4 ms·

No country in the world has the capacity to take care of more than “a couple thousand” ICU patients (well, it’s more like a couple of ten thousand ICU patients

by arrrg 5y ago

No country in the world has the capacity to take care of more than “a couple thousand” ICU patients (well, it’s more like a couple of ten thousand ICU patients for the best equipped and richest large countries in the world, like Germany). Simply because “a couple thousand” is all that’s needed during ordinary times. Yeah, there are issues with staffing and inadequate payment of the staff, sure, and those problems are long-standing and unresolved, but even if they were solved that wouldn’t be much of a help. We would then maybe talk about a couple thousand (here in the literal sense) beds in terms of increasing ICU capacity, if that (simply because it’s not as though Germany’s existing ICU capacity is somehow ridiculously small, it’s quite large, actually if you put it in context and adding a couple thousand beds would be a massive increase). That would be helpful but wouldn’t really solve the underlying problem. And either way: Increasing ICU capacity right now is not a solution. It’s completely misguided. Not least of which because it takes forever to increase capacity. You have to train people for that … Unvaccinated people are to blame for this, but especially cowardly politicians who were too frightened to start implementing vaccination mandates right away (summer 2021), as soon as it was clear that you cannot reach good enough vaccination numbers just based on pleas alone. We do have a solution for this and the solution is vaccination. However, in the very short term even that won’t be good enough, we need to break the 4th wave and for that contact reduction is necessary (and already happening). Think about time frames. Contact reduction, will show its effects within a couple weeks, vaccination mandates plus a logistical push for booster vaccinations, will show their effects within one month to three months, making healthcare more resilient in general, will show its effects within a couple of years, maybe a decade.

