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If hospital capacity is such a concern, why has there been just about zero effort in spinning up some kind of capacity to deal with Covid? Wasn't that the entir

If hospital capacity is such a concern, why has there been just about zero effort in spinning up some kind of capacity to deal with Covid? Wasn't that the entire rationale of these lockdowns in the first place? To build capacity for covid? Like, it's been 2 years. We shouldn't be doing any of these restrictions at all. We should be angry at our governments wasting 2 years of our non-refundable time on this earth while they did nothing. Blaming the public for hospital capacity at this point is absurd.

ChrisRR 5y ago
"Capacity" doesn't mean floor space. It means trained medical professionals, beds, equipment, consumables. These things don't just appear out of thin air
davidw 5y ago
A lot of it is finding the people, beyond the physical space. You can't just 'spin up' nurses like AWS instances. They're in short supply right now, and many are feeling burned out. There's a post going around about a doctor who got assaulted by deranged family members of a man who died. Don't know if it's real, but a lot of people were saying they've experienced similar and are just done with it.
- spookthesunset 5y ago
  When you have virtually unlimited resources you can do almost anything you want. You just have to think outside of the box. If this truly was an emergency, we'd have found a way to staff covid ICU's. Dunno how because it ain't my expertise at all, but there would be a way. We managed to build giant ships in like 3 or 6 months in WWII. I'm pretty sure we could figure out how to staff 400 or so ICU's with people capable of managing sick covid patients. It might be all these people know how to do... but we could do it. We have almost unlimited resources to do so.
  - eropple 5y ago
    "I readily admit that I don't know what I'm talking about but at the same time I'm going to insist that my hypothetical situation is definitely correct and the knowledgeable people working on medical staffing and capacity management for their entire careers simply do not know as much as me, a computer toucher." Somehow I remain unconvinced that "thinking outside the box" conjures doctors and nurses into existence or makes those who refuse to work ICUs suddenly interested in the job. I guess you could demand the military have doctors and nurses work at the point of a gun, all so John Q. Public probably still couldn't go to Target without a mask on two years hence. That sounds great.
    - spookthesunset 5y ago
      > makes those who refuse to work ICUs suddenly interested in the job Then fucking draft them into working in an ICU like you would draft somebody into a war. Build a second story on their house. I don't care. This shit is an existential emergency where we asked hundreds of millions of people to put 2 years of their life on hold to build healthcare up. Figure it out. If healthcare capacity was the reason we did all this, then we should have poured the entire nation's worth of resources into building healthcare capacity. Period. It is absolutely inexcusable to continue playing the "healthcare might collapse" card 2 years into this. If people used this many excuses back in WWII we'd have lost the damn war. "Oh, it takes 4 years to design a build a ship... sorry. we can't just pull ships out of our butt. Guess we will just have to let them win". Bullshit. We made it happen. We could make it happen for this too. This is supposed to be an emergency, remember? Every second you have people in lockdown is a second of each of those peoples very short lives you've now wasted. Figure it out!
      - mardifoufs 5y ago
        Exactly. It's crazy how some people think that shutting down pretty much everything within days is a more viable alternative or even more doable than ramping up healthcare capacity in... 2 years. They'll usually wave away the massive repercussions that shutdowns cause but they will become very perfectionist when it comes to standard of care and how we need fully trained doctors and nothing less. It's an emergency, as you said it's not time for perfection because the costs are extreme
- deleted 5y ago
  [deleted]
mistermann 5y ago
I believe that covid has given us incredible insight into the human psyche, including how well we are able to respond to problems that have political/tribal attributes to them. Considering how relatively minor covid was, and how simple the situation is, that so many people continue to disagree on basics suggests to me that we have learned very little from this (indicating our capacity to learn certain things is not great), and that if we ever get a serious pandemic (or serious anything), we might be f*cked.
- spookthesunset 5y ago
  > if we ever get a serious pandemic (or serious anything), we might be f*cked. If we had a serious pandemic where dudes were dropping like flys on the street and they had horse drawn carrages stacked with bodies, I don't think many people would have an issue dealing with it. The problem with covid is our response to it was way out of line with the actual illness. People kinda have a problem being asked to make huge sacrifies for something they don't perceive to be a major problem.
  - mistermann 5y ago
    I think we're probably in luck somewhat: if something actually serious came along, I agree that people would be much less disagreeable, and perhaps we'd have enough actual problems so authorities wouldn't have to engage in make work projects. That said, I think massive numbers of people (likely the majority still, although the tides seem to be shifting extremely quickly lately) would strongly disagree with us on the degree to which covid is a "major" problem. I am very worried that the inability for people to even mutually agree upon a way of discussing (let alone agreeing on anything) culture war topics, and our inability to take such phenomena seriously, is going to be a gift that keeps on giving for decades into the future (just in time for the climate change culture war).
    - spookthesunset 5y ago
      > just in time for the climate change culture war That will be the fun one for sure. What I do know is the knuckleheads running the show right now up and down the west coast are the last people I’d trust to handle that correctly.
com2kid 5y ago
