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General observation from reading the comments - the folks on HN must not have many friends working in medicine for if they had they'd realize those friends are

General observation from reading the comments - the folks on HN must not have many friends working in medicine for if they had they'd realize those friends are swamped and burned-out. They'd also know that pretty much the only condition we're treating nowadays is Covid. Surgeries are continuing to be postponed - including surgeries that can lead to worse problems down the road such as removing cancerous tumors. And it gets worse. My daughter is in pre-med. Apparently people are dropping out like flies and not just because of the course load. They're watching how medical professionals are being treated and saying screw it! This should concern us all because we've had a marked uptick of medical professionals retiring/resigning since the pandemic started and now the pipeline is thinning out. We're walking headlong into a disaster and nobody seems to care. And that's not even dealing with the problem of Global Climate Change which, guess what? Still hasn't gone away and there doesn't seem to be much interest in caring about that either, not that there ever was. You can see what our child-bearing aged children think of all this - they're not having kids. I don't think this is a short-term aberration. We're a population literally in decline.

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concinds 5y ago
Genuinely asking - What's stopping a country, or hospital, from saying: "we'll prioritize cancer patients, scheduled surgeries, normal operation; you come in with Covid respiratory distress, and we're full? Go away." From the government data I've found, Covid patients are about 5-20% of emergency department patients in the US[0]; in Switzerland that leaves a healthy amount of free beds[1] (though I'm sure staffing is another issue). Why are they causing such disruption? And if they are, why are we not having a debate about whether all the additional cancer deaths, heart attack deaths (from deprogrammed surgeries and screenings) are worth it? In what way is this "healthcare catastrophe" not partly avoidable? > You can see what our child-bearing aged children think of all this - they're not having kids. I don't think this is a short-term aberration. We're a population literally in decline. That's been happening long before Corona, and I doubt it has much do do with politics or "optimism about climate change" compared with wages, housing, etc. [0]: https://www.cdc.gov/nchs/covid19/nhcs/hospital-encounters-by-week.htm https://www.cdc.gov/nchs/covid19/nhcs/hospital-encounters-by... [1]: https://www.covid19.admin.ch/en/hosp-capacity/icu?time=phase2&rel=rel https://www.covid19.admin.ch/en/hosp-capacity/icu?time=phase...
- taylodl 5y ago
  I've asked my friends working in medicine the same thing. What if hospitals were to start turning away those who are willingly unvaccinated? I haven't been able to get a clear answer but the basic theme I hear is you can't, state law prohibits that. Of course the law can be changed, but what legislature is going to do that? This is where politics enters the fray. They'd rather kick the can down the road and bring in the National Guard to help run the hospitals than turn away patients and potentially face voter wrath.
  - nradov 5y ago
    For hospitals it's the federal EMTALA law which makes it illegal for hospitals to deny emergency care on the basis of vaccination status. If a patient shows up with unstable vital signs then the hospital is required to at least stabilize them. For COVID-19 patients that's usually based on respiratory distress or low blood oxygen saturation. https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA https://www.cms.gov/Regulations-and-Guidance/Legislation/EMT...
    - boilerupnc 5y ago
      So, we essentially have mandates to "treat" with no corresponding agreement on defining any mandates to "prevent". Prevention mandates could be a tapestry of options and defined within specific contextual and cultural boundaries. But having nothing on the "prevent" tilts the scale entirely to obligatory treatment and clearly feels imbalanced.
  - lancesells 5y ago
    I'm vaccinated and think everyone capable of receiving the vaccine should get it but turning people away is cruel. That's science-fiction dystopia cruelty in my opinion. Now if a hospital is full and at capacity maybe there are some calculations but just turning people away is wrong.
    - sanderjd 5y ago
      They were explicitly talking about the case of hospitals that are struggling with capacity issues.
tjr225 5y ago
> And it gets worse. My daughter is in pre-med. Apparently people are dropping out like flies and not just because of the course load. They're watching how medical professionals are being treated and saying screw it! This should concern us all because we've had a marked uptick of medical professionals retiring/resigning since the pandemic started and now the pipeline is thinning out. You should be angry at corporate healthcare that has prioritized financial efficiency and monetary gain over doing its job and treating healthcare workers fairly, not strangers on hackernews. > We're a population literally in decline. No, no we're _literally_ not. Not as of right now at least; the US population grew over the last year. But- even if we were, wouldn't that directly address the unrelated issue of climate change that you brought up?
- onedognight 5y ago
  It’s only increasing due to immigration, if I’m reading this correctly. https://www.census.gov/content/dam/Census/library/publications/2020/demo/p25-1146.pdf https://www.census.gov/content/dam/Census/library/publicatio...
  - adamrezich 5y ago
    ah, so everything is going according to plan then. downvoters: is this outcome undesirable? if so, why, and what can we do to fix it? because I'm pretty sure you're not supposed to say that having more kids is a good thing, and using immigration/migration as a means of replacing those kids we're not having is a bad thing. thus, is this outcome (declining citizen birth rates, increased immigration/migration compensating for it) not the intended, desired one?
    - AussieWog93 5y ago
      (I think you may have been downvoted because your initial comment appeared to be referencing the "White Genocide" conspiracy theory - essentially the idea that the Jews are planning to slowly eliminate the white race in the West and replace them with blacks and Muslims.)
rkk3 5y ago
What does this have to do with masking young children, many who are vaccinated, in schools? Are you implying that they are a source of the spread and causing medical professionals to be burnt out? and that therefore we should ignore that both the teacher and student wearing a mask might be detrimental for ESL & Language development ?
adolph 5y ago
> They'd also know that pretty much the only condition we're treating nowadays is Covid. That claim is misinformation, please edit and delete. Medicine as a field is very broad and plenty of other conditions are being treated.
- dsl 5y ago
  At your dentist or plastic surgery clinic, sure. Hospitals everywhere are short on nurses and anything that can be delayed still is. A friend was recently transfered to another hospital to give birth because the maternity ward was unstaffed.
  - adolph 5y ago
    "short on nurses" != "only condition we're treating nowadays is Covid"
tlear 5y ago
People stopped having kids once they could(easily available birth control). Trying to connect it to COVID or Climate change is not supported by any data whatsoever.
- AlexandrB 5y ago
  Call it a vibe. I only see a steady decline in living standards in our future and it makes me pause when I think about whether to subject another human being (i.e. my kids) to that.
  - tlear 5y ago
    We are living in the most safe, prosperous, easy, carefree time in the history of human species. Can we fuck it up? yes we probably can, it won't be easy and would need to involve nukes probably. Realize that doom and fear porn that you are reading addresses certain type of need we have. If you overdo it well you get depression. Then again some people I know use this crap to give themselves excuse to behave like teenagers in their 30s, stuck in childhood(because they can).
  - sometimeshuman 5y ago
    There is no stigma these days for not starting a family kids and men can privately retreat into video games and pornography. When confronted about their selfish* lifestyle the above comment is convenient cover but it is not backed by solid data. I'd take birth in this past decade over birth in my decade any day. *I'd argue that not having at least one child and possibly adopting others is selfish assuming one has financial means. For example, while I thought I wanted kids, upon reflection what I really wanted are mini-me's. If I could buy a clone I'd do it immediately, but child roulette?, no thanks. My selfish lifestyle had made me very happy so far and that feels like a character flaw.
    - AussieWog93 5y ago
      May I ask how old you are? From where I am, a "selfish" lifestyle of video games and porn replacing responsibility does not seem to be healthy long-term. I'm in my late 20s now, and the guys I know who are not working towards getting married and starting a family are pretty much all starting to experience some sort of constant existential anxiety.
perardi 5y ago
