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>Secondly, no, covid capacity really is the problem, because for the last year and a half...<a bunch of non quantitative opinion based unprovable emotional gish

>Secondly, no, covid capacity really is the problem, because for the last year and a half...<a bunch of non quantitative opinion based unprovable emotional gish gallop stuff I didn't read.> Bullshit. Actual data says that Covid patients in ICU take up between 8% to 20ish% of admissions. COVID is not causing the curve to be need flattening. The medical system is. Maybe they shouldn't fire medical professionals who got immunity through COVID infection instead of the vaccine.

joshuamorton 5y ago
> Actual data says that Covid patients in ICU take up between 8% to 20ish% of admissions. Yes, and actual data says this is a problem, because we don't have the capacity to handle a sustained 15% increase in ICU use. That is simply not a thing we have the capacity to handle. > Maybe they shouldn't fire medical professionals who got immunity through COVID infection instead of the vaccine. The less than 1% of people who fall into this category are probably not the issue. 1% more nurses isn't going to address 15% more patients. > <a bunch of non quantitative opinion based unprovable emotional gish gallop stuff I didn't read.> You really should have, because none of it was "emotional" and most of it was quantitative, so this makes you look rather silly. Like c'mon, you've lied about how full hospitals are in California, when confronted on that you claim I'm "gish galloping" with emotional nonsense that's just true[0] factual content about how we handle and have handled hospital capacity and why your (completely conjectured!) conclusion was wrong. [0]: https://revcycleintelligence.com/news/40-hospitals-in-ny-forced-to-stop-elective-surgery-as-covid-19-surges https://revcycleintelligence.com/news/40-hospitals-in-ny-for...
- edmcnulty101 5y ago
  > we don't have the capacity to handle a sustained 15% increase in ICU use. 100 - 15 is 85. There's 85% left to handle it. Where is this 85% going and why is it less of a concern in flattening the curve? why is no one concerned about this 85% of non-covid ICU patients?? Seems to me covid is a small fraction of ICU cases. Seems to me maybe the ICU should work on handling its caseload.. Seems to me maybe there's systemic problems like the AMA limiting the number of health professionals to keep the salaries up and firing the ones who have natural immunity. Maybe that's why the curve can't get flattened. but one thing that is crystal clear from the data is that covid is not the primary cause of hospital overflow.
  - joshuamorton 5y ago
    > Where is this 85% going and why is it less of a concern in flattening the curve? The short answer would be "aging" and "accidents". And we already do huge amounts of research to lessen the impact of those things, but if you have any ideas, do let me know. It's less of a concern because it isn't really something we can change. We can't make people age less quickly, or have fewer accidents. And while we can (and did!) treat some of those things less, that has severe downsides in the long term. > Seems to me covid is a small fraction of ICU cases. No, it's a 20% bump in what the system is meant to handle. Systems don't generally do well when asked to sustain 20% more of what they were doing, forever. > Seems to me maybe there's systemic problems like the AMA limiting the number of health professionals to keep the salaries up and firing the ones who have natural immunity. Can you explain why you keep bringing up nurses when we discuss ICU capacity? Last I checked, we didn't need to vaccinate beds.
    - edmcnulty101 5y ago
      how long have aging and accidents been around? since the dawn of the human race? and they still haven't figured out a way to handle the ICU load? you would think with all kinds of random unplanned disasters happening all over at any time ..like terrorist attacks or earthquakes or tornadoes... they would be able to increase capacity by 20% the problem is not covid patients, the problem is either a poorly planned system or news media sensationalism
      - joshuamorton 5y ago
        > ..like terrorist attacks or earthquakes or tornadoes... they would be able to increase capacity by 20% They can, for brief periods. You start by overflowing to nearby hospitals, you can't do that for covid though, because its global. So you try to drop non-urgent care, but they've already done that. You can't stop treating non-urgent care forever, it's only a temporary approach. So you're left with, well, reducing serious covid case rates. This can absolutely be done, by the way, with a combination of vaccination and varying masking policies as necessary. Because that's the only tool left after all of the others have been exhausted. > and they still haven't figured out a way to handle the ICU load? There is actually a really easy solution, it's just ethically terrible. You refuse (or triage last) unvaccinated covid patients. This solves most of the problems. It is however ethically unconscionable. > the problem is not covid patients, the problem is either a poorly planned system or news media sensationalism Yes, we all recognize that the global healthcare system is not able to handle a sustained 10-20% increase in demand. That doesn't make it "poorly planned" (are you willing to pay 20% extra in healthcare costs to cover the increased slack?)