> If hospital capacity is such a concern, why has there been just about zero effort in spinning up some kind of capacity to deal with Covid? The first wave of COVID killed a bunch of doctors and nurses, and burnt a lot more out. Then Delta made a bunch more doctors and nurses quit, with wide reports right now that 20% of nurses are looking to up and leave their job. Talking to my friends who are nurses, they are short staffed, and have been for some time. On top of that, the way the US does medical training for both nurses and doctors ensures we don't have enough medical professionals during normal times. Nursing schools can't find instructors (pay is too low) and hospitals are purposefully limiting the number of residency spots available to ensure prices for medical care stay high (https://en.wikipedia.org/wiki/Residency_(medicine)#Financing_residency_programs https://en.wikipedia.org/wiki/Residency_(medicine)#Financing...) So, you know, business as usual in the US.
- slaw 5y ago
  > The first wave of COVID killed a bunch of doctors and nurses I never heard about it before. Could you provide link to your claim?
  - deleted 5y ago
    [deleted]
  - com2kid 5y ago
    Some interesting numbers at https://www.nationalnursesunited.org/press/new-report-reveals-continued-government-failure-to-track-and-report-covid-19-deaths-of-nurses https://www.nationalnursesunited.org/press/new-report-reveal... and https://abcnews.go.com/Health/3600-us-health-workers-died-covids-1st-year/story?id=76944085 https://abcnews.go.com/Health/3600-us-health-workers-died-co... All of that is pre-delta, remember that when COVID first hit in 2020 we still didn't have a good idea how it spread. The tl;dr is that the US government doesn't do a good job of collecting statistics of how many health care workers died of COVID. 1.5k nursing home workers seems to be the one reliable # from the first article, and The Guardian is saying around 3600 healthcare workers in total. https://www.statnews.com/2021/10/21/who-estimate-115000-health-workers-have-died-from-covid-19-as-calls-for-vaccine-access-grow/ https://www.statnews.com/2021/10/21/who-estimate-115000-heal... WHO reports over 100k deaths of healthcare workers world wide. So statistically a small #, but it doesn't account for the # of nurses who got COVID and had long term symptoms that kept them from going back to work, or who just decided to no longer work at all. And it looks like these #s are highly biased towards major population centers, so it wasn't an even distribution from the country or anything.
tdfx 5y ago
People will say "well you can't just make more nurses and doctors in 6 months!" However, had we built or repurposed buildings as COVID-specific treatment centers there would be a fairly standard treatment protocol that could be applied by people without 4-8 years of medical training, allowing the highly trained nurses and doctors to supervise the process and multiply their effectiveness. Combat soldiers learn basic emergency medical techniques, with some going from knowing nothing to being able to run IVs and be fully certified EMTs in 6-9 months. Stories abound of how bad they are at hitting the vein the first time, but it's certainly preferable to dying in the waiting room. The lack of healthcare capacity has been a conscious choice. There's been no serious effort to build it out. We've chosen to indulge this fantasy that humanity can get control of COVID and we'll just vaccinate it out of existence, despite decades of knowledge about how difficult that would be from our research into other coronaviruses. So when I hear that we need to give up another year of normal life to "keep the hospitals from being overwhelmed", it is frustrating to hear.
- dragonwriter 5y ago
  > there would be a fairly standard treatment protocol that could be applied by people without 4-8 years of medical training No, there wouldn't, because, among other things, comorbidities that must be managed, especially in the population most COVID hospitalizations come from. > Combat soldiers learn basic emergency medical techniques, even to the point of running IVs Which allows them to serve as, basically, better-than-nothing EMTs in the absence of anyone else, which is useful on the battlefield to keep people alive to get to proper medical care; they don't replace doctors and nurses, though.
  - spookthesunset 5y ago
    > which is useful on the battlefield to keep people alive to get to proper medical care This is a battlefield. It's an emergency, remember? Do whatever it takes. We forced people to sacrifice their short-ass lives in lockdown so these people could figure it out. Where is the results? 2 years and these "experts" still want us to continue locking down to protect a healthcare system they had 2 years to build up specifically to manage covid. It's as if every one of our lives is worthless in the eyes of people making excuses. No. We paid with our time--something we'll never get back. It is a complete travesty that governments continue to blame the public for their own inability to figure shit out.
rsynnott 5y ago
ICU beds require something like 7 specially trained nurses each to operate. Generally, availability of trained staff is the limiting factor (developed countries, at this point, generally have more ventilators etc than they can use), and lead time on making new doctors and nurses is pretty long.
- rhino369 5y ago
  While a nurse is hard to train in 2 years, you can start pulling doctors and nurses from adjacent specialties and cross train them for COVID ICU wards. If we are going to see constant new variants and new waves, then its the only choice we have.
  - rsynnott 5y ago
    At that point you have shortages elsewhere (and that _is_ happening to some extent in some places; hospitals are delaying routine procedures to keep the ICUs running at full capacity). It's not a great solution, especially if it goes on a long time; when you start delaying routine things for years, you start seeing serious problems. Realistically, the only viable course is probably to vaccinate and boost as many people as humanly possible, and await better vaccines and therapeutics. Paxlovid should hopefully help when it's available in quantity.
cynusx 5y ago
You're right, I actually had the benefit of chatting with somebody who organized the lab test network around covid-19 and asked if they (Belgian government) considered ramping up hospital capacity and training non-qualified people the basics of taking care of covid-19 infected people... turns out they never considered it. Personally, after 2 months of being angry with the ridiculous response of the government I just accepted that you can't fight with mass stupid and moved on to areas of my life that are not affected by covid. But I still get surprised from time to time you know, you'd expect politicians to accept that everybody had the chance to get vaccinated and lift all the restrictions so that darwinism can do its work, but it seems they want to impose vaccine mandates instead... trying to protect people who don't want to be protected, what's the grand idea behind that? There's no real end in sight to be honest, it's better to ignore it as much as possible and focus on areas you do control
jamesrcole 5y ago
The capacity issue is staffing, and that can’t just be spun up. Basically because it takes time to train people