Yes, and? The hospital case load is overwhelmingly, screamingly, massively dominated by the elderly unvaccinated. https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/data-tables/421-010-CasesInNotFullyVaccinated.pdf https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/... Given the extremely contagious nature of Omicron, what plausible way do we have to prevent these individuals from getting COVID and using hospital space? And don't say masking up kids—because if they haven't gotten vaccinated, then why do you think they themselves would wear masks and social distance to prevent themselves from getting COVID? I have seen no plausible modeling that shows even high level of masking would significantly blunt the spread of this. https://covid19.healthdata.org/united-states-of-america?view=cumulative-deaths&tab=trend https://covid19.healthdata.org/united-states-of-america?view... So why make the kids put on hair shirts I mean masks? Oh, and by the way: I have plenty of sympathy towards health care workers. I am dating a nurse. I have doctors, nurses, and paramedics as friends. I have extreme empathy towards them, and full seething burning anger towards the unvaccinated septuagenarians ruining our health care system. And the rest of our economy while they're at it.
- dsl 5y ago
  I know multiple households where the initial infection vector was the kids. Grandpa might be stupid and refuse the vaccine, but keeping little Billy from becoming a carrier lessens the hospital load. If screaming Karens are going to insist on in person learning, we need to mask test and vaccinate in the schools.
  - pcmoney 5y ago
    So basically harming Billy possibly violating his rights and not respecting Grandpa’s autonomy to make his own decisions regarding risk/return tradeoffs is the solution? Hasn’t worked well to date.
  - perardi 5y ago
    Or…grandpa can get vaccinated. I'd be more than happy to test and vaccinate in schools. In particular vaccinate. But having kids wear masks…which they don't do well, because they're kids…not like adults do it well either…is a fig leaf. It's not going to work. And you can see that from the massive infection rates in schools that have masks.
jimmyjazz14 5y ago
Isn't the whole point of the article that school mask mandates probably don't reduce spread? If it doesn't reduce spread than it won't help your overwhelmed friends working in medicine. Sorry I guess I just don't understand what point you are trying to make.
- michaelmrose 5y ago
  The thesis of the article is that even though studies show masks work studies in schools had obvious flaws and are measuring multiple confounding factors ergo masks might not work so we have no justification for mask mandates. This is materially different from knowing they don't work. I cannot countenance the idea that keeping most of your spit with you rather than floating around the room doesn't reduce spread of a respiratory virus. At best I would suggest instead that schools ought to have had a mandate to use and reuse sterilized n95 masks instead of a loosely fitting cloth mask oft worn with the nose exposed.
  - jimmyjazz14 5y ago
    Yeah I don't think they are really saying that they absolutely don't work but that the evidence that they do is weak enough to justify removing the mandates. They address N95 mask in the article (did you read it) pointing out that they are more difficult to breath in and hinder communication more (I'll add my own point in that they are harder to keep a seal with which seems to be quite important according to the studies I have seen). Personally I have used N95 mask quite a bit for sanding projects and can to attest to the difficulty of wearing them for long period in a properly fitting way.
    - AnthonBerg 5y ago
      N95 masks are not at all difficult to breathe in in my experience. Not at all.
      - throwawaythekey 5y ago
        > N95 masks are not at all difficult to breathe in in my experience. Not at all. My default assumption would be that if the mask doesn't make it more difficult to breathe then it is unlikely to be effective. The filtration mechanism should introduce friction which you then have to compensate for with additional pressure in your lungs.
lr1970 5y ago
> They'd also know that pretty much the only condition we're treating nowadays is Covid. This statement might be true for your location but is not true in general. Here in New York City hospitalizations due to covid are not very high and going down quickly. Elective surgeries and procedures go on as scheduled. ICUs are not overrun with covid specific cases. Majority of the patients with positive PCR test are hospitalized for medical reasons other than covid. Recorded deaths do not differentiate between "died from covid" and "died while covid positive" making death statistics hard to interpret. In general, compared to the situation on the ground in March-April 2020 this time the covid load on NYC hospital system is lighter. The biggest challenge is staffing shortages in the hospitals due to general burn-out, people being on sick leave due to spreading omicron. Noticeable percentage of nurses were laid off because of the vaccine mandate (i am not judging the mandate, just stating the consequence). SOURCE: several physician relatives and friends working in NYC hospitals (Manhattan, Bronx, Brooklyn).
- perardi 5y ago
  NYTimes has a pretty good source on this. https://www.nytimes.com/interactive/2020/us/covid-hospitals-near-you.html https://www.nytimes.com/interactive/2020/us/covid-hospitals-... I'll tell you that here in Chicago, based off data, and anecdotes: really depends on the neighborhood. Vaccinated areas? Doing fine. Undervaccinated areas? Not doing so well. Gosh, it's like vaccines work and that's the way out of this.
  - colpabar 5y ago
    > Gosh, it's like vaccines work and that's the way out of this. You know, I see snarky little comments like this becoming more and more common on this site, and I'd just like to point out that they are not helpful in any way. Who is it directed towards? Do you think you are convincing anyone, or encouraging a productive discussion? I'd be willing to bet that the overwhelming majority of people on this website are vaccinated. I know I am. In my opinion, that line is the equivalent of saying "gosh, maybe black people should just stop committing crimes if they don't want to go to jail" or "gosh, maybe gay people should just stop having unprotected sex if they don't want HIV." I am begging you, and everyone else, PLEASE, if you want to make a point, please do it in a respectful way that doesn't assume anyone who disagrees is stupid. If you need to be snarky, go do it on the-site-that-must-not-be-named.
baron816 5y ago
> My daughter is in pre-med. Apparently people are dropping out like flies This may not be a bad thing in the long run. There’s a shortage of medical professionals because the medical industry wants it that way. If the crisis becomes acute enough, the government will be forced to loosen regulations, and that would allow for more people to enter the field faster and more easily.
- convolvatron 5y ago
  _thats_ your takeaway? that if the damn government stopped bothering to try to oversee outcomes in an area with extreme information asymmetry, a desire to get treated regardless of the cost, a bunch of agents between the doctor and the patient taking their cut, and a massive problem with cost control....everything would just be fine and we'd have plenty of doctors.
  - baron816 5y ago
    No. You’re putting a bunch of words in my mouth.
- nradov 5y ago
  The shortage of physicians is primarily caused not by regulations but by lack of government funding for residency programs. https://www.ama-assn.org/press-center/press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/press-releases/ama-fun...
  - xyzzyz 5y ago
    So we didn’t have physicians before government started funding residencies? I think not, I think we used to have physicians just fine 100 years ago. So what changed?
    - nradov 5y ago
      Medical education with residencies only really started in about 1930. Before that there was no real consistency, and the results were terrible in terms of iatrogenic harm. https://medlineplus.gov/ency/article/001936.htm https://medlineplus.gov/ency/article/001936.htm The other thing that changed in the past 100 years is that Americans on average are older, sicker, and have higher demand for healthcare.
clutchdude 5y ago
As with many things, nuance is a subject that many on HN fail to grasp. They believe that masking is a binary decision and that once made, the die is cast. Rather, if we tied masking mandates to thresholds of community spread and encouraged/provided high quality masks, the public would at least show medical professionals we're interested in keeping another body out of the morgue, aside from the obvious vaccination need. But I digress - there are many slow moving disasters that were every so slightly accelerated by COVID that are only going to surface in the years to come.
- twblalock 5y ago
  > Rather, if we tied masking mandates to thresholds of community spread and encouraged/provided high quality masks, the public would at least show medical professionals we're interested in keeping another body out of the morgue, aside from the obvious vaccination need. At this point, mandates have convinced everyone who will ever be convinced. There is no more convincing in our future. A subset of people will always reject masks and vaccines.
  - acdha 5y ago
