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The primary concern form day one has been the capacity of our healthcare systems. "Peak pandemic mortality" includes scores of people dying from unrelated illne

The primary concern form day one has been the capacity of our healthcare systems. "Peak pandemic mortality" includes scores of people dying from unrelated illness due to lack of care. Does anyone truly think its acceptable to let people die in ambulances outside of hospitals because a highly contagious disease filled all the hospital beds and medical staff is too fatigued to work? Maybe people with a political axe to grind pretend to think that.

guimplen 5y ago
I think the real problem is that in most countries the healthcare system was "optimized" to such extent that even seasonal flu was almost clogging it every year. And now SURPRISE, any disease, even a tad bit more deadly and contagious than the seasonal flu would make it collapse. TOTALLY UNEXPECTED.
- DrHilarius 5y ago
  As always, the standard gimmick of neoliberalism is to pin the blame for the collateral damage of its policies on the relatively powerless people who refuse its self-serving "solutions."
  - xyzzyz 5y ago
    Which non-“neoliberal” (whatever that means) country had plenty excess hospital capacity to handle peak Covid case counts?
    - Maarten88 5y ago
      Cuba?
  - dang 5y ago
    We've banned this account for using HN primarily for ideological battle. It also appears to be a single-purpose account, which goes against the intended spirit the site (curiosity), and therefore is not allowed here. Would you please not create accounts to break HN's rules with? If you don't want to be banned on HN, you can email us at hn@ycombinator.com and give us reason to believe that you'll use the site as intended in the future. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html
throwaway55421 5y ago
No, lots of people do actually think that, but we believe that three main methods can be employed to mitigate this: 1. aggressive triage based on chances and QALY remaining 2. increased healthcare funding 3. voluntary isolation of individuals who see lockdown as being preferable to their personal coronavirus risk Will it result in more deaths than February 2020? Sure. But we don't have that choice because sars2 exists now. We think it's better to ration healthcare and therefore doom an unlucky minority, versus rationing life itself for everyone (via lockdowns and restrictions) and slow killing everyone. As far as I can tell, most of the lockdown debate centres around an erroneous idea that we can just do X, Y, Z, and then immunosuppressed Harriet can rejoin the world and avoid contracting coronavirus. But she just can't. Even the original strain would have eventually infected her with high probability unless we continued to cycle lockdowns or she voluntarily isolated.
- deleted 5y ago
  [deleted]
lotsofpulp 5y ago
> Does anyone truly think its acceptable to let people die in ambulances outside of hospitals because a highly contagious disease filled all the hospital beds and medical staff is too fatigued to work? Maybe people with a political axe to grind pretend to think that. Given widespread availability of vaccines, I think it is acceptable to turn away any non vaccinated people without medical exemptions to preserve hospital capacity.
- deleted 5y ago
  [deleted]
- smugglerFlynn 5y ago
  Will it be you turning these people away? Always puzzles me to see people suggesting all these “just let them die” silver bullet algorithms.
  - novok 5y ago
    It wouldn't be explicit turning away, but if your in a triage situation, most doctors and medical systems will focus on the most time serious and the people they are most able to save if they have limited capacity. And if your not vaccinated, the ability to save you will be less than the vaccinated and the people with other acute medical issues that are not COVID. That is what will happen in practice in such a regime.
    - dragonwriter 5y ago
      > And if your not vaccinated, the ability to save you will be less than the vaccinated Is there any evidence that this is true at the point of presenting with equal acute symptoms? Sure, your symptoms are likely to be less acute if you are vaccinated, but that's not the issue, the issue is response to treatment given similar symptoms.
- nradov 5y ago
  In the US, hospitals aren't legally allowed to turn away non vaccinated people due to EMTALA. Also note that there is no 100% reliable way for hospitals to determine a particular patient's vaccination status. https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA https://www.cms.gov/Regulations-and-Guidance/Legislation/EMT...
Reichhardt 5y ago
From examining Swedish death spike data, you can see that viruses like COVID occur about once a decade, the last being Swine Flu in 2009: https://swprs.org/wp-content/uploads/2020/10/sweden-monthly-deaths-1851.jpg https://swprs.org/wp-content/uploads/2020/10/sweden-monthly-... Its just that, using Swedish data again, Western societies are significantly more aged: eg. there 120,000 80-84 year old men (prime COVID death territory) in 2020, vs only 101,000 in 2009. Its similar in many other Western countries: about 20% more elderly people, in absolute numbers. As such, the 'same' types of respiratory viruses will simply kill more people. The decisions is thus a social and political one: do we lockdown and force 6-monthly vaccinations on everyone, based on elderly deaths that will occur anyway simply due to the baby boomer cohort entering their twilight years? I think we need to just get more efficient at end-of-life care, focusing on simpler treatments and comfort, as well as euthanasia-on-demand for anyone over age 75.
- zaat 5y ago
  I think taking a shot every six month is totally worth it if that will let your grandma live two years longer.
  - Reichhardt 5y ago
    - zaat 5y ago
      I'm afraid you have no more relevant knowledge in the subject then I do, which means your claims shouldn't be considered as an authoritative in any way, despite being stated as such. I'm out of here.
      - Reichhardt 5y ago
        "U.S. COVID-19 Deaths in 2021 Surpass 2020 Total" https://www.webmd.com/lung/news/20211122/us-covid-deaths-2021-surpass-2020-total https://www.webmd.com/lung/news/20211122/us-covid-deaths-202...
rgrieselhuber 5y ago
Capacity of healthcare systems shouldn’t be the primary concern, preventative immune defense and avoiding hospitalization in the first place should be.
DrHilarius 5y ago
> The primary concern from day one has been the capacity of our healthcare systems. This is clearly not the case for the vast swaths of our public health institutions who have supported and eagerly carried out mass terminations of healthcare workers who refuse the Covid vaccines.

guimplen 5y ago

I think the real problem is that in most countries the healthcare system was "optimized" to such extent that even seasonal flu was almost clogging it every year. And now SURPRISE, any disease, even a tad bit more deadly and contagious than the seasonal flu would make it collapse. TOTALLY UNEXPECTED.

