Interview with German Ventilator Manufacturer • Hacker News Board

Re: Interview with German Ventilator Manufacturer

#81

Post by rkangel » Sat, Mar 28, 2020, 12:59 PM UTC

thu2111 wrote: post #78

nicoburns wrote: post #58

Earlier quoted context omitted.

Note that the UK spends a lot less (per capita) on healthcare than Germany: (£2,989 vs £4,432 in 2017), and that funding for healthcare has generally be considered to be insufficient over at least the last 10 years in the UK, leading to cuts in service. This may account for at least some of the difference. Source: https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

Insufficient by what measure? You're comparing against - it appears - the second highest spender in the world. There have been no cuts in NHS service. Sometimes I think I need to assign this to a keyboard macro because it's such a frequently repeated myth. The NHS has more funding now than it's ever had, it has been explicitly protected from budget reductions when every other government department has seen massive re…

NHS spending has not dropped, but it has not grown at the appropriate rate. There are various discussions that we could have about nursing numbers and junior doctor hours, but instead I'd like to provide one hard data point:

Addenbrookes Hospital in Cambridge (technically Addenbrookes Hospital Trust, comprised of several hospitals on one site) is the largest hospital in the UK. For the tax year 2019/2020, the available budget for capital expenditure (building, large equipment like MRIs etc.) was £0. (accurate prior to Covid-19)

Occasionally as a result of political manoeuvering (General Election campaigning) pots of money for very narrow purposes with a limited time window on them appeared, but in general things like ward refurbishments have been funded by charitable donations. Most worthwhile capital investments take more than a year, so a predictable capital budget is necessary to implement programs. Having no money for CapEx is not how you maintain a health service long term.

Re: Interview with German Ventilator Manufacturer

#82

Post by adwn » Sat, Mar 28, 2020, 1:00 PM UTC

ReptileMan wrote: post #50

peteretep wrote: post #45

Earlier quoted context omitted.

I’ve wondered about this for a little while. Why does Germany have five times as many ICU beds than England? Until now, I’ve never heard a suggestion that England had fewer ICU beds than it needed generally, and assuming England and Germany use beds at the same general capacity, why on earth is Germany running five times more beds that it generally needs? (please don’t answer “for a case like this” unless you have so…

Not saying a case like this, but don't forget that West and East Germany were supposed by the strategists to be main battlefield in eventual non nuclear WWIII ...

That is a long time ago, 30 year now. Neither the attitude nor the infrastructure from that era are still in place.

Re: Interview with German Ventilator Manufacturer

#83

Post by luckylion » Sat, Mar 28, 2020, 1:01 PM UTC

dgellow wrote: post #76

luckylion wrote: post #61

Earlier quoted context omitted.

I'm not so sure. We have an ongoing toilet paper crisis that is in it's third week now and the government is unable or unwilling to do anything about it, despite ensuring everyone that there's plenty of toilet paper somewhere in some storage of some company. If a somewhat trivial problem like coordinating a few trucks is beyond their ability, I have no hope for coordinating planes and import/export. You might say "bu…

Where do you have a toilet paper crisis? In north Germany at least shelves are refilled all the time. I’m back from groceries, Edeka, Lidl, and Rewe had all their shelves full.

Friends from Berlin tell me they still have empty shelves, so do the super markets in (western) Hamburg. They get refilled every few days early in the morning and are empty an hour or two later, only to sit empty for another day or two.

It's gotten so bad where I live that Aldi has apparently decided to just give up and use the space for potting soil.

The pasta shelves are re-stocked though, as is bread. Berlin isn't quite there yet.

Re: Interview with German Ventilator Manufacturer

#84

Post by KingOfCoders » Sat, Mar 28, 2020, 1:02 PM UTC

tyingq wrote: post #52

peteretep wrote: post #45

Earlier quoted context omitted.

I’ve wondered about this for a little while. Why does Germany have five times as many ICU beds than England? Until now, I’ve never heard a suggestion that England had fewer ICU beds than it needed generally, and assuming England and Germany use beds at the same general capacity, why on earth is Germany running five times more beds that it generally needs? (please don’t answer “for a case like this” unless you have so…

That doesn't surprise me culturally. I lived in Germany for a couple of years, and the deference to "rules that matter" was completely different than my US experience. Even for trivial stuff like waiting in line/queues. The Germans were much more literal in following the rules, versus my US and UK peers.

Which funnily contradicts my experience as a German in the US (interesting how cultural perception differs). I've been told in very harsh words to go in line in the US several times, once in a line for the IKEA ferry to Manhattan where I was threatened to be left behind if I do not go to the back of the line. Once in the Metropolitan museum in NYC when I skipped the ropes of an empty queue and was told to go back and follow the route through the zigzag ropes although noone was there.

Another anecdote, whenever I wanted something "unusual" I was denied, and the person "in charge" needed to ask a supervisor. E.g. in an (upscale) hotel I wanted to see a different room for my next stay, took some time to ask different supervisors but in the end it was "impossible". In Germany the person at the reception desk would decide if this is possible or not and most like show me a room.

(Yes all anecdotal and colored by my cultural perception).

Re: Interview with German Ventilator Manufacturer

#85

Post by mkl » Sat, Mar 28, 2020, 1:05 PM UTC

dr_dshiv wrote: post #24

jsilence wrote: post #7

Home made masks are not as good as professional masks, but they have some efficiency (> 70%). https://www.researchgate.net/publication/258525804_Testing_t...

Way better. Two dishtowels equals n95: https://smartairfilters.com/en/blog/best-materials-make-diy-...

Except they're very hard to breath through. I also wonder what kind of dish towels, exactly, since I have different towels with very different permeability.