    > At this point, mandates have convinced everyone who will ever be convinced. There is no more convincing in our future. A subset of people will always reject masks and vaccines. This is defeatist and I don't think it's true. Most of those people have never had a mandate — as we've seen everywhere those have actually been implemented, there are a very few dedicated antivaxers and a whole ton of people who are comfortable repeating their shiboleths as long as there's no personal cost. Once they're forced to accept the consequences of their decision, a significant fraction cave. They'll never admit that they spent the last couple of years parroting lies but at least they're vaccinated and far less likely to be tying up a hospital bed.
    - 015a 5y ago
      Its only defeatist if you give up. And that's effectively what our leadership has done; keep screeching about masks and vaccinations, some listen, some don't, and nothing changes. The curve keeps oscillating. Ok; recognize that. Pivot. If the best solution won't work, then it isn't the best solution; continuing to believe so is like standing on the Titanic as its going down and yelling "god damn it just don't hit the iceberg, its so simple, just turn left." Its not helpful toward driving positive outcomes, and that's what matters. Its what happens when you let scientists and doctors run the show; they present fantastic solutions which work in the lab, if everyone does them, perfectly. The population is not a programmable computer. What's the problem right now? Medical care capacity. What's the best way to solve that? Keep people out of the hospital. That isn't working. Stop doubling down. We need to keep medical professionals in the system, and encourage new ones to join. Pass federal laws limiting the number of patients nurses are responsible for. Supplement medical professional income with tax dollars. Create incentives for retired professionals to come back into the fray, and younger people to stay in the pipeline to join the field. Deploy the military to hard-hit areas. Embrace more easily accessible, quicker trade-skill like training for COVID-care specialist to manpower-supplement existing hospital forces, working underneath more highly trained professionals. There are many things we could do, but we're not doing much of them.
youniverse 5y ago
I'll throw into this that my friend at a big hospital in Topeka, Kansas says all overnight surgeries are canceled so to staff shortage. Including heart surgery. Crazy.
stvswn 5y ago
I find it kind of amazing that the justification for school mask mandates (which was once "keep kids from getting covid") has morphed into "we'll lower the load on hospitals if the kids keep their faces covered." Can anyone imagine if we went back to 2020 and pitched this to parents? "Look, if your kid gets it, it will be similar in nature to a chest cold. It's somewhat more dangerous for the elderly. In order to keep doctors and nurses from getting burned out, the kids are all going to wear masks all day. Other than that, outside of school, we're all going to be pretty much getting back to normal." I have lost track of what the goalposts are. I am starting to think that people just like the idea that children are suffering, it must mean that we're taking the whole thing seriously. As long as none of us are inconvenienced, right?
- namarie 5y ago
  > In order to keep doctors and nurses from getting burned out You say it as if that's the only consequence of a medical shortage... How about replacing that with "in order to have enough functioning doctors and nurses able to treat patients with cancer, respond to car accidents, and do organ transplants"?
kodah 5y ago
> You can see what our child-bearing aged children think of all this - they're not having kids. I don't think this is a short-term aberration. We're a population literally in decline. I'm one of these folks. I think it's wrong to blame this solely on COVID. I won't have kids because my position in the United States is nowhere near guaranteed. I have survived three economic recessions, one of which I lost everything in and the course of my life was permanently altered. I watched as society adopted "the internet" and used it in terrifying detail. I've watched as social problems turned into vitriol, anger, and at times violence. I've watched as climate change was viewed as either "conserve", "don't believe", or "innovate" with the latter being the latest focus - none of which have worked and each took myopic approaches to a very broad problem. I've watched as society became polarized on such arbitrary lines as politics, missing any nuance that may occur across the spectrum; almost turned into a caricature of Star Wars. Home prices are higher than they've ever been, inaccessible to even moderately wealthy citizens. I may not be on the money with each of my perspectives, though I also don't think I'm really that far off. So riddle me this: Why in the hell would I want to add one more responsibility while dodging and dealing with the bullets of life as-we-know-it today?
- curmudgeon81 5y ago
  If you don't feel like taking on that responsibility, don't do it. But understand: the vast majority of human history is colored by a desire to grow a family in order to provide strength to their progeny knowing that they, in turn, will face an unkind future and can be protected, in some degree, by their kin. Sounds like you're at the end of a multi-billion year winning streak. Your ancestors did well.
- Zanneth 5y ago
  I think you are misunderestimating the value that bringing a new life into the world offers you as a parent, and your community. The world in general, and especially the United States, has never been more peaceful and prosperous as it is now. Human civilization needs more people, now more than ever.
  - carapace 5y ago
UncleOxidant 5y ago
> My daughter is in pre-med. Apparently people are dropping out like flies and not just because of the course load. They're watching how medical professionals are being treated and saying screw it! And who can blame them at this point? If anything we need more doctors/nurses/healthcare workers, but now we're going to be moving in the wrong direction for many years.
pnutjam 5y ago
As a wise person once said, "Mind your own business". Take care of yourself and those around you and the rest will fall into place.
aaron695 5y ago
skillpass 5y ago
I understand you are making the argument that removing mandates for masks at schools will lead us to have a shortage of medical practitioners? That seems dubious to me. From what I know, the limits on number of doctors licensed each year are tightly controlled. If students drop out, there are countless others who will be willing to take their place.
- shadowofneptune 5y ago
  It's not just students being affected, but educators and those who supervise residents. There will be less and less spots available in residency programs, nursing programs, etc. due to this. That was already a problem pre-pandemic: https://www.wolterskluwer.com/en/expert-insights/nursing-faculty-shortage-in-the-us https://www.wolterskluwer.com/en/expert-insights/nursing-fac... Compensation helps, but having to do much more work with less people increases burnout regardless of how much you're being paid.
  - skillpass 5y ago
    Appreciate the link, it was an informative read. Based off what I read there, I don't think reducing burden on nurses to prevent burnout at any cost is the right response here. The article makes clear there are two pipelines here: Nursing student applicants -> Nursing students -> Nurses, and Nurses -> Nursing faculty There are more qualified applicants than can be accepted as students due in part to shortages in the faculty, according to the article. So why is there a shortage of faculty? There are several items noted in the article, but I'll point out the one I think is relevant to our conversation. > the pandemic has forced much of nursing education to an online, virtual format ... An overnight switch to virtual learning has not been seamless or easy on students or faculty ... The risk of burnout in these prolonged conditions is high—especially for faculty members who have young children or who are caretakers in the home. So, this article is arguing nursing faculty is burning out because teaching virtually is too taxing. I don't think this article supports the idea that a nursing shortage will result due to overtaxed nurses in hospitals.
    - shadowofneptune 5y ago
shadowofneptune 5y ago
I just graduated from nursing school and am preparing for my board exam. Everyone I talked and worked with during school said this was the worst period in their careers. Now, with Omicron, we're back to peak load on hospitals. The postponements started in the middle of December, it's terrible. I program as a hobby, so I do frequent here. It is unusual how many people talk here about medicine, especially when deciding to debate medical ethics. A lot of it feels like they are working it out a priori.
JPKab 5y ago
General observation from reading YOUR comment - you must not have young kids at a key developmental age in primary school for if you did you'd realize how detrimental arbitrary, poorly-fitting, non-medical masks are to small children's ability to learn to speak, read other's emotions, and other crucial milestones. It's an uncontrolled experiment that was launched, without any regard for potential negative consequences. Your kids are older, you don't know anything about what they are facing. My wife is a kindergarten teacher. It's a huge topic of constant discussion amongst the entire faculty at her school and others about how insanely developmentally delayed and poorly socialized the current crop of kindergartners are. They've been stuck in isolation, left alone on ipads and other screens since they were 3. This isn't just anecdotal, there are studies showing small children are TWO STANDARD DEVIATIONS behind where they should be. Your sitting here whining about young adults in an extremely high-paying profession being worn out saving a population that will mostly be dead of old age in less than 20 years, and ignoring the damage that has already been done (needlessly) and the continuing damage being done for bio-security theater. Utterly infuriating. These kids are OUR future. Your comment showed zero empathy or thought towards that. YOUR kids didn't miss kindergarten. YOUR kids didn't get isolated. YOUR kids had a normal childhood. Mine aren't. Many others aren't. But really glad you care so much about "Global Climate Change" (why capitalize it, is it your religion?). The selfishness of your statement is appalling.
