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Interview with German Ventilator Manufacturer

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Re: Interview with German Ventilator Manufacturer

#171

Post by luckylion »

Zenst wrote: post #150
luckylion wrote: post #83

Earlier quoted context omitted.

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…

Cause and effect, it will settle down in week or two and those who overstocked won't be buying more and those who are responsible and now short due to the hoarders of panic are slowly getting back to normal. But certainly an insight into the culture and humanity of some people. Alas we have a society that seems to always see good responsible people suffer at the hands of the irresponsible.

I believe that the important lesson is that when government steps back, people will resort to ingrained behaviors, and "stock up when a crisis begins" is one of those. The wrong answer to that is to limit the amount anyone can buy, because you're just increasing the crisis-feel. The right answer is to make sure that people calm down, and the easiest way to do that is to demonstrate that the supply of goods is not affected. You do that by adding a fleet of trucks to transport goods to super markets and add a temporary night shift to re-stock shelves. If people see that there is no shortage, they will calm down.

The opposite is happening, you have (local, temporary) shortages and some politician who hasn't bought their own groceries in the last decade says "I assure you, there are no shortages", while everybody sees the empty shelves on a daily basis.

Re: Interview with German Ventilator Manufacturer

#172

Post by cycomanic »

thu2111 wrote: post #165
seanmcdirmid wrote: post #164

Earlier quoted context omitted.

Inflation and population growth will force spending increases no matter what, and if the increases don’t track with those two variables, then service will obviously have to decline. Doctor and nursing salaries are pretty low in the UK, if management is diverting capital expense money to salary increases, they are doing a poor job of it.

Talk of cuts is a lie no matter how it's sliced. https://fullfact.org/health/spending-english-nhs/ "Looking at the wider UK, the amount spent on health has been increasing over the long-term. That’s true whether it’s expressed in cash, cash adjusted for inflation, per person, or as a proportion of the size of the economy." Population growth puts pressure on public services. The British people have been asking for red…

That's some selective (mis-)quoting. First the fullfact reference you give directly stated in 2013 there was a predicted funding gap of 30 billion pound by 2020. The conservative government gave them 10 and said you need to find 20 billion in cuts. That is an effective cut.

Health costs have been rising everywhere in the world and this has little to do with population growth (that's actually good because young people pay taxes), but more with rising life expectancies and the resulting average age. Every country has been experiencing the same trend (the US being an exception likely because of privatized healthcare): https://en.wikipedia.org/wiki/Healthcare_in_Germany and those country have pretty different population developments.

Also you are comparing a Facharzt salary to a consultant, that's not a fair comparison. You should compare to a specialist and look what do they earn in the UK? £40,037 to £74,661. https://www.healthcareers.nhs.uk/explore-roles/doctors/pay-d...

That looks awfully similar to what a Facharzt earns (actually with the current rates the German earns significantly more more): 70.000 – 95.000 Euro https://www.praktischarzt.de/arzt/gehalt-arzt/

Re: Interview with German Ventilator Manufacturer

#173

Post by avaika »

dominotw wrote: post #132
dalai wrote: post #128

Earlier quoted context omitted.

The number of beds per capita is one thing, how many are free or can be freed in the next few days/weeks is another. At least in Germany it was reported that a lot of them were in use and less than half were available for coronavirus patients.

> in Germany it was reported that a lot of them were in use Why would this be unique to germany. Can we just assume this is more or less identical everywhere?

We can't. It's not just a number of beds. It's also how long people stay there (which really depends on healthcare system). E.g. in countries with poor healthcare level people tend to stay in bed longer than in countries with good healthcare. Plus the average "normal" level of ICU occupation might be different (e.g. one country has 70% threshold, while another one 40%).

Re: Interview with German Ventilator Manufacturer

#174

Post by Zenst »

luckylion wrote: post #171
Zenst wrote: post #150

Earlier quoted context omitted.

Cause and effect, it will settle down in week or two and those who overstocked won't be buying more and those who are responsible and now short due to the hoarders of panic are slowly getting back to normal. But certainly an insight into the culture and humanity of some people. Alas we have a society that seems to always see good responsible people suffer at the hands of the irresponsible.

I believe that the important lesson is that when government steps back, people will resort to ingrained behaviors, and "stock up when a crisis begins" is one of those. The wrong answer to that is to limit the amount anyone can buy, because you're just increasing the crisis-feel. The right answer is to make sure that people calm down, and the easiest way to do that is to demonstrate that the supply of goods is not aff…

Bit like the ban effect, like many a record seen sales increase down to the aspect that some radio or other avenue deemed to ban the record.

Equally, once many heard news of something was being brought up, the net effect was to drive others into panic and drive them to do the same.

Panic begats panic. So you start to enter into the aspect of https://en.wikipedia.org/wiki/Crowd_psychology

Re: Interview with German Ventilator Manufacturer

#175

Post by lazyjones »

cycomanic wrote: post #137
lazyjones wrote: post #94

Earlier quoted context omitted.

> he 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]. The UK has done around 110k tests, Germany more than 400k. Don't confuse positive test results with actual infections. If the UK tested more, it'd very likely have more "cases".

But the testing is somewhat part of the picture. Germany is now testing 400k a week (I think that is what your number is referring to). Again that is a reflection of the German healthcare system. Another poster mentioned the decentralised nature of the German system, that has been mentioned as one of the reasons why Germany was able to test so much.