ChrisRR 5y ago

"Capacity" doesn't mean floor space. It means trained medical professionals, beds, equipment, consumables. These things don't just appear out of thin air

davidw 5y ago

A lot of it is finding the people, beyond the physical space. You can't just 'spin up' nurses like AWS instances. They're in short supply right now, and many are feeling burned out. There's a post going around about a doctor who got assaulted by deranged family members of a man who died. Don't know if it's real, but a lot of people were saying they've experienced similar and are just done with it.

spookthesunset 5y ago
When you have virtually unlimited resources you can do almost anything you want. You just have to think outside of the box. If this truly was an emergency, we'd have found a way to staff covid ICU's. Dunno how because it ain't my expertise at all, but there would be a way. We managed to build giant ships in like 3 or 6 months in WWII. I'm pretty sure we could figure out how to staff 400 or so ICU's with people capable of managing sick covid patients. It might be all these people know how to do... but we could do it. We have almost unlimited resources to do so.
- eropple 5y ago
  "I readily admit that I don't know what I'm talking about but at the same time I'm going to insist that my hypothetical situation is definitely correct and the knowledgeable people working on medical staffing and capacity management for their entire careers simply do not know as much as me, a computer toucher." Somehow I remain unconvinced that "thinking outside the box" conjures doctors and nurses into existence or makes those who refuse to work ICUs suddenly interested in the job. I guess you could demand the military have doctors and nurses work at the point of a gun, all so John Q. Public probably still couldn't go to Target without a mask on two years hence. That sounds great.
  - spookthesunset 5y ago
    > makes those who refuse to work ICUs suddenly interested in the job Then fucking draft them into working in an ICU like you would draft somebody into a war. Build a second story on their house. I don't care. This shit is an existential emergency where we asked hundreds of millions of people to put 2 years of their life on hold to build healthcare up. Figure it out. If healthcare capacity was the reason we did all this, then we should have poured the entire nation's worth of resources into building healthcare capacity. Period. It is absolutely inexcusable to continue playing the "healthcare might collapse" card 2 years into this. If people used this many excuses back in WWII we'd have lost the damn war. "Oh, it takes 4 years to design a build a ship... sorry. we can't just pull ships out of our butt. Guess we will just have to let them win". Bullshit. We made it happen. We could make it happen for this too. This is supposed to be an emergency, remember? Every second you have people in lockdown is a second of each of those peoples very short lives you've now wasted. Figure it out!
    - mardifoufs 5y ago
      Exactly. It's crazy how some people think that shutting down pretty much everything within days is a more viable alternative or even more doable than ramping up healthcare capacity in... 2 years. They'll usually wave away the massive repercussions that shutdowns cause but they will become very perfectionist when it comes to standard of care and how we need fully trained doctors and nothing less. It's an emergency, as you said it's not time for perfection because the costs are extreme
deleted 5y ago
[deleted]

