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GM’s CEO Offers to Make Ventilators in WWII-Style Mobilization

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Re: GM’s CEO Offers to Make Ventilators in WWII-Style Mobilization

#481

Earlier quoted context omitted.

I don't know how to operate a ventilator, and have zero medical training, but I'm getting frustrated by the comments claiming medicine is trivially easy. Even using a syringe or blood draw on a patient is something one needs certification to do properly. That isn't bureaucratic nonsense. Having worked with syringes and sterile technique, there are so many ways you can give your patient an infection or otherwise cause…

I am getting frustrated by the comments that miss the big picture. There are likely going to be lots of people that are going to die without ventilator. Now, who with any common sense and decency[1] cares if 30% of them are dying because the device was not used properly/broke/whatever if the only other available option is that 100% of them die? [1] Sigh... I know, I know. American lawyers and legal system.

In your example, a 30% mortality rate is a very big deal. If we had a hypothetical cure that killed 30% of the people it was administered to, I doubt it would get very far.

I'm not saying the alternative is do nothing. But playing doctor because you think that you're reasonably qualified to administer a ventilator, then we're going to end up with, say 30% mortality rates from patients whose lungs were sucked through a ventilator tube because you guessed the wrong pressure. Or, more realistically, a terrible infection because you decided soap and water in the bathroom sink would be sufficient to clean the apparatus.

And then what do you suppose will happen after 30% of these amateur medical procedures go South? Are you going to throw in the towel, try something even more reckless, or decide that you need to get an actual doctor involved to clean up your mess? At which point, you've just added yet another case to the already overburdened medical system. And at a 30% failure rate, that would become a major burden.

There's a lot of room for action between doing nothing and acting foolishly (such as claiming a 30% mortality rate for botched medical procedures is a rational tradeoff). There are ways to help the situation here that don't involve magically becoming a nurse overnight.

Re: GM’s CEO Offers to Make Ventilators in WWII-Style Mobilization

#482
post #134

I still can't believe that most large companies were not offering everything they could several weeks ago. All Army/Navy/Air Force medical personnel should already be deployed to the field with makeshift drive-in testing spots. The Army is good at creating controlled zones. They can direct traffic while someone takes a swab. All other military personnel should be working with hospitals to do 'anything non-medically r…

The military is legally prohibited from operating on US soil (kind of something the framers didn't feel comfortable with). Perhaps you mean the National Guard, which is controlled by the governor of each state?

Re: GM’s CEO Offers to Make Ventilators in WWII-Style Mobilization

#483

Earlier quoted context omitted.

> A commercialized health care system also has absolutely no incentive to keep excess capacity for emergencies. I disagree, I'd say it's the opposite. A commercial system can value surge capacity for peaks just like an online retailer does; the capacity to handle extra load means extra profit. Whereas in a public health systems like the UK NHS everything is geared towards routine operational targets such as A&E waiti…

Private providers are not immune to oversights and waste.

Atleast they get punished for it, unlike public systems which might get punished once every 20 election cycles.

Re: GM’s CEO Offers to Make Ventilators in WWII-Style Mobilization

#484
post #209

Yeah, I'm personally not too concerned with the "stuff" end of things. This is America; in spite of rhetoric to the contrary, we remain a manufacturing powerhouse. Apply enough money and we'll get whatever "stuff" we need on pretty short order. I think the big problem is medical technicians and doctors. My feeling is that we should be focusing on training up medical people on a massive scale, as that's something that…

No this isn't true. The competition to get any residency slot is insanely difficult. There are people who graduate from medical school that apply to hundreds of residencies every year and still don't get anything.

Re: GM’s CEO Offers to Make Ventilators in WWII-Style Mobilization

#485
post #262
post #239

Earlier quoted context omitted.

Yeah, remove the limiter, and how long does it take to make a doctor? I mean, sure, some people are saying that this thing is still gonna be here in four years (I am not a medical person, but that's what some of them say. something about the type of virus this is that will make a vaccine difficult) so that might not be a bad idea, but... I think we probably need to be focusing on how we can increase medical capacity…

It's easy if we are willing to cut red tape and willing to prioritize people over pets. Veterinarians need almost no training to do the job. Test runs done for emergency preparation have proven that veterinarians do a better job than all medical professionals who aren't already specialized in respiratory care.

>Test runs done for emergency preparation have proven that veterinarians do a better job than all medical professionals who aren't already specialized in respiratory care.

That's amazing.

Re: GM’s CEO Offers to Make Ventilators in WWII-Style Mobilization

#486
post #158

Earlier quoted context omitted.