> Germany is now testing 400k a week (I think that is what your number is referring to).&

It's over 400k total as of March 23rd and 100k in the week of 20th. https://www.zeit.de/wissen/gesundheit/2020-03/coronatests-de...

> Another poster mentioned the decentralised nature of the German system, that has been mentioned as one of the reasons why Germany was able to test so much.*

Seems to be, but that makes Austria's excuses look a bit poor. Here they have a similar decentralised system, but they're claiming that they don't get enough test kits on the market and that's why they're now testing 3k-5k a day despite having lab capacities >15k/day. If Germany can get them, Austria can, too - money shouldn't be an issue.

Re: Interview with German Ventilator Manufacturer

#176

Post by ggeorgovassilis »

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…

Two reasons: Germany's much higher per capita income than England and it's federal structure. I won't comment on the first claim, it's self-evident. Germany is a federation of states: each state needs to provide adequate healthcare; states can't absorb spikes by distributing excessive patients to other states' hospitals (unless in a crisis) so they must over-provision infrastructure.

Re: Interview with German Ventilator Manufacturer

#177

Post by thu2111 »

cycomanic wrote: post #172
thu2111 wrote: post #165

Earlier quoted context omitted.

Talk of cuts is a lie no matter how it's sliced. https://fullfact.org/health/spending-english-nhs/ "Looking at the wider UK, the amount spent on health has been increasing over the long-term. That’s true whether it’s expressed in cash, cash adjusted for inflation, per person, or as a proportion of the size of the economy." Population growth puts pressure on public services. The British people have been asking for red…

That's some selective (mis-)quoting. First the fullfact reference you give directly stated in 2013 there was a predicted funding gap of 30 billion pound by 2020. The conservative government gave them 10 and said you need to find 20 billion in cuts. That is an effective cut. Health costs have been rising everywhere in the world and this has little to do with population growth (that's actually good because young people…

there was a predicted funding gap of 30 billion pound by 2020 ... That is an effective cut.

Please, just stop this. Departments asking for more money than they know they'll be allowed and then getting less is a universal truth of organisations, both governmental and corporate. It's called negotiation. Being given more money than you had before is not, and never will be, a "cut" in the English language. That word has a precise meaning and it simply doesn't apply here.

Likewise the NHS wasn't asked to find 20 billion in "cuts". That doesn't even make sense. You can't increase your own budget by reducing it. They were told that if they really needed that much they would be expected to find it through increased efficiency. Keeping a check on NHS waste is a key function of elected governments which voters expect them to fulfil, simply writing them blank cheques has been tried before and didn't work (as in costs went up, but healthcare outcomes didn't or didn't by anywhere near as much).

Health costs have been rising everywhere ... more with rising life expectancies and the resulting average age

And the NHS budget has been rising too.

Also you are comparing a Facharzt salary to a consultant, that's not a fair comparison

Alright, fair enough, then focus on the original statement - doctors and nurses get anywhere between good and extraordinarily good pay relative to the average salary in the UK. There are doctors in the UK earning significantly more than the Prime Minister, and their pay went up significantly during the last Labour government (not sure about this one, didn't look, but I assume pay inflation has been only slightly lower).

The point is that significant amounts of the money given to the NHS ended up being spent on increased OpEx like salary increases, rather than CapEx like capacity increases or efficiency improvements. Obviously the NHS must raise salaries at least in line with inflation, and really more in line with global healthcare inflation to avoid brain drains. But the idea its hospitals are run down because evil central government keeps cutting its budget is just far wrong.

Re: Interview with German Ventilator Manufacturer

#178

Post by ggeorgovassilis »

amylene wrote: post #162
ajuc wrote: post #115

Earlier quoted context omitted.

If you ever drove a German car after driving a British car you'll understand :) The standards for "it's good enough" are vastly different in these countries.

Why do you believe that vehicle quality is related to anything else? This seems like halo effect bias.

The quality of a complex product is indicative of the available quality of supply chain and skill.

Re: Interview with German Ventilator Manufacturer

#179

Post by Gravityloss »

ben_w wrote: post #73
Gravityloss wrote: post #5

Earlier quoted context omitted.

Yes. Or things like oxygen. There are so much more things than ventilators that are much easier to scale.

Making oxygen is easy. I’m sure half the people on this site can fill a soda bottle with pure oxygen using a machine hacked together from just things found in an average kitchen. Industrial scale production, transport, making sure it doesn’t set everything on fire, and supplying a medically appropriate quality without risking hyperoxia? That’s hard.

At least there is industrial oxygen production that could be repurposed.

Also oxygen enrichers could be made and distributed, they could also help some people. I know of a person who made one themselves in a week. Both should be a lot easier than ventilators (which of course also should be pursued).

If you read the reports from Italy, they first ran out of ventilators, then CPAP machines and finally even oxygen.

But for some reason the talk is very concentrated on ventilators for now.

Also other equipment saves lives. Pulse oximeters so those needing help breathing can be identified. Protective equipment. A lot of things that save lives and are a thousand times easier to make than ventilators.

Re: Interview with German Ventilator Manufacturer

#180

Post by raverbashing »

hef19898 wrote: post #88
raverbashing wrote: post #18

Earlier quoted context omitted.

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 wo…

Yeah speaking of that: https://www.dw.com/en/coronavirus-netherlands-recalls-defect...
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