5 ms·

The only hard question is hospital triaging. Who gets treatment if there's only room for 50% or 20%? Who can even decide? Does anyone volunteer to be excluded f

The only hard question is hospital triaging. Who gets treatment if there's only room for 50% or 20%? Who can even decide? Does anyone volunteer to be excluded from medical care? This affects more than just covid patients too. Any way we choose, it amounts to sacrificing XYZk people so we can go back to living a normal life. I don't think that's an exchange most people are willing to take. And yes, lockdown measures are usually in response to hospitals filling up. Check for example [0] against the timeline of lockdowns for that area. If you know any counter examples I'd like to hear about it. [0]: https://www.alberta.ca/stats/covid-19-alberta-statistics.htm?fbclid=IwAR2N14Dno27OZNFr4BRNzuJvKyvskHMzlR2mVL2KmomxuENSrNTct_cpn48#healthcare-capacity https://www.alberta.ca/stats/covid-19-alberta-statistics.htm...

jaywalk 5y ago
> As viruses can remain active on surfaces, unless you irradiate the deliveries with a UV lamp (and do it again after unboxing them, since there may be viruses on the actual item) even that would not be enough. Covid does not spread in any meaningful way via surfaces. All of the cleaning and disinfecting nonsense that is still going on is pure theatre. > Any way we choose, it amounts to sacrificing XYZk people so we can go back to living a normal life. I don't think that's an exchange most people are willing to take. It's an exchange everyone makes every single day in order for society to function.
- csdvrx 5y ago
  > Covid does not spread in any meaningful way via surfaces. All of the cleaning and disinfecting nonsense that is still going on is pure theatre. It's a reasonable precaution take, at least until we know precisely how the virus could get to the isolated Belgian Antarctic base, where everyone was isolated for weeks and tested and retested prior to being sent there.
  - jaywalk 5y ago
    It was a reasonable precaution to take in March of 2020. But enough studies have been done by now to show that it's no longer a reasonable precaution in general. We may never know how it got to that base, and even if we find out that it was via surface contamination, that doesn't invalidate everything else we know now.
- Tade0 5y ago
  > It's an exchange everyone makes every single day in order for society to function. Not at this rate though. In my country covid deaths are easily 20x that of traffic fatalities and the latter is seen as a serious social issue. Also my friends in the medical profession are simply tired of doing 300h months.
- Root_Denied 5y ago
  > Covid does not spread in any meaningful way via surfaces. All of the cleaning and disinfecting nonsense that is still going on is pure theatre. You may be correct about covid, but cleaning surfaces helps to prevent other illnesses from spreading anyway. In a situation where hospitals are impacted there's a strong argument that such behavior and precautions leads to better healthcare outcomes.
cascom 5y ago
I was under the impression that this was already a solved question in the medical community (essentially boiled down to: who will benefit the most from treatment) Or are you talking about other considerations like vaxxed/in-vaxxed?
- srcreigh 5y ago
  You may be right. I guess there is a risk that even the number of people dying from treatable conditions exceeds capacity. The spectrum you mention seems more geared to handle broken arm vs heart attack situation, not "We have 100 people dying and 20 beds".
  - cascom 5y ago
    This takes place daily in any ER on a low intensity basis (broken arm can wait for the heart attack), but hospitals specifically consider the 100 people dying 20 beds situations when they train for mass casualty events (with specific doctors and nurses tasked with triaging incoming patients)
dham 5y ago
Unfortunately we could have made this exchange in March 2020. Mostly older people in exchange for younger people. It would have been over in a few months. June/July of 2020. Now we make the exchange but this time it's everyone. Someone younger having heart attack, cancer etc. So we're mostly worst off had we just let it rip through society back then.
908B64B197 5y ago
> The only hard question is hospital triaging. Who gets treatment if there's only room for 50% or 20%? Who can even decide? The voters should decide. A jurisdiction could simply decide to allocate capacity based on vaccination status (ie, if 20% of the population is unvaccinated, they get 20% of available beds for COVID). Completely fair.
giantg2 5y ago
Perhaps we should incentivize recruitment of, and reduce restrictions for, medical professionals. Things like residency availability, overhead from various requirements and restrictions, and a ton of upfront investment followed up with long hours and potentially decades to pay of debt. Something has to be done around capacity issues, or we'll be in the same situation indefinitely. Or even worse when the next pandemic hits. Probably not realistic, but I would love to see more personal involvement in care. One level could be prevention, and not just the vaccine. Lose weight, exercise, eat right. It's hard to change people though. Another is care after the fact. Short staffed? Give me a procedure card and let me do the less skilled stuff. Most of nursing is really basic and many things are handled by machines (when's the last time a nurse took your BP with a manual sphig?). Maybe that's beyond many people's abilities, but there are some who are used to wearing respirators, practicing aseptic techniques, and following procedures. The artificial constraints of regulation and law prohibit it. So I guess that's another way society might be making the choice to sacrifice people.
- srcreigh 5y ago
  It probably comes down to other things such as costs for medical equipment, legal medical malpractice liability, costs for training, investment in more facilities and equipment, etc. I wonder if they have looked into it- not a new idea, China famously built a hospital early pandemic. I do have the same questions as you though. How can we make this happen?
  - giantg2 5y ago
    In a scenario where people are left to die or risk malpractice, I would hope the system sees this as an extenuating circumstance. I would think on the brink of collapse many of the tedious red tape rules will be ignored.
mrfusion 5y ago
Hospitals have always been overwhelmed. Check out this 2018 article about the flu: https://dfw.cbslocal.com/2018/01/08/hospital-overrun-by-flu-cases-having-to-turn-them-away/ https://dfw.cbslocal.com/2018/01/08/hospital-overrun-by-flu-... Empty beds aren’t making money for hospitals so they often run close to capacity.
- srcreigh 5y ago
  The question is of degree. Is "covid overwhelmed" meaningfully the same as "yearly flu season overwhelmed"? Based on Government actions, it seems like covid is much worse. (I wish I had the epidemiological understanding to look at data and understand that conclusion, but I don't.)