mandmandam 5y ago
> Unvaccinated people are to blame for this This satirical article from Ireland is probably applicable in every Western country that has had its health system systematically hollowed out by cynical neoliberal fuckheads: https://waterfordwhispersnews.com/2021/11/19/unvaccinated-behind-all-hse-failures-finds-government-report/ https://waterfordwhispersnews.com/2021/11/19/unvaccinated-be... > Increasing ICU capacity right now is not a solution. It's completely misguided What you fail to understand is that the people who cut those bed numbers across Europe are responsible for far more death than a small percent of mRNA vaccine hesitant people. And they're fucking delighted that so many people are so misdirected.
- stefs 5y ago
  the cynical neoliberal fuckheads didn't manage to cut ICU beds in time in austria (they tried but the epidemic beat them to it). we're still extremely close to running out though. currently, patients are transferred to hospitals across the country and surgeries are put off.
nzk 5y ago
In three months, the booster efficiency might start waning again, we don't know that yet. These vaccines so far aren't looking like they are the solution to the pandemic either, better vaccines or better treatment might be. I'm not saying it doesn't make sense to get vaccinated if you want to help with the situation, but I do find the way our politicians deflect blame and openly insult a not so small segment of the population completely distasteful. They shouldn't be surprised if the people they're insulting are not willing to help anymore, now or in the future. A strategy that would make sense would include BOTH vaccination and ICU capacity, one of which could have been started in March 2020, and it would have put us in a much better position today. Letting capacity decrease while waiting for vaccines that may or may not end the pandemic is negligent. Not getting vaccinated may be seen by some as negligent also, but different standards apply for governments and citizens. The pandemic comes in waves, we do not need to plan for endless exponential growth. A few weeks of extra capacity would make the whole thing much easier to handle, given that we might be already at the peak and cases seem to be going down again[0]. The RKI weekly report[1] currently lists 1700 ICU cases, a month ago it was 1100[2]. So the 4000 beds we lost throughout the year[3] could have made a big difference. [0]https://www.tagesschau.de/inland/rki-infektionen-103.html https://www.tagesschau.de/inland/rki-infektionen-103.html [1]https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/Wochenbericht/Wochenbericht_2021-12-02.pdf?__blob=publicationFile https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus... [2]https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/Wochenbericht/Wochenbericht_2021-11-11.pdf?__blob=publicationFile https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus... [3]https://www.intensivregister.de/#/aktuelle-lage/zeitreihen https://www.intensivregister.de/#/aktuelle-lage/zeitreihen
- arrrg 5y ago
  Please source the 4,000 number properly: https://news.ycombinator.com/item?id=29422105 https://news.ycombinator.com/item?id=29422105 As I point out in my other comment, you cannot interpret that number in any to imply as though we ever actually had those 4,000 beds.
  - nzk 5y ago
    Fair enough, thanks for the info, I'll check it out. But let it be 2594 then, that is still too many given that we should have increased it by any means possible before starting to publically insult 20% of the population. I'm not assuming a deliberate reduction, I am assuming negligence.
Barrin92 5y ago
>Simply because “a couple thousand” is all that’s needed during ordinary times. Yes but.. extraordinary times exist, if we were sane we would prepare for crises before they happen, because we always knew that it would hit us eventually, people have been warning about this for ages, this is not some black swan. More healthcare capacity would help, just like more supply chain capacity would help, or the ability to manufacture some masks, the entire problem is we've been running on the idiotic 80s managerial efficiency mindset for decades and now we're running on fumes on every front. If we had any appreciation for crisis management, robustness, redundancy and had some shock absorbers in our system many people would not have needed to die. And no it's not just the unvaccinated. Plenty of countries this year, including the US, will lose more people in total to covid in 2021 than in 2020. Vaccines help but they are not pandemic ending, and our systems are deeply screwed up.
- est31 5y ago
  This is also about appreciation. The main bottleneck for increasing capacity is not machines, rooms or beds, those are available. It's hospital staff that's lacking. ICU beds are the most staff intensive beds in a hospital. It's a job that requires years of training, so you can't just scale it up. Also, the willingness to be a nurse has decreased during the last couple months. A lot of hospital staff has burned out during the first few waves and either reduced their contracts to part time, or quit entirely. The remaining staff has to work hard, until exhaustion and beyond, in order to fight for the patient's lives. Covid stations require proper hygiene which puts extra stress on the hospital staff. And they put in all of this work because some people couldn't be bothered to seek out vaccination, often even the patients themselves. This is the main difference to the first few waves where vaccination has not been available to everyone.
  - kazen44 5y ago
    > Also, the willingness to be a nurse has decreased during the last couple months this was entirely preventable by providing nurses and those keeping hospitals running with the support they need to do suchs jobs during a time of crisis. In the netherlands for instance, many nurses have been running 12h shifts during the peaks, and there has been very little practical support in helping those people. I am not even talking about monetary funds, but mainly practical stuff. (for instance, some volunteers decided to do grocery shopping for nurses during peaks). If people are busting their ass off to prevent the healthcare systems from collepsing, maybe the goverment should have done far more in its power to prevent those people from quitting.

by arrrg 5y ago

mandmandam 5y ago

> Unvaccinated people are to blame for this This satirical article from Ireland is probably applicable in every Western country that has had its health system systematically hollowed out by cynical neoliberal fuckheads: https://waterfordwhispersnews.com/2021/11/19/unvaccinated-behind-all-hse-failures-finds-government-report/ https://waterfordwhispersnews.com/2021/11/19/unvaccinated-be... > Increasing ICU capacity right now is not a solution. It's completely misguided What you fail to understand is that the people who cut those bed numbers across Europe are responsible for far more death than a small percent of mRNA vaccine hesitant people. And they're fucking delighted that so many people are so misdirected.

stefs 5y ago
the cynical neoliberal fuckheads didn't manage to cut ICU beds in time in austria (they tried but the epidemic beat them to it). we're still extremely close to running out though. currently, patients are transferred to hospitals across the country and surgeries are put off.

