (staffed by military medical). What Javits did get tended to be folks the hospitals thought would be unable to pay, and/or Medicaid (ie capped reimbursement rates). The general feeling on the military medical side is that hospitals didn't want to lose the revenue patients represented, and so were retaining as many as possible, even as their doctors, nurses, and staff (rightly so) told the media they'd been working non-stop for weeks. Source: doctors in NYC, people who served at Javits and had colleagues on the Comfort Please see guidelines for HN commenting. Specifically, "Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize. Assume good faith." https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
  - craftinator 6y ago

collyw 6y ago

We have a rather good state run healthcare system where I am and we also had the first two problems you describe. - You can't get free tests easily. - almost overwhelmed hospitals - pretty much at their limit. We have pretty much the same % deaths as the US - 0.1% of the population, so less than Heart disease or cancer, but worse than an average flu.

ethbr0 6y ago
One thing that disappoints me most about the entire response is the shifting narrative. I'm in a technical field. I understand the fits and starts and retractions that constitute actual scientific process. But my understanding from reading earlier governmental / military pandemic wargames is that there was one overriding discovery: never hide or obscure the truth, as once public trust is lost it can never be regained. This was always participants' original sin, and again and again it failed. You need public participation and adherence, and you can't do that without their trust. So in scenarios where you have limited test kits available, don't tell people they don't need to get tested. Tell them the scenarios they should get tested in, on Day 1, and then explain that there's a shortage of tests, who they're currently going to, and what you're doing to increase the supply. A vacuum of information creates panic. Trustworthiness, even in dire circumstances, creates shared goals. (PS: I'm painfully aware the US president was leading most of this, but prefer to treat that situation like the racist uncle at Thanksgiving. Roll your eyes, dig a steak knife into your own leg, ignore what he said, and get on with the business of talking to other adults)
- collyw 6y ago
  Agree. I used to respect and defend the scientific establishment. In the days of Covid it seems more of an appeal to authority on what some scientist says rather than actual science. And there are plenty of other experts who are ignored for going against the mainstream narrative.