mistermann 5y ago

I believe that covid has given us incredible insight into the human psyche, including how well we are able to respond to problems that have political/tribal attributes to them. Considering how relatively minor covid was, and how simple the situation is, that so many people continue to disagree on basics suggests to me that we have learned very little from this (indicating our capacity to learn certain things is not great), and that if we ever get a serious pandemic (or serious anything), we might be f*cked.

spookthesunset 5y ago
> if we ever get a serious pandemic (or serious anything), we might be f*cked. If we had a serious pandemic where dudes were dropping like flys on the street and they had horse drawn carrages stacked with bodies, I don't think many people would have an issue dealing with it. The problem with covid is our response to it was way out of line with the actual illness. People kinda have a problem being asked to make huge sacrifies for something they don't perceive to be a major problem.
- mistermann 5y ago
  I think we're probably in luck somewhat: if something actually serious came along, I agree that people would be much less disagreeable, and perhaps we'd have enough actual problems so authorities wouldn't have to engage in make work projects. That said, I think massive numbers of people (likely the majority still, although the tides seem to be shifting extremely quickly lately) would strongly disagree with us on the degree to which covid is a "major" problem. I am very worried that the inability for people to even mutually agree upon a way of discussing (let alone agreeing on anything) culture war topics, and our inability to take such phenomena seriously, is going to be a gift that keeps on giving for decades into the future (just in time for the climate change culture war).
  - spookthesunset 5y ago
    > just in time for the climate change culture war That will be the fun one for sure. What I do know is the knuckleheads running the show right now up and down the west coast are the last people I’d trust to handle that correctly.

com2kid 5y ago

> If hospital capacity is such a concern, why has there been just about zero effort in spinning up some kind of capacity to deal with Covid? The first wave of COVID killed a bunch of doctors and nurses, and burnt a lot more out. Then Delta made a bunch more doctors and nurses quit, with wide reports right now that 20% of nurses are looking to up and leave their job. Talking to my friends who are nurses, they are short staffed, and have been for some time. On top of that, the way the US does medical training for both nurses and doctors ensures we don't have enough medical professionals during normal times. Nursing schools can't find instructors (pay is too low) and hospitals are purposefully limiting the number of residency spots available to ensure prices for medical care stay high (https://en.wikipedia.org/wiki/Residency_(medicine)#Financing_residency_programs https://en.wikipedia.org/wiki/Residency_(medicine)#Financing...) So, you know, business as usual in the US.

slaw 5y ago
> The first wave of COVID killed a bunch of doctors and nurses I never heard about it before. Could you provide link to your claim?
- deleted 5y ago
  [deleted]
- com2kid 5y ago
  Some interesting numbers at https://www.nationalnursesunited.org/press/new-report-reveals-continued-government-failure-to-track-and-report-covid-19-deaths-of-nurses https://www.nationalnursesunited.org/press/new-report-reveal... and https://abcnews.go.com/Health/3600-us-health-workers-died-covids-1st-year/story?id=76944085 https://abcnews.go.com/Health/3600-us-health-workers-died-co... All of that is pre-delta, remember that when COVID first hit in 2020 we still didn't have a good idea how it spread. The tl;dr is that the US government doesn't do a good job of collecting statistics of how many health care workers died of COVID. 1.5k nursing home workers seems to be the one reliable # from the first article, and The Guardian is saying around 3600 healthcare workers in total. https://www.statnews.com/2021/10/21/who-estimate-115000-health-workers-have-died-from-covid-19-as-calls-for-vaccine-access-grow/ https://www.statnews.com/2021/10/21/who-estimate-115000-heal... WHO reports over 100k deaths of healthcare workers world wide. So statistically a small #, but it doesn't account for the # of nurses who got COVID and had long term symptoms that kept them from going back to work, or who just decided to no longer work at all. And it looks like these #s are highly biased towards major population centers, so it wasn't an even distribution from the country or anything.

