121–130 of 355 posts
https://jamanetwork.com/journals/JAMA/articlepdf/403323/jama...
(or course, it didn't need to be sterile because unlike modern positive pressure ventilators, the air it pumped didn't go inside the patient).
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They acknowledge the New York Times at the end of the article. Perhaps they licensed the content. I don't think that anybody aside from legal staff at the New York Times can determine if anybody was fully ripped off. If you have concerns about copyright and want to do something about it, you could report the issue. I assume that the New York Times is fully capable of hunting down violations without any help. The site…
Normally I use less emphatic language. However, I looked at the submission history for the site. Of 11 articles posted to HN, every one was a copy. They've copied from NYT, bgr.com, Polygon, FT, and Fast Company. That's a lot of "licensing". True, they were nice enough to link to the originals, but for some reason the vast majority of blogspam sites do that. Only the very bottomest of the barrel do not. I assume ther…
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Ask any doc if they want 4th year medical students to help in the ICU with COVID-19 patients and they will say “No, they would most likely be a hindrance rather than help”. If a 4th year medical student can’t help, then why do you suppose somebody with zero training would?
I'm not saying "zero training". I'm suggesting the minimum training necessary to run a ventilator. That way doctors or nurses could simply hand off care to ventilator-operators who could contact the doctor or nurses if things got out of control. This wouldn't be as high quality care as people would usually get, but hopefully it would be better than nothing. Regarding whether doctors would want undertrained help - tha…
Getting nurses, doctors from other specialties, or even medical students through an intensive training is one thing, and I suspect it's actually a good idea. These are people who have (or, in the case of students, are at least likely to have) the knowledge required not just to learn how to operate a piece of machinery, but also to understand when they're in over their heads, when to ask for help, and to understand the magnitude of what they're doing.
But IMHO -- also based on my experience in other potentially dangerous fields -- putting people with zero medical education except for a thirty-day training in charge of observing people in a life-or-death situation is a really bad idea. Under-educated, even if well-trained assistance has a very high potential of making things worse, not better -- worse than doing nothing at all, that is.
Running a ventilator as in pushing the right buttons is something you can learn to do just by reading the manual. I can obviously operate every medical device I've worked on. I've obviously had more than 30 days of exposure to them. And nonetheless, I think the chances of getting someone killed by operating them are extremely high. I am also 100% convinced that they are much higher than the chances of someone who's had some medical education doing the same thing, even if they've never seen that machine and have never read the manual. What doctors and nurses do with the things I've built is way above my level of understanding.
I can't speak for medical students but I can guarantee that, if you let 30 final-year engineering students walk around a power plant without constant supervision, one of them will get themselves killed by the end of the day. And that's after three years of education. 30 days shouldn't even get you past the lobby.
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> The issue in some sense isn't government, it's the corruption of government Ok, so how do we keep the government from being corrupted? Nobody has yet solved that problem, and people have been trying for centuries. > Control for monetary expansion, and the US Government's portion of the economy has been steadily shrinking. The money supply is not the same as the economy. Government spending as a percentage of GDP, w…
Well the first thing you do is ban professional politicians and lobbying.
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You answered your own question in the last sentence.
Is it though? Can't you train people on the basics of a single device as a sort of Tier-1 support with the ability to escalate to Tier-2 immediately? Governor Cuomo said in at least one briefing that they were considering training national guard troops to do exactly that.
Those are a lot simpler and safer than a mechanical ventilator, which requires intubation or a tracheostomy, which you might say is highly invasive of the respiratory abstraction layer, and can cause correspondingly subtle and messy failures.
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Most Covid patients die on respirators anyway, can a nurse do 90% of the job ("good enough") and ask a doc if the rest is needed? The other option is worse and I doubt USA can afford to have docs sitting for decades waiting for another Covid like scenario. Remember these ventilators will be produced and go in storage to wait...
The numbers from Wuhan were something like 30% fatalities for those moved to ventilation. That doesn't detract from your point but does support why the path "make a ton of ventilators" is being persued.
I find it strange that all we hear about these days is the shortage of ventilators (okay, PPE too), as if it’s the only bottleneck. The reality is ventilators are useless without intensivists to operate them, and you need anesthesiologists and probably other skilled personnel too. I learned through a personal connection who was actually on the ground in Hubei (but not Wuhan) caring for serious but non-ICU patients th…
From what I’m reading the treatment of COVID19 seems to require a pretty narrow set of practices. Mostly around monitoring, administering of medication, ventilation / oxygen and general bedside care. If this is true can we not cross train adjacent areas like EMT, army medics etc fairly quickly to provide care? They don’t even need to perform diagnostics.
I always criticized the idea that “radical technology could exist but the competition buys it up” as a naive conspiracy theory. It’s pretty remarkable that the government paid for this but somehow the international medical corporation can swoop in, buy the competitor who is threatening their margins, and void the contract.
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But the government agreed to cancel the contract at the big company's request. I don't see how the deliverable being the design instead of the ventilator itself would have changed that.
Agreement to cancel could be made conditional upon publishing the design and releasing it into the public domain. If the big company detests that idea, well, they don't get out of the original contract.
It probably could have been (that would depend on the details of the terms of the original contract), but it wasn't.
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> If the government had done it in house they could have succeeded. Ok, so how do we get the government to do it in house, and stick to it long enough so that the stockpile is there when the next disease crisis happens, which might not be for another 10 years? That's five Congressional elections and at least two changes of Presidential administration.
Party politics is a separate shit show. It should be an elected council with no single representation. That would allow smaller, manageable policy changes rather than burn the entire universe every few years.
Ok, so your plan for solving the ventilator issue is to change the entire system of government. Good luck with that.