11 ms·

in terms of covid hospitalisations overwhelming our hospitals: i‘m optimistic as well that this might not happen at scale. but in terms of a large part of soci

in terms of covid hospitalisations overwhelming our hospitals: i‘m optimistic as well that this might not happen at scale. but in terms of a large part of society getting sick (level 3 still makes you stick in bed) at the same time - this will lead to worker shortage - i’m kind of neutral-pessimistic. in terms of longterm long covid effect on our demographic - i’m fearful. in terms of society getting their act together to avert anything of this: absolutely pessimistic.

zrail 5y ago
> in terms of covid hospitalisations overwhelming our hospitals: i‘m optimistic as well that this might not happen at scale. I see no reason for this optimism. Every hospital that I know of in SE Michigan has been over capacity for several weeks. We have gotten regular emails from both hospital systems in Ann Arbor begging everyone to get vaccinated.
- toolz 5y ago
  This is inaccurate https://www.michigan.gov/coronavirus/0,9753,7-406-98159-523641--,00.html https://www.michigan.gov/coronavirus/0,9753,7-406-98159-5236...
  - ianhawes 5y ago
    Most people don’t realize that hospitals typically run at 98%+ capacity in the winter in a pre-COVID environment. This maximizes their profitability and allows them to operate relatively at a loss for the rest of the year.
    - ajuc 5y ago
      This varies greatly between countries. In many countries hospitals don't have profits - they operate like courts or army with yearly budgets assigned by the government.
    - maxerickson 5y ago
      Michigan has certificates of need for hospital beds. Capacity is centrally planned (no doubt the incumbents are good friends with their regulators). That's in addition to the games CMS plays with Medicare certification and funding.
    - toolz 5y ago
      Pre-covid, if you picked a random hospital at a random point in time in the U.S. there was a 16% chance it would be at max capacity and something like a 30% chance it would be over 80% capacity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840149/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840149/ It amazes me that hospitals are shutting down, healthcare worker numbers have barely recovered to 2018 numbers, bed capacity is shrinking in many areas and even still people think we have a healthcare crisis. We've created 80% of all dollars ever created in the past two years. We have the money. It seems obvious (to me, anyways) our healthcare spending would explode in that sector and solve simple issues like capacity and worker shortage, if in fact that was an issue to begin with.
      - zrail 5y ago
        Healthcare workers take many years to train. When they die of COVID, go on long term disability because of long COVID, or burn out because they can't mentally handle watching another willfully unvaccinated person die, that person is irreplaceable in the short term.
        toolz 5y ago
        HCW aren't on the decline because of any of those things (at least not primarily). This is made abundantly clear by looking at the steep dropoff in march of 2020 https://fred.stlouisfed.org/series/PAYEMS https://fred.stlouisfed.org/series/PAYEMS HCWs are below where they would otherwise be because of policy. Aside from that, long covid is psychosomatic. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785832 https://jamanetwork.com/journals/jamainternalmedicine/fullar... which means the root cause of long covid is likely misinformation about long covid to begin with (thanks "The Atlantic", for scaring everyone into being sick)
  - skuhn 5y ago
    Above 75% is roughly considered to be high occupancy. Efficiency drops at that point for various reasons, such as the difficulty in moving patients between units due to a lack of beds. These numbers are also comprised of large regions of the state with multiple facilities, but the facilities still operate independently. For adults, those regions of Michigan have the following ICU utilizations: Region 1: 90% Region 2N: 82% Region 2S: 89% Region 3: 94% Region 5: 85% Region 6: 87% Region 7: 94% Region 8: 72% The NYT compiles per-hospital stats at [1], although the data is incomplete. If Detroit were to not have beds available for patients, one option might be to transport patients as far away as Cleveland. There's a recent article discussing the situation at the Cleveland Clinic's 64 bed MICU [2]. [1] https://www.nytimes.com/interactive/2020/us/covid-hospitals-near-you.html https://www.nytimes.com/interactive/2020/us/covid-hospitals-... [2] https://fox59.com/news/national-world/not-gonna-make-it-out-of-this-hospital-what-staffers-see-inside-the-cleveland-clinic-icu/ https://fox59.com/news/national-world/not-gonna-make-it-out-...
toolz 5y ago
I can't stress enough how dangerous it is to pretend society can end a virus that is not only incredibly contagious between humans but also has many animal carriers. There is nothing more dangerous than society with no trust and this completely fabricated idea that people's behavior is to blame for the continued existence of covid serves no purpose other than to erode trust.
- impendingchange 5y ago
  How did humanity ever survive this long without modern medicine?
  - throwaway894345 5y ago
    Well, a lot of people died, mostly.
  - dahfizz 5y ago
    By letting people die. If covid came around in the 1200s, then everyone would have gotten it and ~3% of the world population would have died. Definitely suboptimal but nowhere near an extinction event.
    - jtc331 5y ago
      Given COVID’s risk/age relationship and already lower life spans in that time period plus higher vitamin D exposure rates it’s quite likely rate of death would have been lower in that population.
    - nradov 5y ago
      The infection fatality rate was never as high as 3%. The CDC estimated it at 0.6% back when almost no one was vaccinated.
      - astura 5y ago
        Nobody said it was? The question was about a world without modern medicine. It's totally reasonable to speculate there would be a higher fatality rate without medical intervention keeping people from dying.
tim333 5y ago
The thing with the worker shortage is it'll be brief. SA's already peaked. We'll have maybe a month of worker shortage I guess.

