Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The U.S. tried to build a new fleet of ventilators

nytimes.com

Post reply on HN
Print view View original

251–260 of 355 posts

Re: The U.S. tried to build a new fleet of ventilators

#251

Post by mistermann »

omar_a1 wrote: post #207
ALittleLight wrote: post #205

Earlier quoted context omitted.

Earlier in this thread it's stipulated that the bottleneck is not the number of ventilators but the trained people to operate them. As such, training more operators is an obvious solution, and allowing the new operators to be substandard will mean we can get more operators faster. This pretty much dissolves your only real objection, that we'd be keeping a ventilator occupied that would otherwise be in use. Nope. The…

I'm sorry, I still haven't seen your empirical research and relevant credentials. So, to be clear, you can blindly assert that sending incompetent pseudo-medics to perform invasive procedures will be beneficial, and assert that claim with absolute certainty and zero evidence. But when I explain that, no, medicine is more complicated than you think, and back that up with concrete examples of how that is factually accu…

You are accusing him of saying things that he has clearly not said. And then on top of it, accuse him of having a problem with his imagination.

At the very least, this behavior seems disrespectful.

I encourage you to print off, on paper, your portions of this thread, and then draw lines between your claims of what he said, and the corresponding words he wrote. Then, compare the contents of the pairs.

After doing this, you can make a well informed judgement on whether you are treating your counterpart in a manner that is both fair and consistent with the HN guidelines.

Re: The U.S. tried to build a new fleet of ventilators

#252

Post by triangleman »

jacquesm wrote: post #233
joe_the_user wrote: post #225

Earlier quoted context omitted.

Life is not a movie, some stuff is just hard ... I think this sort of language is why a lot of non-professionals are sort-of balking. Life currently is like a movie. A zombie or some similar disaster movie, a situation where things are changing fast, where the normal plans are expected to fail. ...and requires a long time of training before we'll let you go 'solo'. One mistake and someone ends up dead, there are no d…

> Life currently is like a movie. A zombie or some similar disaster movie, a situation where things are changing fast, where the normal plans are expected to fail. No, because after a movie you get to go home, no matter how terrible it was. And in real life you don't get to go home. So you will have to trust in the people that have spent their lives preparing for stuff like this while we, the software smartasses were…

From what I have read the Italians have repurposed all kinds of doctors to be able to treat Covid patients as best they can with all available equipment. So I don't think it's too far out to say that in New York and other places you will see doctors stepping up and learning on the job in order to treat this disease. You will also see doctors coming into New York from other places to help.

Re: The U.S. tried to build a new fleet of ventilators

#253

Post by omar_a1 »

mistermann wrote: post #240
Kalium wrote: post #91

Earlier quoted context omitted.

I believe the point is that the minimum amount of training required to be of greater help than hindrance (i.e., net benefit) in an ICU and running ventilators is sufficiently high that it's not a small thing to spin up a cohort. To my exceptionally limited understanding - and I would love to be corrected if I'm wrong - operating a ventilator correctly is not a matter of standing in front of a machine and watching a f…

> I believe the point is that the minimum amount of training required to be of greater help than hindrance (i.e., net benefit) in an ICU and running ventilators is sufficiently high that it's not a small thing to spin up a cohort. Point of contention is what it seems like to me. There's certainly no shortage of people asserting that point, but what confuses me is, how does everyone know with such high certainty what…

Because it's common sense that an invasive medical procedure needs to be administered by someone with some semblance of competence in medicine, if you expect the patient to have a shot at not dying. An emergency doesn't change the hard technical requirement of administering ventilation.

Or rather, this should be common sense, but the over-inflated egos on HN don't understand that it takes more than knowing which button does what to operate a ventilator. Being able to hold a paint brush is a very different skill level than painting a portrait.

Re: The U.S. tried to build a new fleet of ventilators

#254

Post by jacquesm »

mistermann wrote: post #234
joe_the_user wrote: post #225

Earlier quoted context omitted.

Life is not a movie, some stuff is just hard ... I think this sort of language is why a lot of non-professionals are sort-of balking. Life currently is like a movie. A zombie or some similar disaster movie, a situation where things are changing fast, where the normal plans are expected to fail. ...and requires a long time of training before we'll let you go 'solo'. One mistake and someone ends up dead, there are no d…

> The only thing I hear is "this won't work" "but what can we do?" "don't you understand that this won't work".... I find it doubly frustrating because the majority of these are asserted as fact, typically based on flawed reasoning, when what they really are, are estimations/predictions. If this lack of concern (if not outright disdain) for correctness becomes too prevalent within a society, I worry that it may affec…

The flawed decision making was right at the start, when this thing could have been bottled up, and then after that at just about every junction where decisions were postponed. Now it's too late and everybody and their brother will start telling the ICU personnel how to clean up our messes?