DrHilarius 5y ago
As always, the standard gimmick of neoliberalism is to pin the blame for the collateral damage of its policies on the relatively powerless people who refuse its self-serving "solutions."
- xyzzyz 5y ago
  Which non-“neoliberal” (whatever that means) country had plenty excess hospital capacity to handle peak Covid case counts?
  - Maarten88 5y ago
    Cuba?
- dang 5y ago
  We've banned this account for using HN primarily for ideological battle. It also appears to be a single-purpose account, which goes against the intended spirit the site (curiosity), and therefore is not allowed here. Would you please not create accounts to break HN's rules with? If you don't want to be banned on HN, you can email us at hn@ycombinator.com and give us reason to believe that you'll use the site as intended in the future. https://news.ycombinator.com/newsguidelines.html https://news.ycombinator.com/newsguidelines.html

throwaway55421 5y ago

No, lots of people do actually think that, but we believe that three main methods can be employed to mitigate this: 1. aggressive triage based on chances and QALY remaining 2. increased healthcare funding 3. voluntary isolation of individuals who see lockdown as being preferable to their personal coronavirus risk Will it result in more deaths than February 2020? Sure. But we don't have that choice because sars2 exists now. We think it's better to ration healthcare and therefore doom an unlucky minority, versus rationing life itself for everyone (via lockdowns and restrictions) and slow killing everyone. As far as I can tell, most of the lockdown debate centres around an erroneous idea that we can just do X, Y, Z, and then immunosuppressed Harriet can rejoin the world and avoid contracting coronavirus. But she just can't. Even the original strain would have eventually infected her with high probability unless we continued to cycle lockdowns or she voluntarily isolated.

deleted 5y ago
[deleted]

lotsofpulp 5y ago

> Does anyone truly think its acceptable to let people die in ambulances outside of hospitals because a highly contagious disease filled all the hospital beds and medical staff is too fatigued to work? Maybe people with a political axe to grind pretend to think that. Given widespread availability of vaccines, I think it is acceptable to turn away any non vaccinated people without medical exemptions to preserve hospital capacity.

deleted 5y ago
[deleted]
smugglerFlynn 5y ago
Will it be you turning these people away? Always puzzles me to see people suggesting all these “just let them die” silver bullet algorithms.
- novok 5y ago
  It wouldn't be explicit turning away, but if your in a triage situation, most doctors and medical systems will focus on the most time serious and the people they are most able to save if they have limited capacity. And if your not vaccinated, the ability to save you will be less than the vaccinated and the people with other acute medical issues that are not COVID. That is what will happen in practice in such a regime.
  - dragonwriter 5y ago
    > And if your not vaccinated, the ability to save you will be less than the vaccinated Is there any evidence that this is true at the point of presenting with equal acute symptoms? Sure, your symptoms are likely to be less acute if you are vaccinated, but that's not the issue, the issue is response to treatment given similar symptoms.
nradov 5y ago
In the US, hospitals aren't legally allowed to turn away non vaccinated people due to EMTALA. Also note that there is no 100% reliable way for hospitals to determine a particular patient's vaccination status. https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA https://www.cms.gov/Regulations-and-Guidance/Legislation/EMT...

Reichhardt 5y ago

From examining Swedish death spike data, you can see that viruses like COVID occur about once a decade, the last being Swine Flu in 2009: https://swprs.org/wp-content/uploads/2020/10/sweden-monthly-deaths-1851.jpg https://swprs.org/wp-content/uploads/2020/10/sweden-monthly-... Its just that, using Swedish data again, Western societies are significantly more aged: eg. there 120,000 80-84 year old men (prime COVID death territory) in 2020, vs only 101,000 in 2009. Its similar in many other Western countries: about 20% more elderly people, in absolute numbers. As such, the 'same' types of respiratory viruses will simply kill more people. The decisions is thus a social and political one: do we lockdown and force 6-monthly vaccinations on everyone, based on elderly deaths that will occur anyway simply due to the baby boomer cohort entering their twilight years? I think we need to just get more efficient at end-of-life care, focusing on simpler treatments and comfort, as well as euthanasia-on-demand for anyone over age 75.

zaat 5y ago
I think taking a shot every six month is totally worth it if that will let your grandma live two years longer.
- Reichhardt 5y ago
  - zaat 5y ago
    I'm afraid you have no more relevant knowledge in the subject then I do, which means your claims shouldn't be considered as an authoritative in any way, despite being stated as such. I'm out of here.
    - Reichhardt 5y ago
      "U.S. COVID-19 Deaths in 2021 Surpass 2020 Total" https://www.webmd.com/lung/news/20211122/us-covid-deaths-2021-surpass-2020-total https://www.webmd.com/lung/news/20211122/us-covid-deaths-202...

rgrieselhuber 5y ago

Capacity of healthcare systems shouldn’t be the primary concern, preventative immune defense and avoiding hospitalization in the first place should be.

DrHilarius 5y ago

> The primary concern from day one has been the capacity of our healthcare systems. This is clearly not the case for the vast swaths of our public health institutions who have supported and eagerly carried out mass terminations of healthcare workers who refuse the Covid vaccines.