3 ms·

> If you were put in charge, how would you formulate policy for managing a resource-constrained health system? I would delegate those decisions to healthcare s

> If you were put in charge, how would you formulate policy for managing a resource-constrained health system? I would delegate those decisions to healthcare subject matter experts. I'm not qualified to make those sorts of decisions. Neither are politicians, economists, or statisticians on their own. It is a big, complicated subject and just being generally clever isn't enough to qualify someone for that type of thing. > Have you seen the excess deaths data for Europe 2020-2022? I had not, and it's concerning. I don't think it automatically counts as proof that covid interventions did more harm than the disease though. For example, I've seen other papers that suggest excess deaths are actually proof that covid deaths were wildly underreported, especially early on. That and the paper you linked earlier are certainly enough to suggest we need more research to determine which interventions worked, and which didn't, with greater certainty. This won't be the last pandemic. I may fully read the book by the statistician you cited earlier. I think he touches on the subject of those excess deaths a bit.

logifail 3y ago
> I would delegate those decisions to healthcare subject matter experts. I'm not qualified to make those sorts of decisions. Neither are politicians, economists, or statisticians on their own. Like the UK NHS's NICE? "The UK’s National Institute for Health and Care Excellence (NICE) is responsible for conducting health technology assessment (HTA) on behalf of the National Health Service (NHS). In seeking to justify its recommendations to the NHS about which technologies to fund, NICE claims to adopt two complementary ethical frameworks, one procedural—accountability for reasonableness (AfR)—and one substantive—an ‘ethics of opportunity costs’ (EOC) that rests primarily on the notion of allocative efficiency."[0] "NICE’s use of ICERs, quality-adjusted life-years (QALYs) and the cost-effectiveness threshold as its preferred tools for decision-making, with some allowance for relevant social and ethical values, has been consistent since the institute’s inception"[0] and as Karol Sikora said: "QALY [is] not a perfect metric, but it’s the best we’ve got" "[NICE] guidelines are based on the best available evidence. Our recommendations are put together by experts, people using services, carers and the public"[1][2] Sounds not unlike what you suggested ... and yet they've consistently used 'value for money' measures such as QALY. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387327/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387327/ [1] https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/how-we-develop-nice-guidelines https://www.nice.org.uk/about/what-we-do/our-programmes/nice... [2] https://www.nice.org.uk/process/pmg20/chapter/introduction#who-is-involved https://www.nice.org.uk/process/pmg20/chapter/introduction#w...
- stevenAthompson 3y ago
  Systems like this are necessary primarily because these programs are given lower priority than other government spending. If I were in charge the queen would've been buried in a pine box, and the money wasted on her funeral would've gone towards life saving medical treatments. Any system that prioritizes anything above human health is fundamentally broken, and that's not the SME's fault. That said, the world is finite and tough decisions do still need to be made. In those cases I would defer to the SME's. If they still thought a system like the above was necessary after being fully funded I would accept that, despite it being distasteful to me.
t0bia_s 3y ago
About increased mortality in EU there are stats here: https://euromomo.eu https://euromomo.eu In winter 2023 triple more deaths in 15-44y than during winter 2020. Overall we have same deaths as during 2021. Elephant in room.
- stevenAthompson 3y ago
  This would seem to disprove the idea that COVID interventions caused the excess deaths, and support the idea that COVID was responsible. It also seems to indicate that COVID interventions were effective at preventing excess deaths. By winter of 23 most of us were done with COVID restrictions and back to operating as if COVID were a bad memory.
  - t0bia_s 3y ago
    Cause of deaths is not described. If vaccines works, why productive population still dies in high numbers during winters? Why elders are dying in same numbers?
    - mapontosevenths 3y ago
      Based only on this there is insufficient evidence to say for certain. My guess is that the end of most COVID countermeasures caused people to die in larger numbers, especially the unvaccinated.
      - t0bia_s 3y ago
        Covid is not threat for healthy 15-44y individuals. Do we have overcrowded hospitals full of people hooked to oxygen? Did you recently hear about unexpected deaths, rapid cancers, increased suicides or myocarditis among productive generation?
        stevenAthompson 3y ago
        Per the statistics cited above it doubled their risk of death. DOUBLED. I've also seen recent studies that indicated a serious drop in IQ, even among the otherwise young and healthy.[1] Both count as a serious threat to me. I am honestly not sure why you world disagree. [1] https://www.nejm.org/doi/full/10.1056/NEJMoa2311330 https://www.nejm.org/doi/full/10.1056/NEJMoa2311330