zrail 5y ago

> in terms of covid hospitalisations overwhelming our hospitals: i‘m optimistic as well that this might not happen at scale. I see no reason for this optimism. Every hospital that I know of in SE Michigan has been over capacity for several weeks. We have gotten regular emails from both hospital systems in Ann Arbor begging everyone to get vaccinated.

toolz 5y ago
This is inaccurate https://www.michigan.gov/coronavirus/0,9753,7-406-98159-523641--,00.html https://www.michigan.gov/coronavirus/0,9753,7-406-98159-5236...
- ianhawes 5y ago
  Most people don’t realize that hospitals typically run at 98%+ capacity in the winter in a pre-COVID environment. This maximizes their profitability and allows them to operate relatively at a loss for the rest of the year.
  - ajuc 5y ago
    This varies greatly between countries. In many countries hospitals don't have profits - they operate like courts or army with yearly budgets assigned by the government.
  - maxerickson 5y ago
    Michigan has certificates of need for hospital beds. Capacity is centrally planned (no doubt the incumbents are good friends with their regulators). That's in addition to the games CMS plays with Medicare certification and funding.
  - toolz 5y ago
    Pre-covid, if you picked a random hospital at a random point in time in the U.S. there was a 16% chance it would be at max capacity and something like a 30% chance it would be over 80% capacity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840149/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3840149/ It amazes me that hospitals are shutting down, healthcare worker numbers have barely recovered to 2018 numbers, bed capacity is shrinking in many areas and even still people think we have a healthcare crisis. We've created 80% of all dollars ever created in the past two years. We have the money. It seems obvious (to me, anyways) our healthcare spending would explode in that sector and solve simple issues like capacity and worker shortage, if in fact that was an issue to begin with.
    - zrail 5y ago
      Healthcare workers take many years to train. When they die of COVID, go on long term disability because of long COVID, or burn out because they can't mentally handle watching another willfully unvaccinated person die, that person is irreplaceable in the short term.
      - toolz 5y ago
        HCW aren't on the decline because of any of those things (at least not primarily). This is made abundantly clear by looking at the steep dropoff in march of 2020 https://fred.stlouisfed.org/series/PAYEMS https://fred.stlouisfed.org/series/PAYEMS HCWs are below where they would otherwise be because of policy. Aside from that, long covid is psychosomatic. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2785832 https://jamanetwork.com/journals/jamainternalmedicine/fullar... which means the root cause of long covid is likely misinformation about long covid to begin with (thanks "The Atlantic", for scaring everyone into being sick)
- skuhn 5y ago
  Above 75% is roughly considered to be high occupancy. Efficiency drops at that point for various reasons, such as the difficulty in moving patients between units due to a lack of beds. These numbers are also comprised of large regions of the state with multiple facilities, but the facilities still operate independently. For adults, those regions of Michigan have the following ICU utilizations: Region 1: 90% Region 2N: 82% Region 2S: 89% Region 3: 94% Region 5: 85% Region 6: 87% Region 7: 94% Region 8: 72% The NYT compiles per-hospital stats at [1], although the data is incomplete. If Detroit were to not have beds available for patients, one option might be to transport patients as far away as Cleveland. There's a recent article discussing the situation at the Cleveland Clinic's 64 bed MICU [2]. [1] https://www.nytimes.com/interactive/2020/us/covid-hospitals-near-you.html https://www.nytimes.com/interactive/2020/us/covid-hospitals-... [2] https://fox59.com/news/national-world/not-gonna-make-it-out-of-this-hospital-what-staffers-see-inside-the-cleveland-clinic-icu/ https://fox59.com/news/national-world/not-gonna-make-it-out-...

toolz 5y ago

I can't stress enough how dangerous it is to pretend society can end a virus that is not only incredibly contagious between humans but also has many animal carriers. There is nothing more dangerous than society with no trust and this completely fabricated idea that people's behavior is to blame for the continued existence of covid serves no purpose other than to erode trust.

impendingchange 5y ago
How did humanity ever survive this long without modern medicine?
- throwaway894345 5y ago
  Well, a lot of people died, mostly.
- dahfizz 5y ago
  By letting people die. If covid came around in the 1200s, then everyone would have gotten it and ~3% of the world population would have died. Definitely suboptimal but nowhere near an extinction event.
  - jtc331 5y ago
    Given COVID’s risk/age relationship and already lower life spans in that time period plus higher vitamin D exposure rates it’s quite likely rate of death would have been lower in that population.
  - nradov 5y ago
    The infection fatality rate was never as high as 3%. The CDC estimated it at 0.6% back when almost no one was vaccinated.
    - astura 5y ago
      Nobody said it was? The question was about a world without modern medicine. It's totally reasonable to speculate there would be a higher fatality rate without medical intervention keeping people from dying.

tim333 5y ago

The thing with the worker shortage is it'll be brief. SA's already peaked. We'll have maybe a month of worker shortage I guess.