Re: Interview with German Ventilator Manufacturer

#86

Post by tyingq » Sat, Mar 28, 2020, 1:06 PM UTC

KingOfCoders wrote: post #84

tyingq wrote: post #52

Earlier quoted context omitted.

That doesn't surprise me culturally. I lived in Germany for a couple of years, and the deference to "rules that matter" was completely different than my US experience. Even for trivial stuff like waiting in line/queues. The Germans were much more literal in following the rules, versus my US and UK peers.

Which funnily contradicts my experience as a German in the US (interesting how cultural perception differs). I've been told in very harsh words to go in line in the US several times, once in a line for the IKEA ferry to Manhattan where I was threatened to be left behind if I do not go to the back of the line. Once in the Metropolitan museum in NYC when I skipped the ropes of an empty queue and was told to go back and…

Your frustration with US rules, to me, only emphasizes my point. You want the rules to work. Versus the US born/bred idea that they never will. Flippant, I know, but that's my observation.

It's also completly possibile that you're an outlier German that is frustrated with the current rules. For sure, I've seen that in spades. it isn't the mainstream though.

Re: Interview with German Ventilator Manufacturer

#87

Post by freeflight » Sat, Mar 28, 2020, 1:09 PM UTC

peteretep wrote: post #45

sabertoothed wrote: post #41

Some key statements: "Dräger: In Europe, the number of intensive-care beds per capita is very unequally distributed. In Italy, it is three times lower than here. In England, five times lower. The challenge in England will be greater than in Spain. And the situation in the U.S. is very alarming. The reporting system there is also underdeveloped."

I’ve wondered about this for a little while. Why does Germany have five times as many ICU beds than England? Until now, I’ve never heard a suggestion that England had fewer ICU beds than it needed generally, and assuming England and Germany use beds at the same general capacity, why on earth is Germany running five times more beds that it generally needs? (please don’t answer “for a case like this” unless you have so…

> why on earth is Germany running five times more beds that it generally needs?

I feel like that question is asked the wrong way around because you are assuming England has "exactly enough", that's how you end up with Germany supposedly "running five times more beds than it needs".

But there's good reason to believe England has not enough ICU beds, even outside of a pandemic, the result of years of austerity cuts to the NHS [0].

There's also the fact that Germany is a healthcare powerhouse. Often forgotten among all the "cars and engineering" exports, but pharma and vaccines are the other two German top exports [1]

These are fields you can only really innovate in if you have a matching clinical and medical infrastructure behind it, which Germany has.

It's this combination that allows Germany to have such low fatality rates [2]. To put them in numbers: The UK right now sits at 11 deaths per 1m population, Germany at 5, and that's with Germany having tens of thousands of more cases [3].

[0] https://www.theguardian.com/politics/2019/jun/01/perfect-sto...

[1] https://oec.world/en/profile/country/deu/

[2] https://apnews.com/ad9a6af47c3b55fd83080c9168afaaf4

[3] https://www.worldometers.info/coronavirus/#countries

Re: Interview with German Ventilator Manufacturer

#88

Post by hef19898 » Sat, Mar 28, 2020, 1:11 PM UTC

raverbashing wrote: post #18

hef19898 wrote: post #3

Earlier quoted context omitted.

The main problem I see regarding masks is, besides price, distribution. Now that Chinese manufacturers are running again, they are producing 24/7. Sure prices are way higher than before. But the masks are there. Problem is, Chinese suppliers sell FOB, meaning export cleared delivered to a (air)port terminal in China. Customers in Germany want to buy DDP (import cleared and delivered a specified location in Germany).…

What do you mean product liability? Delivery liability or faults? Ideally you would import it from a vetted manufacturer I don't think anything but FOB is common, except in specific cases.

The importer is considered to be the manufacturer in case something bad happens, caused by the product. Meaning, worst case,you import a mask. It fails. Patients in the practice you supplied the mask to get infected and some die. Now we are talking tens of millions.

I asked the Allianz and Munich Re (the insurers insurer). Both declined to insure that at the moment.

Which sucks. Because the gap between FOB and DDP would otherwise just be logistics. Ignoring prices, that is rather easy to solve. I try to get hold of someone at the armed forces department charged with that. Hopefully it leads somewhere.

EDIT: Product liability is th problem. Transport insurance is easy to obtain and no problem.

Re: Interview with German Ventilator Manufacturer

#89

Post by [deleted] » Sat, Mar 28, 2020, 1:11 PM UTC

tyingq wrote: post #52

peteretep wrote: post #45

Earlier quoted context omitted.

I’ve wondered about this for a little while. Why does Germany have five times as many ICU beds than England? Until now, I’ve never heard a suggestion that England had fewer ICU beds than it needed generally, and assuming England and Germany use beds at the same general capacity, why on earth is Germany running five times more beds that it generally needs? (please don’t answer “for a case like this” unless you have so…

That doesn't surprise me culturally. I lived in Germany for a couple of years, and the deference to "rules that matter" was completely different than my US experience. Even for trivial stuff like waiting in line/queues. The Germans were much more literal in following the rules, versus my US and UK peers.

[deleted]

Re: Interview with German Ventilator Manufacturer

#90

Post by hardlianotion » Sat, Mar 28, 2020, 1:12 PM UTC

mrfusion wrote: post #75

dillonmckay wrote: post #21

Earlier quoted context omitted.

My concern is the rush to acquire PPE, rules be damned, a decent amount of counterfeit masks will make it into circulation, and will provide a false sense of security.

I bet someone could develop a simple mask test everyone could even do at home. (Let’s present solutions, HN. Don’t just tell people things won’t work.)

I think this is done in Czech Republic at scale.