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The virus is dangerous, albeit not in the way that most people think. Our institutions, like health care and education, have been running so close to the edge

by II2II 5y ago

The virus is dangerous, albeit not in the way that most people think. Our institutions, like health care and education, have been running so close to the edge for so long that the added pressure is pushing them over the edge. Before the pandemic, teachers would show up to work sick since they knew there may not be a substitute to take their place (and certainly not a substitute who would ensure continuity in teaching). Before the pandemic, nurses would work marathon shifts since there was a staffing shortage even before taking sick days into consideration. Now we are in a situation where we have to slow the spread of the virus to protect our institutions. I cannot speak to whether the measures are genuinely effective or a manifestation of security theatre, since that is not my domain. What I can say is it is putting more pressure on the limited amount of staff available. This is more than missing work because of a close contact. It is because of people missing work because they are genuinely sick or people being unable to keep up with the added responsibilities (such as teaching when they are supposed to be prepping). Unfortunately, we cannot solve the resource shortage overnight. Even if we could magically train the people to fill the role overnight, we don't have the infrastructure to support them. So now we are paying the price.

chiefalchemist 5y ago
Fair analysis. But why is this (truth) so far from the narrative? At some point there needs to be accountablity. I understand that might not be right now. But the list of names and institutions should start sooner rather than later.
- roenxi 5y ago
  And a supplementary question: Is this what the people making the decisions actually think, or is this being projected on them by II2II?
- II2II 5y ago
  The narrative has been changing continually during the pandemic, which is to be expected since we've gone from not understanding what it is and realizing that we were completely unprepared, to lulls where we thought we were getting over it, to spikes where we were largely willing to use what we learned earlier on, to the current spike where people are figuring out that this may be with us for the long run. As for holding people accountable, where would we even begin? I saw politicians closing beds and physically demolishing hospitals 30 years ago. Politicians of varying stripes did little to rebuild the system after that. While there was a push to hire more people at the start of the pandemic (both in health care and education), the interest seems to have dwindled off since no one wants to deal with the long term costs. Even if they were willing to live with the costs, few sensible people are willing to take on those roles because the involve continual sacrifice. There is also no guarantee that months or years of training will be rewarded with a career since the demand is likely to be short-term. There are so many people who can be blamed, so many people who should be blamed, but it won't address the problem since the decisions were either made in the distant past or are a consequence of inaction rather than of action.
gus_massa 5y ago
> Our institutions, like health care and education, have been running so close to the edge Do you have some hard numbers about this? Here in Buenos Aires we had a big wave in July 2021, and we had a daily report of the ICU occupation rate and at the peak it was like 95%. We delayed some medical procedures to keep the number under 100% and there was a huge discussion about increasing the lockdown. Lucky, we keep the number under 100%. Now we have a new big omicron wave, but the ICU occupation rate is still low, finger crossed. > Before the pandemic, nurses would work marathon shifts We have the same problem here. I don't understand how it's consider to be sane.
- bonzini 5y ago
  If the peak was 95%, it's quite likely that at least in some places some people were triaged out of the ICU.
- MathMonkeyMan 5y ago
  > > Before the pandemic, nurses would work marathon shifts > > We have the same problem here. I don't understand how it's consider to be sane. I don't know anything about nursing, but I've read elsewhere that the 12 hour shifts are to reduce the number of nurses a patient goes through in a single hospital visit. Speculation: A patient in a hospital is like a software project -- better not to change ownership before release, if you can avoid it.
- stefan_ 5y ago
  The ICU will never be "over capacity". At that level of occupation, there is permanent triage (oh no! bad word! the ethicists haven't written their op-eds yet!) as the "least likely to die" patients are moved out of the close observation in ICU. Make no mistake, when ICUs are full of COVID patients, it is a really bad time to be in a car crash or have any other kind of emergency.

by II2II 5y ago

chiefalchemist 5y ago

Fair analysis. But why is this (truth) so far from the narrative? At some point there needs to be accountablity. I understand that might not be right now. But the list of names and institutions should start sooner rather than later.

roenxi 5y ago
And a supplementary question: Is this what the people making the decisions actually think, or is this being projected on them by II2II?
II2II 5y ago
The narrative has been changing continually during the pandemic, which is to be expected since we've gone from not understanding what it is and realizing that we were completely unprepared, to lulls where we thought we were getting over it, to spikes where we were largely willing to use what we learned earlier on, to the current spike where people are figuring out that this may be with us for the long run. As for holding people accountable, where would we even begin? I saw politicians closing beds and physically demolishing hospitals 30 years ago. Politicians of varying stripes did little to rebuild the system after that. While there was a push to hire more people at the start of the pandemic (both in health care and education), the interest seems to have dwindled off since no one wants to deal with the long term costs. Even if they were willing to live with the costs, few sensible people are willing to take on those roles because the involve continual sacrifice. There is also no guarantee that months or years of training will be rewarded with a career since the demand is likely to be short-term. There are so many people who can be blamed, so many people who should be blamed, but it won't address the problem since the decisions were either made in the distant past or are a consequence of inaction rather than of action.

gus_massa 5y ago

> Our institutions, like health care and education, have been running so close to the edge Do you have some hard numbers about this? Here in Buenos Aires we had a big wave in July 2021, and we had a daily report of the ICU occupation rate and at the peak it was like 95%. We delayed some medical procedures to keep the number under 100% and there was a huge discussion about increasing the lockdown. Lucky, we keep the number under 100%. Now we have a new big omicron wave, but the ICU occupation rate is still low, finger crossed. > Before the pandemic, nurses would work marathon shifts We have the same problem here. I don't understand how it's consider to be sane.

bonzini 5y ago
If the peak was 95%, it's quite likely that at least in some places some people were triaged out of the ICU.
MathMonkeyMan 5y ago
> > Before the pandemic, nurses would work marathon shifts > > We have the same problem here. I don't understand how it's consider to be sane. I don't know anything about nursing, but I've read elsewhere that the 12 hour shifts are to reduce the number of nurses a patient goes through in a single hospital visit. Speculation: A patient in a hospital is like a software project -- better not to change ownership before release, if you can avoid it.
stefan_ 5y ago
The ICU will never be "over capacity". At that level of occupation, there is permanent triage (oh no! bad word! the ethicists haven't written their op-eds yet!) as the "least likely to die" patients are moved out of the close observation in ICU. Make no mistake, when ICUs are full of COVID patients, it is a really bad time to be in a car crash or have any other kind of emergency.