- tagoregrtst 5y ago
  This. Adults have offloaded as much of the burden of the pandemic on young people as possible. - Suicide rates are through the roof - Developmentally delays - Societal debt And it goes on. Medical professional have it rough… oh well! Open up more medical schools, theres far more people willing to go to med school than get in. Id rather not go to the Dr. and not need prescriptions to buy most drugs. Lets loosen those regulations and 80% of the reasons Ive been to the Dr. in the last six years will be covered with the same formula: 10 days of augmentin.
  - JPKab 5y ago
    You can't open up more medical schools because the American Medical Association has lobbied for decades and use their accreditation authority to put a cap on the number of seats in med schools in the US. There's been virtually no change since the 1980s despite a 30% increase in the population. They are perhaps one of the most significant drags on economic growth in the history of the United States. Because of the artificially induced scarcity, we pay mediocre physicians the wages that CEOs earn in other industries. Everyone in the US thinks insurance companies are to blame, while they are certainly not efficient, there have been numerous studies that show that the majority of growth in price increases in medicine are due to physician wages and their organized bargaining power with insurance companies driving up prices. What other service have you encountered where you routinely have the person you are paying reschedule your appointments at the last minute? Thanks to the American Medical Association, they have the ability to do this with impunity. What's insane is we actually have to import medical workers from overseas where they are trained in countries that don't have an evil organization limiting supply. Knowing about this has made it even more unbearable to get scolded by these people for 2 years. I'm terribly sorry that they have to endure such horrible conditions while earning over $400,000 a year. It really is primarily a profession of non-creative, rule following mid-wits, kissing the ass of their licensing boards and taking defacto bribes from pharma reps to push the latest overprescribed Big Pharma product.
baskethead 5y ago
The article was written by a infectious disease expert. and an emergency room doctor at UCSF. Are you saying you know better than those two about whether or not masks are necessary at schools? If I were you I would simply trust the experts on this one.
- spydum 5y ago
  we only trust experts we agree with. this is why covid response has been such a wild ride.
nostromo 5y ago
> They'd also know that pretty much the only condition we're treating nowadays is Covid. This isn't true. Here in Washington State we're experiencing peak Covid, and only about 30% of hospital capacity is for Covid. And that's an all-time high. For most of the pandemic it's been between 10 and 20%. https://www.doh.wa.gov/Emergencies/COVID19/DataDashboard#dashboard https://www.doh.wa.gov/Emergencies/COVID19/DataDashboard#das...
buzzard1 5y ago
>they'd realize those friends are swamped and burned-out The ones dancing on tiktok a year and a half ago? Or the ones who are left in an understaffed environment after their unvaccinated colleagues were canned?
edmcnulty101 5y ago
So many inaccuracies. ICU's are not overflowing. They run at an 80 to 90 percent capacity in general. Flattening the curve has been a news media myth for YEARS now that has never come true. Here's actual ICU data around the U.S. They all run high because they ALWAYS HAVE. https://www.npr.org/sections/health-shots/2020/12/09/944379919/new-data-reveal-which-hospitals-are-dangerously-full-is-yours https://www.npr.org/sections/health-shots/2020/12/09/9443799... More medical professionals are being fired for not getting the vaccine than retiring. People weren't having kids BEFORE COVID. On a geological time scale the earth temperature is not even close to the hottest it's ever been. It's a gish gallop of unfounded liberal news media talking points.
ouid 5y ago
If the concern is hospitals being overwhelmed for long periods of time, then there's really no reason not to just let them get overwhelmed all the way. They can return to normal working conditions earlier, and people can get important surgeries again.
refurb 5y ago
This is a perfect example of catastrophizing our situation and seems riddled with anxiety and fear. The CDC has already admitted half of the people in the hospital with Covid aren’t there because of Covid and this lines up with other countries experiences. The world has been through far worse than what we are going through now and we made it just fine. You personally may die from Covid or you could get run over by a car walking your doggy. Rather than worrying about it, try and turn off the internet, spend time with people you love and enjoy your life. There will always be time to worry and stress.
SkyPuncher 5y ago
> They're watching how medical professionals are being treated and saying screw it! This was a trend before the pandemic. The financials of becoming a doctor just don't make any damn sense any more. Sure you'll make more in the long run, but it's a grind to get there and you basically give up your 20's to get there. This has a lot of negative impacts on your social life and your ability to build any sort of financial stability until your 30's. I'm really happy to see the change in attitude in medicine. Hospital leadership has been milking the Hypocratic Oath for all the can. Physicians (and other health care workers) are starting to realize this bullshit. ---- PS: I know it's not my place, but I'd really recommend having a conversation with your daughter about going into medicine. Take a peak at places like /r/medicalschool, /r/residency/, /r/medicine, and student doctor network. March 18 will be a sobering day for many.
tpoacher 5y ago
People were quitting medicine for greener pastures way before the pandemic. I should know, I'm one of them since 10 years ago.
14 5y ago
I am in healthcare and the leadership whoever that is makes me question continuing. Their decisions just don’t come with reason I am starting to question who is making such decisions. We are not supported and are left out to face the front lines with no sound decision making process behind what we do. If I come across a severely sick patient I am asked to wear a gown that covers 2/3s of my front from my neck to my knees along with my basic medical mask and face shield. That is all the protection I get. My head nurses do not show up and test the clients for covid they just get deemed droplet precautions until they get better. If they are confirmed covid then we can get an N95 mask but no one is testing them unless they test their selves and all my clients are elderly so not going to be tested. Now 2 months after firing those who choose not to get vaccinated we are told we have to work even with covid if our symptoms are not serious. The lunacy I am seeing is highly turning me off from doing this forever. What if it was Ebola? There is no way I can trust my leadership to make the correct decisions to keep me safe. And I don’t have any authority to use resources or make change myself. It is very tiring to do this job day after day and with the housing market I can not even afford to get into a house. I love my job but am considering a change to get into something higher paying and worth my time.
ya_throw 5y ago
>They'd also know that pretty much the only condition we're treating nowadays is Covid. Do you have a source for that? The percentage of Covid patients in ICU wards in the UK peaked at somewhere near 30% for a short period in January 2021. >the folks on HN must not have many friends working in medicine for if they had they'd realize those friends are swamped and burned-out. Now I do know this to be true, but it's not due to the absolute numbers of Covid patients. In my experience (as I know several people in frontline healthcare), its the side-effects of Covid restrictions making healthcare impossible to provide.
pibechorro 5y ago
Firing front line responders, nurses, etc for refusing the mRna shots backfiring? Not encouraging preemptive healthy lifestyles backfiring? (Obesity, etc) Things will work out just fine.
hardolaf 5y ago
It took me two months in Chicago to see a general practitioner and I'm still waiting (4 months later) for an in-network physical therapist to start taking non-critical, new patients for a back issue. Everything is completely understaffed and overwhelmed, even the services that aren't even associated with emergency care are swamped. Heck, getting just a dentist appointment now is a multi-month out scheduling nightmare with a side of random cancellations because the staff got COVID followed by being rescheduled several more months out and hoping to be bumped again.