tdfx 5y ago

People will say "well you can't just make more nurses and doctors in 6 months!" However, had we built or repurposed buildings as COVID-specific treatment centers there would be a fairly standard treatment protocol that could be applied by people without 4-8 years of medical training, allowing the highly trained nurses and doctors to supervise the process and multiply their effectiveness. Combat soldiers learn basic emergency medical techniques, with some going from knowing nothing to being able to run IVs and be fully certified EMTs in 6-9 months. Stories abound of how bad they are at hitting the vein the first time, but it's certainly preferable to dying in the waiting room. The lack of healthcare capacity has been a conscious choice. There's been no serious effort to build it out. We've chosen to indulge this fantasy that humanity can get control of COVID and we'll just vaccinate it out of existence, despite decades of knowledge about how difficult that would be from our research into other coronaviruses. So when I hear that we need to give up another year of normal life to "keep the hospitals from being overwhelmed", it is frustrating to hear.

dragonwriter 5y ago
> there would be a fairly standard treatment protocol that could be applied by people without 4-8 years of medical training No, there wouldn't, because, among other things, comorbidities that must be managed, especially in the population most COVID hospitalizations come from. > Combat soldiers learn basic emergency medical techniques, even to the point of running IVs Which allows them to serve as, basically, better-than-nothing EMTs in the absence of anyone else, which is useful on the battlefield to keep people alive to get to proper medical care; they don't replace doctors and nurses, though.
- spookthesunset 5y ago
  > which is useful on the battlefield to keep people alive to get to proper medical care This is a battlefield. It's an emergency, remember? Do whatever it takes. We forced people to sacrifice their short-ass lives in lockdown so these people could figure it out. Where is the results? 2 years and these "experts" still want us to continue locking down to protect a healthcare system they had 2 years to build up specifically to manage covid. It's as if every one of our lives is worthless in the eyes of people making excuses. No. We paid with our time--something we'll never get back. It is a complete travesty that governments continue to blame the public for their own inability to figure shit out.

rsynnott 5y ago

ICU beds require something like 7 specially trained nurses each to operate. Generally, availability of trained staff is the limiting factor (developed countries, at this point, generally have more ventilators etc than they can use), and lead time on making new doctors and nurses is pretty long.

rhino369 5y ago
While a nurse is hard to train in 2 years, you can start pulling doctors and nurses from adjacent specialties and cross train them for COVID ICU wards. If we are going to see constant new variants and new waves, then its the only choice we have.
- rsynnott 5y ago
  At that point you have shortages elsewhere (and that _is_ happening to some extent in some places; hospitals are delaying routine procedures to keep the ICUs running at full capacity). It's not a great solution, especially if it goes on a long time; when you start delaying routine things for years, you start seeing serious problems. Realistically, the only viable course is probably to vaccinate and boost as many people as humanly possible, and await better vaccines and therapeutics. Paxlovid should hopefully help when it's available in quantity.

cynusx 5y ago

You're right, I actually had the benefit of chatting with somebody who organized the lab test network around covid-19 and asked if they (Belgian government) considered ramping up hospital capacity and training non-qualified people the basics of taking care of covid-19 infected people... turns out they never considered it. Personally, after 2 months of being angry with the ridiculous response of the government I just accepted that you can't fight with mass stupid and moved on to areas of my life that are not affected by covid. But I still get surprised from time to time you know, you'd expect politicians to accept that everybody had the chance to get vaccinated and lift all the restrictions so that darwinism can do its work, but it seems they want to impose vaccine mandates instead... trying to protect people who don't want to be protected, what's the grand idea behind that? There's no real end in sight to be honest, it's better to ignore it as much as possible and focus on areas you do control

jamesrcole 5y ago

The capacity issue is staffing, and that can’t just be spun up. Basically because it takes time to train people