nzk 5y ago

In three months, the booster efficiency might start waning again, we don't know that yet. These vaccines so far aren't looking like they are the solution to the pandemic either, better vaccines or better treatment might be. I'm not saying it doesn't make sense to get vaccinated if you want to help with the situation, but I do find the way our politicians deflect blame and openly insult a not so small segment of the population completely distasteful. They shouldn't be surprised if the people they're insulting are not willing to help anymore, now or in the future. A strategy that would make sense would include BOTH vaccination and ICU capacity, one of which could have been started in March 2020, and it would have put us in a much better position today. Letting capacity decrease while waiting for vaccines that may or may not end the pandemic is negligent. Not getting vaccinated may be seen by some as negligent also, but different standards apply for governments and citizens. The pandemic comes in waves, we do not need to plan for endless exponential growth. A few weeks of extra capacity would make the whole thing much easier to handle, given that we might be already at the peak and cases seem to be going down again[0]. The RKI weekly report[1] currently lists 1700 ICU cases, a month ago it was 1100[2]. So the 4000 beds we lost throughout the year[3] could have made a big difference. [0]https://www.tagesschau.de/inland/rki-infektionen-103.html https://www.tagesschau.de/inland/rki-infektionen-103.html [1]https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/Wochenbericht/Wochenbericht_2021-12-02.pdf?__blob=publicationFile https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus... [2]https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus/Situationsberichte/Wochenbericht/Wochenbericht_2021-11-11.pdf?__blob=publicationFile https://www.rki.de/DE/Content/InfAZ/N/Neuartiges_Coronavirus... [3]https://www.intensivregister.de/#/aktuelle-lage/zeitreihen https://www.intensivregister.de/#/aktuelle-lage/zeitreihen

arrrg 5y ago
Please source the 4,000 number properly: https://news.ycombinator.com/item?id=29422105 https://news.ycombinator.com/item?id=29422105 As I point out in my other comment, you cannot interpret that number in any to imply as though we ever actually had those 4,000 beds.
- nzk 5y ago
  Fair enough, thanks for the info, I'll check it out. But let it be 2594 then, that is still too many given that we should have increased it by any means possible before starting to publically insult 20% of the population. I'm not assuming a deliberate reduction, I am assuming negligence.

Barrin92 5y ago

>Simply because “a couple thousand” is all that’s needed during ordinary times. Yes but.. extraordinary times exist, if we were sane we would prepare for crises before they happen, because we always knew that it would hit us eventually, people have been warning about this for ages, this is not some black swan. More healthcare capacity would help, just like more supply chain capacity would help, or the ability to manufacture some masks, the entire problem is we've been running on the idiotic 80s managerial efficiency mindset for decades and now we're running on fumes on every front. If we had any appreciation for crisis management, robustness, redundancy and had some shock absorbers in our system many people would not have needed to die. And no it's not just the unvaccinated. Plenty of countries this year, including the US, will lose more people in total to covid in 2021 than in 2020. Vaccines help but they are not pandemic ending, and our systems are deeply screwed up.

est31 5y ago
This is also about appreciation. The main bottleneck for increasing capacity is not machines, rooms or beds, those are available. It's hospital staff that's lacking. ICU beds are the most staff intensive beds in a hospital. It's a job that requires years of training, so you can't just scale it up. Also, the willingness to be a nurse has decreased during the last couple months. A lot of hospital staff has burned out during the first few waves and either reduced their contracts to part time, or quit entirely. The remaining staff has to work hard, until exhaustion and beyond, in order to fight for the patient's lives. Covid stations require proper hygiene which puts extra stress on the hospital staff. And they put in all of this work because some people couldn't be bothered to seek out vaccination, often even the patients themselves. This is the main difference to the first few waves where vaccination has not been available to everyone.
- kazen44 5y ago
  > Also, the willingness to be a nurse has decreased during the last couple months this was entirely preventable by providing nurses and those keeping hospitals running with the support they need to do suchs jobs during a time of crisis. In the netherlands for instance, many nurses have been running 12h shifts during the peaks, and there has been very little practical support in helping those people. I am not even talking about monetary funds, but mainly practical stuff. (for instance, some volunteers decided to do grocery shopping for nurses during peaks). If people are busting their ass off to prevent the healthcare systems from collepsing, maybe the goverment should have done far more in its power to prevent those people from quitting.