deleted 5y ago

[deleted]

concinds 5y ago

Genuinely asking - What's stopping a country, or hospital, from saying: "we'll prioritize cancer patients, scheduled surgeries, normal operation; you come in with Covid respiratory distress, and we're full? Go away." From the government data I've found, Covid patients are about 5-20% of emergency department patients in the US[0]; in Switzerland that leaves a healthy amount of free beds[1] (though I'm sure staffing is another issue). Why are they causing such disruption? And if they are, why are we not having a debate about whether all the additional cancer deaths, heart attack deaths (from deprogrammed surgeries and screenings) are worth it? In what way is this "healthcare catastrophe" not partly avoidable? > You can see what our child-bearing aged children think of all this - they're not having kids. I don't think this is a short-term aberration. We're a population literally in decline. That's been happening long before Corona, and I doubt it has much do do with politics or "optimism about climate change" compared with wages, housing, etc. [0]: https://www.cdc.gov/nchs/covid19/nhcs/hospital-encounters-by-week.htm https://www.cdc.gov/nchs/covid19/nhcs/hospital-encounters-by... [1]: https://www.covid19.admin.ch/en/hosp-capacity/icu?time=phase2&rel=rel https://www.covid19.admin.ch/en/hosp-capacity/icu?time=phase...

taylodl 5y ago
I've asked my friends working in medicine the same thing. What if hospitals were to start turning away those who are willingly unvaccinated? I haven't been able to get a clear answer but the basic theme I hear is you can't, state law prohibits that. Of course the law can be changed, but what legislature is going to do that? This is where politics enters the fray. They'd rather kick the can down the road and bring in the National Guard to help run the hospitals than turn away patients and potentially face voter wrath.
- nradov 5y ago
  For hospitals it's the federal EMTALA law which makes it illegal for hospitals to deny emergency care on the basis of vaccination status. If a patient shows up with unstable vital signs then the hospital is required to at least stabilize them. For COVID-19 patients that's usually based on respiratory distress or low blood oxygen saturation. https://www.cms.gov/Regulations-and-Guidance/Legislation/EMTALA https://www.cms.gov/Regulations-and-Guidance/Legislation/EMT...
  - boilerupnc 5y ago
    So, we essentially have mandates to "treat" with no corresponding agreement on defining any mandates to "prevent". Prevention mandates could be a tapestry of options and defined within specific contextual and cultural boundaries. But having nothing on the "prevent" tilts the scale entirely to obligatory treatment and clearly feels imbalanced.
- lancesells 5y ago
  I'm vaccinated and think everyone capable of receiving the vaccine should get it but turning people away is cruel. That's science-fiction dystopia cruelty in my opinion. Now if a hospital is full and at capacity maybe there are some calculations but just turning people away is wrong.
  - sanderjd 5y ago
    They were explicitly talking about the case of hospitals that are struggling with capacity issues.

tjr225 5y ago

> And it gets worse. My daughter is in pre-med. Apparently people are dropping out like flies and not just because of the course load. They're watching how medical professionals are being treated and saying screw it! This should concern us all because we've had a marked uptick of medical professionals retiring/resigning since the pandemic started and now the pipeline is thinning out. You should be angry at corporate healthcare that has prioritized financial efficiency and monetary gain over doing its job and treating healthcare workers fairly, not strangers on hackernews. > We're a population literally in decline. No, no we're _literally_ not. Not as of right now at least; the US population grew over the last year. But- even if we were, wouldn't that directly address the unrelated issue of climate change that you brought up?

onedognight 5y ago
It’s only increasing due to immigration, if I’m reading this correctly. https://www.census.gov/content/dam/Census/library/publications/2020/demo/p25-1146.pdf https://www.census.gov/content/dam/Census/library/publicatio...
- adamrezich 5y ago
  ah, so everything is going according to plan then. downvoters: is this outcome undesirable? if so, why, and what can we do to fix it? because I'm pretty sure you're not supposed to say that having more kids is a good thing, and using immigration/migration as a means of replacing those kids we're not having is a bad thing. thus, is this outcome (declining citizen birth rates, increased immigration/migration compensating for it) not the intended, desired one?
  - AussieWog93 5y ago
    (I think you may have been downvoted because your initial comment appeared to be referencing the "White Genocide" conspiracy theory - essentially the idea that the Jews are planning to slowly eliminate the white race in the West and replace them with blacks and Muslims.)

rkk3 5y ago

What does this have to do with masking young children, many who are vaccinated, in schools? Are you implying that they are a source of the spread and causing medical professionals to be burnt out? and that therefore we should ignore that both the teacher and student wearing a mask might be detrimental for ESL & Language development ?

adolph 5y ago

> They'd also know that pretty much the only condition we're treating nowadays is Covid. That claim is misinformation, please edit and delete. Medicine as a field is very broad and plenty of other conditions are being treated.

dsl 5y ago
At your dentist or plastic surgery clinic, sure. Hospitals everywhere are short on nurses and anything that can be delayed still is. A friend was recently transfered to another hospital to give birth because the maternity ward was unstaffed.
- adolph 5y ago
  "short on nurses" != "only condition we're treating nowadays is Covid"

tlear 5y ago

People stopped having kids once they could(easily available birth control). Trying to connect it to COVID or Climate change is not supported by any data whatsoever.

AlexandrB 5y ago
Call it a vibe. I only see a steady decline in living standards in our future and it makes me pause when I think about whether to subject another human being (i.e. my kids) to that.
- tlear 5y ago
  We are living in the most safe, prosperous, easy, carefree time in the history of human species. Can we fuck it up? yes we probably can, it won't be easy and would need to involve nukes probably. Realize that doom and fear porn that you are reading addresses certain type of need we have. If you overdo it well you get depression. Then again some people I know use this crap to give themselves excuse to behave like teenagers in their 30s, stuck in childhood(because they can).
- sometimeshuman 5y ago
  There is no stigma these days for not starting a family kids and men can privately retreat into video games and pornography. When confronted about their selfish* lifestyle the above comment is convenient cover but it is not backed by solid data. I'd take birth in this past decade over birth in my decade any day. *I'd argue that not having at least one child and possibly adopting others is selfish assuming one has financial means. For example, while I thought I wanted kids, upon reflection what I really wanted are mini-me's. If I could buy a clone I'd do it immediately, but child roulette?, no thanks. My selfish lifestyle had made me very happy so far and that feels like a character flaw.
  - AussieWog93 5y ago
    May I ask how old you are? From where I am, a "selfish" lifestyle of video games and porn replacing responsibility does not seem to be healthy long-term. I'm in my late 20s now, and the guys I know who are not working towards getting married and starting a family are pretty much all starting to experience some sort of constant existential anxiety.