> That being said, auto manufacturers likely have no experience manufacturing these devices. The don't know which optimizations will be dangerous. They may not recognize they are doing anything different from an experienced manufacturer. Given that this is a crisis, the existing ventilator manufactures need to send over a couple experienced ventilator engineers to help.

And open source all their blueprints, schematics and software. Getting a supply chain for parts up and running is going to be the tricky part.

Producing safe medical devices is about more than just schematics. It is a social process with people having a huge impact on how safe the result is. All the blueprints in the world have no value if you don’t know whether they’ve been followed and the materials used are correct. And when there are defects you need to have socialized how people are to respond to those defects or your not building a competent organization. I see many comments about blueprints on here that miss the point. It’s like saying your software product is just the source code. The reality is that you have to build a competent knowledgeable organization around those blueprints or what you’re making will kill or injure patients.

Re: GM’s CEO Offers to Make Ventilators in WWII-Style Mobilization

#487
post #222

Earlier quoted context omitted.

I was going to say: surely the US military maintains a manufacturing core? I’m a metal fabricator by trade, and one thing you quickly notice is: with a machine shop and a fabrication shop you are tooled up to build the machines to manufacture almost anything.

Folks, military physician here, operating at the national level on the analysis that informs these projects. The recent post on HN about the MIT $100 ventilator is one of the things that got this rolling. Manufacturing is spinning up. What I really need is developers on this project: https://github.com/joshua-s/coronavirus-diary

There are a lot of software projects spinning up -- how do we know that this one is going to see active use?

As an example for my concern -- I've had a consistently-updated pull-request[1] outstanding for the JHU data repository for more than a week. It is their prerogative not to pull, but it means my contribution is largely wasted.

The coronavirus-diary project has one contributor, no issues, and no pull requests.

[1]https://github.com/CSSEGISandData/COVID-19/pull/296

Re: GM’s CEO Offers to Make Ventilators in WWII-Style Mobilization

#488
post #220

Earlier quoted context omitted.

A commercialized health care system also has absolutely no incentive to keep excess capacity for emergencies. It seems to be very good at finding the optimal efficiency point, which essentially is very close to "no unused resources in the nimal situation". But societal resiliency requires that health care, utilities, food supply, etc, has some excess capacity just because at some point something will happen. A public…

> A commercialized health care system also has absolutely no incentive to keep excess capacity for emergencies. I disagree, I'd say it's the opposite. A commercial system can value surge capacity for peaks just like an online retailer does; the capacity to handle extra load means extra profit. Whereas in a public health systems like the UK NHS everything is geared towards routine operational targets such as A&E waiti…

>A commercial system can value surge capacity for peaks just like an online retailer does; the capacity to handle extra load means extra profit.

Sure it can, but that's obviously not the reality and spinning up extra servers is not the same as adding extra physical rooms and beds. This analogy doesn't make any sense.

>ncidentally the NHS has just identified an unintended reserve: a pool of nurses who have been sitting in nadministrative middle-management roles for years. They are being retrained and redeployed now, but it illustrates the lack of efficiency in the system. A private provider would not have 'wasted' nursing staff in those positions.

You're right. A private company would just fire the nurses instead.

Re: GM’s CEO Offers to Make Ventilators in WWII-Style Mobilization

#489

Quote from a recent Scott Manley episode seems appropriate: We choose to do these things not because they are easy, but because we asked ourselves "how hard could it be?"[0] I'm pondering how long would it take GM to modify their ERP systems to handle an entirely new business line. Never mind that... how long would it take them to define the requirements for the plan to determine the framework for the project to expl…

FWIW automanufacturers in China did this. So this isn't anything, or out of the realm of possibility (we do have more red tape in the US, i.e. see what happened w/ the Seattle Flu Study when people tried to be helpful).

I don't have any English source for this. But Boris Johnson requested the same in England, too.

Re: GM’s CEO Offers to Make Ventilators in WWII-Style Mobilization

#490
post #209

Yeah, I'm personally not too concerned with the "stuff" end of things. This is America; in spite of rhetoric to the contrary, we remain a manufacturing powerhouse. Apply enough money and we'll get whatever "stuff" we need on pretty short order. I think the big problem is medical technicians and doctors. My feeling is that we should be focusing on training up medical people on a massive scale, as that's something that…

Just an idea (that would never happen)- Why not make it like Engineering? You do your 4 year undergrad and at your first job, no one trusts you. Your supervisor/senior engineer checks Everything you do. You are reserved for paperwork and unskilled manual labor which is also checked. After a few years (4) you get some Freedom, but still checked by your seniors. Anything important, even when you are a senior engineer g…

How do you think medical education works? Because it's basically exactly this.
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