logifail 3y ago

> I would delegate those decisions to healthcare subject matter experts. I'm not qualified to make those sorts of decisions. Neither are politicians, economists, or statisticians on their own. Like the UK NHS's NICE? "The UK’s National Institute for Health and Care Excellence (NICE) is responsible for conducting health technology assessment (HTA) on behalf of the National Health Service (NHS). In seeking to justify its recommendations to the NHS about which technologies to fund, NICE claims to adopt two complementary ethical frameworks, one procedural—accountability for reasonableness (AfR)—and one substantive—an ‘ethics of opportunity costs’ (EOC) that rests primarily on the notion of allocative efficiency."[0] "NICE’s use of ICERs, quality-adjusted life-years (QALYs) and the cost-effectiveness threshold as its preferred tools for decision-making, with some allowance for relevant social and ethical values, has been consistent since the institute’s inception"[0] and as Karol Sikora said: "QALY [is] not a perfect metric, but it’s the best we’ve got" "[NICE] guidelines are based on the best available evidence. Our recommendations are put together by experts, people using services, carers and the public"[1][2] Sounds not unlike what you suggested ... and yet they've consistently used 'value for money' measures such as QALY. [0] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387327/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387327/ [1] https://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-guidelines/how-we-develop-nice-guidelines https://www.nice.org.uk/about/what-we-do/our-programmes/nice... [2] https://www.nice.org.uk/process/pmg20/chapter/introduction#who-is-involved https://www.nice.org.uk/process/pmg20/chapter/introduction#w...

stevenAthompson 3y ago
Systems like this are necessary primarily because these programs are given lower priority than other government spending. If I were in charge the queen would've been buried in a pine box, and the money wasted on her funeral would've gone towards life saving medical treatments. Any system that prioritizes anything above human health is fundamentally broken, and that's not the SME's fault. That said, the world is finite and tough decisions do still need to be made. In those cases I would defer to the SME's. If they still thought a system like the above was necessary after being fully funded I would accept that, despite it being distasteful to me.

t0bia_s 3y ago

About increased mortality in EU there are stats here: https://euromomo.eu https://euromomo.eu In winter 2023 triple more deaths in 15-44y than during winter 2020. Overall we have same deaths as during 2021. Elephant in room.

stevenAthompson 3y ago
This would seem to disprove the idea that COVID interventions caused the excess deaths, and support the idea that COVID was responsible. It also seems to indicate that COVID interventions were effective at preventing excess deaths. By winter of 23 most of us were done with COVID restrictions and back to operating as if COVID were a bad memory.
- t0bia_s 3y ago
  Cause of deaths is not described. If vaccines works, why productive population still dies in high numbers during winters? Why elders are dying in same numbers?
  - mapontosevenths 3y ago
    Based only on this there is insufficient evidence to say for certain. My guess is that the end of most COVID countermeasures caused people to die in larger numbers, especially the unvaccinated.
    - t0bia_s 3y ago
      Covid is not threat for healthy 15-44y individuals. Do we have overcrowded hospitals full of people hooked to oxygen? Did you recently hear about unexpected deaths, rapid cancers, increased suicides or myocarditis among productive generation?
      - stevenAthompson 3y ago
        Per the statistics cited above it doubled their risk of death. DOUBLED. I've also seen recent studies that indicated a serious drop in IQ, even among the otherwise young and healthy.[1] Both count as a serious threat to me. I am honestly not sure why you world disagree. [1] https://www.nejm.org/doi/full/10.1056/NEJMoa2311330 https://www.nejm.org/doi/full/10.1056/NEJMoa2311330