perardi 5y ago

Yes, and? The hospital case load is overwhelmingly, screamingly, massively dominated by the elderly unvaccinated. https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/data-tables/421-010-CasesInNotFullyVaccinated.pdf https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/... Given the extremely contagious nature of Omicron, what plausible way do we have to prevent these individuals from getting COVID and using hospital space? And don't say masking up kids—because if they haven't gotten vaccinated, then why do you think they themselves would wear masks and social distance to prevent themselves from getting COVID? I have seen no plausible modeling that shows even high level of masking would significantly blunt the spread of this. https://covid19.healthdata.org/united-states-of-america?view=cumulative-deaths&tab=trend https://covid19.healthdata.org/united-states-of-america?view... So why make the kids put on hair shirts I mean masks? Oh, and by the way: I have plenty of sympathy towards health care workers. I am dating a nurse. I have doctors, nurses, and paramedics as friends. I have extreme empathy towards them, and full seething burning anger towards the unvaccinated septuagenarians ruining our health care system. And the rest of our economy while they're at it.

dsl 5y ago
I know multiple households where the initial infection vector was the kids. Grandpa might be stupid and refuse the vaccine, but keeping little Billy from becoming a carrier lessens the hospital load. If screaming Karens are going to insist on in person learning, we need to mask test and vaccinate in the schools.
- pcmoney 5y ago
  So basically harming Billy possibly violating his rights and not respecting Grandpa’s autonomy to make his own decisions regarding risk/return tradeoffs is the solution? Hasn’t worked well to date.
- perardi 5y ago
  Or…grandpa can get vaccinated. I'd be more than happy to test and vaccinate in schools. In particular vaccinate. But having kids wear masks…which they don't do well, because they're kids…not like adults do it well either…is a fig leaf. It's not going to work. And you can see that from the massive infection rates in schools that have masks.

jimmyjazz14 5y ago

Isn't the whole point of the article that school mask mandates probably don't reduce spread? If it doesn't reduce spread than it won't help your overwhelmed friends working in medicine. Sorry I guess I just don't understand what point you are trying to make.

michaelmrose 5y ago
The thesis of the article is that even though studies show masks work studies in schools had obvious flaws and are measuring multiple confounding factors ergo masks might not work so we have no justification for mask mandates. This is materially different from knowing they don't work. I cannot countenance the idea that keeping most of your spit with you rather than floating around the room doesn't reduce spread of a respiratory virus. At best I would suggest instead that schools ought to have had a mandate to use and reuse sterilized n95 masks instead of a loosely fitting cloth mask oft worn with the nose exposed.
- jimmyjazz14 5y ago
  Yeah I don't think they are really saying that they absolutely don't work but that the evidence that they do is weak enough to justify removing the mandates. They address N95 mask in the article (did you read it) pointing out that they are more difficult to breath in and hinder communication more (I'll add my own point in that they are harder to keep a seal with which seems to be quite important according to the studies I have seen). Personally I have used N95 mask quite a bit for sanding projects and can to attest to the difficulty of wearing them for long period in a properly fitting way.
  - AnthonBerg 5y ago
    N95 masks are not at all difficult to breathe in in my experience. Not at all.
    - throwawaythekey 5y ago
      > N95 masks are not at all difficult to breathe in in my experience. Not at all. My default assumption would be that if the mask doesn't make it more difficult to breathe then it is unlikely to be effective. The filtration mechanism should introduce friction which you then have to compensate for with additional pressure in your lungs.

lr1970 5y ago

> They'd also know that pretty much the only condition we're treating nowadays is Covid. This statement might be true for your location but is not true in general. Here in New York City hospitalizations due to covid are not very high and going down quickly. Elective surgeries and procedures go on as scheduled. ICUs are not overrun with covid specific cases. Majority of the patients with positive PCR test are hospitalized for medical reasons other than covid. Recorded deaths do not differentiate between "died from covid" and "died while covid positive" making death statistics hard to interpret. In general, compared to the situation on the ground in March-April 2020 this time the covid load on NYC hospital system is lighter. The biggest challenge is staffing shortages in the hospitals due to general burn-out, people being on sick leave due to spreading omicron. Noticeable percentage of nurses were laid off because of the vaccine mandate (i am not judging the mandate, just stating the consequence). SOURCE: several physician relatives and friends working in NYC hospitals (Manhattan, Bronx, Brooklyn).

perardi 5y ago
NYTimes has a pretty good source on this. https://www.nytimes.com/interactive/2020/us/covid-hospitals-near-you.html https://www.nytimes.com/interactive/2020/us/covid-hospitals-... I'll tell you that here in Chicago, based off data, and anecdotes: really depends on the neighborhood. Vaccinated areas? Doing fine. Undervaccinated areas? Not doing so well. Gosh, it's like vaccines work and that's the way out of this.
- colpabar 5y ago
  > Gosh, it's like vaccines work and that's the way out of this. You know, I see snarky little comments like this becoming more and more common on this site, and I'd just like to point out that they are not helpful in any way. Who is it directed towards? Do you think you are convincing anyone, or encouraging a productive discussion? I'd be willing to bet that the overwhelming majority of people on this website are vaccinated. I know I am. In my opinion, that line is the equivalent of saying "gosh, maybe black people should just stop committing crimes if they don't want to go to jail" or "gosh, maybe gay people should just stop having unprotected sex if they don't want HIV." I am begging you, and everyone else, PLEASE, if you want to make a point, please do it in a respectful way that doesn't assume anyone who disagrees is stupid. If you need to be snarky, go do it on the-site-that-must-not-be-named.

baron816 5y ago

> My daughter is in pre-med. Apparently people are dropping out like flies This may not be a bad thing in the long run. There’s a shortage of medical professionals because the medical industry wants it that way. If the crisis becomes acute enough, the government will be forced to loosen regulations, and that would allow for more people to enter the field faster and more easily.

convolvatron 5y ago
_thats_ your takeaway? that if the damn government stopped bothering to try to oversee outcomes in an area with extreme information asymmetry, a desire to get treated regardless of the cost, a bunch of agents between the doctor and the patient taking their cut, and a massive problem with cost control....everything would just be fine and we'd have plenty of doctors.
- baron816 5y ago
  No. You’re putting a bunch of words in my mouth.
nradov 5y ago
The shortage of physicians is primarily caused not by regulations but by lack of government funding for residency programs. https://www.ama-assn.org/press-center/press-releases/ama-fund-graduate-medical-education-address-physician-shortages https://www.ama-assn.org/press-center/press-releases/ama-fun...
- xyzzyz 5y ago
  So we didn’t have physicians before government started funding residencies? I think not, I think we used to have physicians just fine 100 years ago. So what changed?
  - nradov 5y ago
    Medical education with residencies only really started in about 1930. Before that there was no real consistency, and the results were terrible in terms of iatrogenic harm. https://medlineplus.gov/ency/article/001936.htm https://medlineplus.gov/ency/article/001936.htm The other thing that changed in the past 100 years is that Americans on average are older, sicker, and have higher demand for healthcare.

clutchdude 5y ago

As with many things, nuance is a subject that many on HN fail to grasp. They believe that masking is a binary decision and that once made, the die is cast. Rather, if we tied masking mandates to thresholds of community spread and encouraged/provided high quality masks, the public would at least show medical professionals we're interested in keeping another body out of the morgue, aside from the obvious vaccination need. But I digress - there are many slow moving disasters that were every so slightly accelerated by COVID that are only going to surface in the years to come.