jaywalk 5y ago

> As viruses can remain active on surfaces, unless you irradiate the deliveries with a UV lamp (and do it again after unboxing them, since there may be viruses on the actual item) even that would not be enough. Covid does not spread in any meaningful way via surfaces. All of the cleaning and disinfecting nonsense that is still going on is pure theatre. > Any way we choose, it amounts to sacrificing XYZk people so we can go back to living a normal life. I don't think that's an exchange most people are willing to take. It's an exchange everyone makes every single day in order for society to function.

csdvrx 5y ago
> Covid does not spread in any meaningful way via surfaces. All of the cleaning and disinfecting nonsense that is still going on is pure theatre. It's a reasonable precaution take, at least until we know precisely how the virus could get to the isolated Belgian Antarctic base, where everyone was isolated for weeks and tested and retested prior to being sent there.
- jaywalk 5y ago
  It was a reasonable precaution to take in March of 2020. But enough studies have been done by now to show that it's no longer a reasonable precaution in general. We may never know how it got to that base, and even if we find out that it was via surface contamination, that doesn't invalidate everything else we know now.
Tade0 5y ago
> It's an exchange everyone makes every single day in order for society to function. Not at this rate though. In my country covid deaths are easily 20x that of traffic fatalities and the latter is seen as a serious social issue. Also my friends in the medical profession are simply tired of doing 300h months.
Root_Denied 5y ago
> Covid does not spread in any meaningful way via surfaces. All of the cleaning and disinfecting nonsense that is still going on is pure theatre. You may be correct about covid, but cleaning surfaces helps to prevent other illnesses from spreading anyway. In a situation where hospitals are impacted there's a strong argument that such behavior and precautions leads to better healthcare outcomes.

cascom 5y ago

I was under the impression that this was already a solved question in the medical community (essentially boiled down to: who will benefit the most from treatment) Or are you talking about other considerations like vaxxed/in-vaxxed?

srcreigh 5y ago
You may be right. I guess there is a risk that even the number of people dying from treatable conditions exceeds capacity. The spectrum you mention seems more geared to handle broken arm vs heart attack situation, not "We have 100 people dying and 20 beds".
- cascom 5y ago
  This takes place daily in any ER on a low intensity basis (broken arm can wait for the heart attack), but hospitals specifically consider the 100 people dying 20 beds situations when they train for mass casualty events (with specific doctors and nurses tasked with triaging incoming patients)

dham 5y ago

Unfortunately we could have made this exchange in March 2020. Mostly older people in exchange for younger people. It would have been over in a few months. June/July of 2020. Now we make the exchange but this time it's everyone. Someone younger having heart attack, cancer etc. So we're mostly worst off had we just let it rip through society back then.

908B64B197 5y ago

> The only hard question is hospital triaging. Who gets treatment if there's only room for 50% or 20%? Who can even decide? The voters should decide. A jurisdiction could simply decide to allocate capacity based on vaccination status (ie, if 20% of the population is unvaccinated, they get 20% of available beds for COVID). Completely fair.

giantg2 5y ago

Perhaps we should incentivize recruitment of, and reduce restrictions for, medical professionals. Things like residency availability, overhead from various requirements and restrictions, and a ton of upfront investment followed up with long hours and potentially decades to pay of debt. Something has to be done around capacity issues, or we'll be in the same situation indefinitely. Or even worse when the next pandemic hits. Probably not realistic, but I would love to see more personal involvement in care. One level could be prevention, and not just the vaccine. Lose weight, exercise, eat right. It's hard to change people though. Another is care after the fact. Short staffed? Give me a procedure card and let me do the less skilled stuff. Most of nursing is really basic and many things are handled by machines (when's the last time a nurse took your BP with a manual sphig?). Maybe that's beyond many people's abilities, but there are some who are used to wearing respirators, practicing aseptic techniques, and following procedures. The artificial constraints of regulation and law prohibit it. So I guess that's another way society might be making the choice to sacrifice people.

srcreigh 5y ago
It probably comes down to other things such as costs for medical equipment, legal medical malpractice liability, costs for training, investment in more facilities and equipment, etc. I wonder if they have looked into it- not a new idea, China famously built a hospital early pandemic. I do have the same questions as you though. How can we make this happen?
- giantg2 5y ago
  In a scenario where people are left to die or risk malpractice, I would hope the system sees this as an extenuating circumstance. I would think on the brink of collapse many of the tedious red tape rules will be ignored.

mrfusion 5y ago

Hospitals have always been overwhelmed. Check out this 2018 article about the flu: https://dfw.cbslocal.com/2018/01/08/hospital-overrun-by-flu-cases-having-to-turn-them-away/ https://dfw.cbslocal.com/2018/01/08/hospital-overrun-by-flu-... Empty beds aren’t making money for hospitals so they often run close to capacity.

srcreigh 5y ago
The question is of degree. Is "covid overwhelmed" meaningfully the same as "yearly flu season overwhelmed"? Based on Government actions, it seems like covid is much worse. (I wish I had the epidemiological understanding to look at data and understand that conclusion, but I don't.)