joshuamorton 5y ago

> Actual data says that Covid patients in ICU take up between 8% to 20ish% of admissions. Yes, and actual data says this is a problem, because we don't have the capacity to handle a sustained 15% increase in ICU use. That is simply not a thing we have the capacity to handle. > Maybe they shouldn't fire medical professionals who got immunity through COVID infection instead of the vaccine. The less than 1% of people who fall into this category are probably not the issue. 1% more nurses isn't going to address 15% more patients. > <a bunch of non quantitative opinion based unprovable emotional gish gallop stuff I didn't read.> You really should have, because none of it was "emotional" and most of it was quantitative, so this makes you look rather silly. Like c'mon, you've lied about how full hospitals are in California, when confronted on that you claim I'm "gish galloping" with emotional nonsense that's just true[0] factual content about how we handle and have handled hospital capacity and why your (completely conjectured!) conclusion was wrong. [0]: https://revcycleintelligence.com/news/40-hospitals-in-ny-forced-to-stop-elective-surgery-as-covid-19-surges https://revcycleintelligence.com/news/40-hospitals-in-ny-for...

edmcnulty101 5y ago
> we don't have the capacity to handle a sustained 15% increase in ICU use. 100 - 15 is 85. There's 85% left to handle it. Where is this 85% going and why is it less of a concern in flattening the curve? why is no one concerned about this 85% of non-covid ICU patients?? Seems to me covid is a small fraction of ICU cases. Seems to me maybe the ICU should work on handling its caseload.. Seems to me maybe there's systemic problems like the AMA limiting the number of health professionals to keep the salaries up and firing the ones who have natural immunity. Maybe that's why the curve can't get flattened. but one thing that is crystal clear from the data is that covid is not the primary cause of hospital overflow.
- joshuamorton 5y ago
  > Where is this 85% going and why is it less of a concern in flattening the curve? The short answer would be "aging" and "accidents". And we already do huge amounts of research to lessen the impact of those things, but if you have any ideas, do let me know. It's less of a concern because it isn't really something we can change. We can't make people age less quickly, or have fewer accidents. And while we can (and did!) treat some of those things less, that has severe downsides in the long term. > Seems to me covid is a small fraction of ICU cases. No, it's a 20% bump in what the system is meant to handle. Systems don't generally do well when asked to sustain 20% more of what they were doing, forever. > Seems to me maybe there's systemic problems like the AMA limiting the number of health professionals to keep the salaries up and firing the ones who have natural immunity. Can you explain why you keep bringing up nurses when we discuss ICU capacity? Last I checked, we didn't need to vaccinate beds.
  - edmcnulty101 5y ago
    how long have aging and accidents been around? since the dawn of the human race? and they still haven't figured out a way to handle the ICU load? you would think with all kinds of random unplanned disasters happening all over at any time ..like terrorist attacks or earthquakes or tornadoes... they would be able to increase capacity by 20% the problem is not covid patients, the problem is either a poorly planned system or news media sensationalism
    - joshuamorton 5y ago
      > ..like terrorist attacks or earthquakes or tornadoes... they would be able to increase capacity by 20% They can, for brief periods. You start by overflowing to nearby hospitals, you can't do that for covid though, because its global. So you try to drop non-urgent care, but they've already done that. You can't stop treating non-urgent care forever, it's only a temporary approach. So you're left with, well, reducing serious covid case rates. This can absolutely be done, by the way, with a combination of vaccination and varying masking policies as necessary. Because that's the only tool left after all of the others have been exhausted. > and they still haven't figured out a way to handle the ICU load? There is actually a really easy solution, it's just ethically terrible. You refuse (or triage last) unvaccinated covid patients. This solves most of the problems. It is however ethically unconscionable. > the problem is not covid patients, the problem is either a poorly planned system or news media sensationalism Yes, we all recognize that the global healthcare system is not able to handle a sustained 10-20% increase in demand. That doesn't make it "poorly planned" (are you willing to pay 20% extra in healthcare costs to cover the increased slack?)