twblalock 5y ago
> Rather, if we tied masking mandates to thresholds of community spread and encouraged/provided high quality masks, the public would at least show medical professionals we're interested in keeping another body out of the morgue, aside from the obvious vaccination need. At this point, mandates have convinced everyone who will ever be convinced. There is no more convincing in our future. A subset of people will always reject masks and vaccines.
- acdha 5y ago
  > At this point, mandates have convinced everyone who will ever be convinced. There is no more convincing in our future. A subset of people will always reject masks and vaccines. This is defeatist and I don't think it's true. Most of those people have never had a mandate — as we've seen everywhere those have actually been implemented, there are a very few dedicated antivaxers and a whole ton of people who are comfortable repeating their shiboleths as long as there's no personal cost. Once they're forced to accept the consequences of their decision, a significant fraction cave. They'll never admit that they spent the last couple of years parroting lies but at least they're vaccinated and far less likely to be tying up a hospital bed.
  - 015a 5y ago
    Its only defeatist if you give up. And that's effectively what our leadership has done; keep screeching about masks and vaccinations, some listen, some don't, and nothing changes. The curve keeps oscillating. Ok; recognize that. Pivot. If the best solution won't work, then it isn't the best solution; continuing to believe so is like standing on the Titanic as its going down and yelling "god damn it just don't hit the iceberg, its so simple, just turn left." Its not helpful toward driving positive outcomes, and that's what matters. Its what happens when you let scientists and doctors run the show; they present fantastic solutions which work in the lab, if everyone does them, perfectly. The population is not a programmable computer. What's the problem right now? Medical care capacity. What's the best way to solve that? Keep people out of the hospital. That isn't working. Stop doubling down. We need to keep medical professionals in the system, and encourage new ones to join. Pass federal laws limiting the number of patients nurses are responsible for. Supplement medical professional income with tax dollars. Create incentives for retired professionals to come back into the fray, and younger people to stay in the pipeline to join the field. Deploy the military to hard-hit areas. Embrace more easily accessible, quicker trade-skill like training for COVID-care specialist to manpower-supplement existing hospital forces, working underneath more highly trained professionals. There are many things we could do, but we're not doing much of them.

youniverse 5y ago

I'll throw into this that my friend at a big hospital in Topeka, Kansas says all overnight surgeries are canceled so to staff shortage. Including heart surgery. Crazy.

stvswn 5y ago

I find it kind of amazing that the justification for school mask mandates (which was once "keep kids from getting covid") has morphed into "we'll lower the load on hospitals if the kids keep their faces covered." Can anyone imagine if we went back to 2020 and pitched this to parents? "Look, if your kid gets it, it will be similar in nature to a chest cold. It's somewhat more dangerous for the elderly. In order to keep doctors and nurses from getting burned out, the kids are all going to wear masks all day. Other than that, outside of school, we're all going to be pretty much getting back to normal." I have lost track of what the goalposts are. I am starting to think that people just like the idea that children are suffering, it must mean that we're taking the whole thing seriously. As long as none of us are inconvenienced, right?

namarie 5y ago
> In order to keep doctors and nurses from getting burned out You say it as if that's the only consequence of a medical shortage... How about replacing that with "in order to have enough functioning doctors and nurses able to treat patients with cancer, respond to car accidents, and do organ transplants"?

kodah 5y ago

> You can see what our child-bearing aged children think of all this - they're not having kids. I don't think this is a short-term aberration. We're a population literally in decline. I'm one of these folks. I think it's wrong to blame this solely on COVID. I won't have kids because my position in the United States is nowhere near guaranteed. I have survived three economic recessions, one of which I lost everything in and the course of my life was permanently altered. I watched as society adopted "the internet" and used it in terrifying detail. I've watched as social problems turned into vitriol, anger, and at times violence. I've watched as climate change was viewed as either "conserve", "don't believe", or "innovate" with the latter being the latest focus - none of which have worked and each took myopic approaches to a very broad problem. I've watched as society became polarized on such arbitrary lines as politics, missing any nuance that may occur across the spectrum; almost turned into a caricature of Star Wars. Home prices are higher than they've ever been, inaccessible to even moderately wealthy citizens. I may not be on the money with each of my perspectives, though I also don't think I'm really that far off. So riddle me this: Why in the hell would I want to add one more responsibility while dodging and dealing with the bullets of life as-we-know-it today?

curmudgeon81 5y ago
If you don't feel like taking on that responsibility, don't do it. But understand: the vast majority of human history is colored by a desire to grow a family in order to provide strength to their progeny knowing that they, in turn, will face an unkind future and can be protected, in some degree, by their kin. Sounds like you're at the end of a multi-billion year winning streak. Your ancestors did well.
Zanneth 5y ago
I think you are misunderestimating the value that bringing a new life into the world offers you as a parent, and your community. The world in general, and especially the United States, has never been more peaceful and prosperous as it is now. Human civilization needs more people, now more than ever.
- carapace 5y ago

UncleOxidant 5y ago

> My daughter is in pre-med. Apparently people are dropping out like flies and not just because of the course load. They're watching how medical professionals are being treated and saying screw it! And who can blame them at this point? If anything we need more doctors/nurses/healthcare workers, but now we're going to be moving in the wrong direction for many years.

pnutjam 5y ago

As a wise person once said, "Mind your own business". Take care of yourself and those around you and the rest will fall into place.

aaron695 5y ago

skillpass 5y ago

I understand you are making the argument that removing mandates for masks at schools will lead us to have a shortage of medical practitioners? That seems dubious to me. From what I know, the limits on number of doctors licensed each year are tightly controlled. If students drop out, there are countless others who will be willing to take their place.

shadowofneptune 5y ago
It's not just students being affected, but educators and those who supervise residents. There will be less and less spots available in residency programs, nursing programs, etc. due to this. That was already a problem pre-pandemic: https://www.wolterskluwer.com/en/expert-insights/nursing-faculty-shortage-in-the-us https://www.wolterskluwer.com/en/expert-insights/nursing-fac... Compensation helps, but having to do much more work with less people increases burnout regardless of how much you're being paid.
- skillpass 5y ago
  Appreciate the link, it was an informative read. Based off what I read there, I don't think reducing burden on nurses to prevent burnout at any cost is the right response here. The article makes clear there are two pipelines here: Nursing student applicants -> Nursing students -> Nurses, and Nurses -> Nursing faculty There are more qualified applicants than can be accepted as students due in part to shortages in the faculty, according to the article. So why is there a shortage of faculty? There are several items noted in the article, but I'll point out the one I think is relevant to our conversation. > the pandemic has forced much of nursing education to an online, virtual format ... An overnight switch to virtual learning has not been seamless or easy on students or faculty ... The risk of burnout in these prolonged conditions is high—especially for faculty members who have young children or who are caretakers in the home. So, this article is arguing nursing faculty is burning out because teaching virtually is too taxing. I don't think this article supports the idea that a nursing shortage will result due to overtaxed nurses in hospitals.
  - shadowofneptune 5y ago

shadowofneptune 5y ago

I just graduated from nursing school and am preparing for my board exam. Everyone I talked and worked with during school said this was the worst period in their careers. Now, with Omicron, we're back to peak load on hospitals. The postponements started in the middle of December, it's terrible. I program as a hobby, so I do frequent here. It is unusual how many people talk here about medicine, especially when deciding to debate medical ethics. A lot of it feels like they are working it out a priori.

JPKab 5y ago

General observation from reading YOUR comment - you must not have young kids at a key developmental age in primary school for if you did you'd realize how detrimental arbitrary, poorly-fitting, non-medical masks are to small children's ability to learn to speak, read other's emotions, and other crucial milestones. It's an uncontrolled experiment that was launched, without any regard for potential negative consequences. Your kids are older, you don't know anything about what they are facing. My wife is a kindergarten teacher. It's a huge topic of constant discussion amongst the entire faculty at her school and others about how insanely developmentally delayed and poorly socialized the current crop of kindergartners are. They've been stuck in isolation, left alone on ipads and other screens since they were 3. This isn't just anecdotal, there are studies showing small children are TWO STANDARD DEVIATIONS behind where they should be. Your sitting here whining about young adults in an extremely high-paying profession being worn out saving a population that will mostly be dead of old age in less than 20 years, and ignoring the damage that has already been done (needlessly) and the continuing damage being done for bio-security theater. Utterly infuriating. These kids are OUR future. Your comment showed zero empathy or thought towards that. YOUR kids didn't miss kindergarten. YOUR kids didn't get isolated. YOUR kids had a normal childhood. Mine aren't. Many others aren't. But really glad you care so much about "Global Climate Change" (why capitalize it, is it your religion?). The selfishness of your statement is appalling.

tagoregrtst 5y ago
This. Adults have offloaded as much of the burden of the pandemic on young people as possible. - Suicide rates are through the roof - Developmentally delays - Societal debt And it goes on. Medical professional have it rough… oh well! Open up more medical schools, theres far more people willing to go to med school than get in. Id rather not go to the Dr. and not need prescriptions to buy most drugs. Lets loosen those regulations and 80% of the reasons Ive been to the Dr. in the last six years will be covered with the same formula: 10 days of augmentin.
- JPKab 5y ago
  You can't open up more medical schools because the American Medical Association has lobbied for decades and use their accreditation authority to put a cap on the number of seats in med schools in the US. There's been virtually no change since the 1980s despite a 30% increase in the population. They are perhaps one of the most significant drags on economic growth in the history of the United States. Because of the artificially induced scarcity, we pay mediocre physicians the wages that CEOs earn in other industries. Everyone in the US thinks insurance companies are to blame, while they are certainly not efficient, there have been numerous studies that show that the majority of growth in price increases in medicine are due to physician wages and their organized bargaining power with insurance companies driving up prices. What other service have you encountered where you routinely have the person you are paying reschedule your appointments at the last minute? Thanks to the American Medical Association, they have the ability to do this with impunity. What's insane is we actually have to import medical workers from overseas where they are trained in countries that don't have an evil organization limiting supply. Knowing about this has made it even more unbearable to get scolded by these people for 2 years. I'm terribly sorry that they have to endure such horrible conditions while earning over $400,000 a year. It really is primarily a profession of non-creative, rule following mid-wits, kissing the ass of their licensing boards and taking defacto bribes from pharma reps to push the latest overprescribed Big Pharma product.

baskethead 5y ago

The article was written by a infectious disease expert. and an emergency room doctor at UCSF. Are you saying you know better than those two about whether or not masks are necessary at schools? If I were you I would simply trust the experts on this one.

spydum 5y ago
we only trust experts we agree with. this is why covid response has been such a wild ride.

nostromo 5y ago

> They'd also know that pretty much the only condition we're treating nowadays is Covid. This isn't true. Here in Washington State we're experiencing peak Covid, and only about 30% of hospital capacity is for Covid. And that's an all-time high. For most of the pandemic it's been between 10 and 20%. https://www.doh.wa.gov/Emergencies/COVID19/DataDashboard#dashboard https://www.doh.wa.gov/Emergencies/COVID19/DataDashboard#das...

buzzard1 5y ago

>they'd realize those friends are swamped and burned-out The ones dancing on tiktok a year and a half ago? Or the ones who are left in an understaffed environment after their unvaccinated colleagues were canned?

edmcnulty101 5y ago

So many inaccuracies. ICU's are not overflowing. They run at an 80 to 90 percent capacity in general. Flattening the curve has been a news media myth for YEARS now that has never come true. Here's actual ICU data around the U.S. They all run high because they ALWAYS HAVE. https://www.npr.org/sections/health-shots/2020/12/09/944379919/new-data-reveal-which-hospitals-are-dangerously-full-is-yours https://www.npr.org/sections/health-shots/2020/12/09/9443799... More medical professionals are being fired for not getting the vaccine than retiring. People weren't having kids BEFORE COVID. On a geological time scale the earth temperature is not even close to the hottest it's ever been. It's a gish gallop of unfounded liberal news media talking points.

ouid 5y ago

If the concern is hospitals being overwhelmed for long periods of time, then there's really no reason not to just let them get overwhelmed all the way. They can return to normal working conditions earlier, and people can get important surgeries again.

refurb 5y ago

This is a perfect example of catastrophizing our situation and seems riddled with anxiety and fear. The CDC has already admitted half of the people in the hospital with Covid aren’t there because of Covid and this lines up with other countries experiences. The world has been through far worse than what we are going through now and we made it just fine. You personally may die from Covid or you could get run over by a car walking your doggy. Rather than worrying about it, try and turn off the internet, spend time with people you love and enjoy your life. There will always be time to worry and stress.

SkyPuncher 5y ago

> They're watching how medical professionals are being treated and saying screw it! This was a trend before the pandemic. The financials of becoming a doctor just don't make any damn sense any more. Sure you'll make more in the long run, but it's a grind to get there and you basically give up your 20's to get there. This has a lot of negative impacts on your social life and your ability to build any sort of financial stability until your 30's. I'm really happy to see the change in attitude in medicine. Hospital leadership has been milking the Hypocratic Oath for all the can. Physicians (and other health care workers) are starting to realize this bullshit. ---- PS: I know it's not my place, but I'd really recommend having a conversation with your daughter about going into medicine. Take a peak at places like /r/medicalschool, /r/residency/, /r/medicine, and student doctor network. March 18 will be a sobering day for many.

tpoacher 5y ago

People were quitting medicine for greener pastures way before the pandemic. I should know, I'm one of them since 10 years ago.

14 5y ago

I am in healthcare and the leadership whoever that is makes me question continuing. Their decisions just don’t come with reason I am starting to question who is making such decisions. We are not supported and are left out to face the front lines with no sound decision making process behind what we do. If I come across a severely sick patient I am asked to wear a gown that covers 2/3s of my front from my neck to my knees along with my basic medical mask and face shield. That is all the protection I get. My head nurses do not show up and test the clients for covid they just get deemed droplet precautions until they get better. If they are confirmed covid then we can get an N95 mask but no one is testing them unless they test their selves and all my clients are elderly so not going to be tested. Now 2 months after firing those who choose not to get vaccinated we are told we have to work even with covid if our symptoms are not serious. The lunacy I am seeing is highly turning me off from doing this forever. What if it was Ebola? There is no way I can trust my leadership to make the correct decisions to keep me safe. And I don’t have any authority to use resources or make change myself. It is very tiring to do this job day after day and with the housing market I can not even afford to get into a house. I love my job but am considering a change to get into something higher paying and worth my time.

ya_throw 5y ago

>They'd also know that pretty much the only condition we're treating nowadays is Covid. Do you have a source for that? The percentage of Covid patients in ICU wards in the UK peaked at somewhere near 30% for a short period in January 2021. >the folks on HN must not have many friends working in medicine for if they had they'd realize those friends are swamped and burned-out. Now I do know this to be true, but it's not due to the absolute numbers of Covid patients. In my experience (as I know several people in frontline healthcare), its the side-effects of Covid restrictions making healthcare impossible to provide.

pibechorro 5y ago

Firing front line responders, nurses, etc for refusing the mRna shots backfiring? Not encouraging preemptive healthy lifestyles backfiring? (Obesity, etc) Things will work out just fine.

hardolaf 5y ago

It took me two months in Chicago to see a general practitioner and I'm still waiting (4 months later) for an in-network physical therapist to start taking non-critical, new patients for a back issue. Everything is completely understaffed and overwhelmed, even the services that aren't even associated with emergency care are swamped. Heck, getting just a dentist appointment now is a multi-month out scheduling nightmare with a side of random cancellations because the staff got COVID followed by being rescheduled several more months out and hoping to be bumped again.