Re: The U.S. tried to build a new fleet of ventilators

#255

Post by jacquesm »

triangleman wrote: post #252
jacquesm wrote: post #233

Earlier quoted context omitted.

> Life currently is like a movie. A zombie or some similar disaster movie, a situation where things are changing fast, where the normal plans are expected to fail. No, because after a movie you get to go home, no matter how terrible it was. And in real life you don't get to go home. So you will have to trust in the people that have spent their lives preparing for stuff like this while we, the software smartasses were…

From what I have read the Italians have repurposed all kinds of doctors to be able to treat Covid patients as best they can with all available equipment. So I don't think it's too far out to say that in New York and other places you will see doctors stepping up and learning on the job in order to treat this disease. You will also see doctors coming into New York from other places to help.

Yes, and for doctors that may make more or less sense. But that's very far from the ideal situation: that we had managed to keep things under control when we could and that right now we stay home as much as possible to reduce the load on the system. But since people aren't even doing that (see this gem of a thread: https://news.ycombinator.com/item?id=22724268 ) I fail to see why we should at the same time break things even further.

Let's first all stay the fuck home, then ensure good personal hygiene and if and when infected self isolate as much as possible and leave the rest to the HCWs who are risking their lives in the most literal way possible.

All this well intentioned backseat driving isn't going to move the needle, not even a little bit.

Re: The U.S. tried to build a new fleet of ventilators

#256

Post by jacquesm »

joe_the_user wrote: post #250
jacquesm wrote: post #233

Earlier quoted context omitted.

> Life currently is like a movie. A zombie or some similar disaster movie, a situation where things are changing fast, where the normal plans are expected to fail. No, because after a movie you get to go home, no matter how terrible it was. And in real life you don't get to go home. So you will have to trust in the people that have spent their lives preparing for stuff like this while we, the software smartasses were…

The ICU staff is working double shifts and around the clock in plenty of places. They too get ill, plenty of them have already died. It's a bit late to stick your oar in now and make it your mission, I totally sympathize with the intentions but this isn't your fight other than to stay put, tell other people to stay put and accept that this story will not have a Hollywood ending for many people. This language of addre…

> This language of addressing each posters as if they personally had this intention is pretty bizarre.

Oh, so it's just posturing. Forgive me then for taking you serious.

Re: The U.S. tried to build a new fleet of ventilators

#257

Post by jacquesm »

tcbawo wrote: post #238
SkyPuncher wrote: post #97

Earlier quoted context omitted.

> It’s much harder to ramp up production of medical professionals. I have a mixed opinion on this. In particular, I don't think we really need to create more skilled medical professionals, we just need to change the way they work. Most of doctors have exposure to the basics of intubating and ventilation through medical school. Those without direct critical care experience would likely be absolutely terrible at it. Ho…

There is an ophthalmologist/comedian on Twitter @dglaucomflecken with an entertaining, somewhat tongue in cheek feed with similar sentiments ( https://twitter.com/DGlaucomflecken/status/12389545581407723... )

Priceless, and just what the ICU backseat driver crowd needs to see.

Re: The U.S. tried to build a new fleet of ventilators

#258

Post by jacquesm »

omar_a1 wrote: post #253
mistermann wrote: post #240

Earlier quoted context omitted.

> I believe the point is that the minimum amount of training required to be of greater help than hindrance (i.e., net benefit) in an ICU and running ventilators is sufficiently high that it's not a small thing to spin up a cohort. Point of contention is what it seems like to me. There's certainly no shortage of people asserting that point, but what confuses me is, how does everyone know with such high certainty what…

Because it's common sense that an invasive medical procedure needs to be administered by someone with some semblance of competence in medicine, if you expect the patient to have a shot at not dying. An emergency doesn't change the hard technical requirement of administering ventilation. Or rather, this should be common sense, but the over-inflated egos on HN don't understand that it takes more than knowing which butt…

> Being able to hold a paint brush is a very different skill level than painting a portrait.

Painful given some past threads on this subject.

Other than that: spot on.

Re: The U.S. tried to build a new fleet of ventilators

#259

Post by jacquesm »

stainforth wrote: post #227
omar_a1 wrote: post #198

Earlier quoted context omitted.

No, it's that I'm aware that "ventilator bootcamps" would be a resounding failure that would kill more people than it saves. Going from zero to medical professional - not a doctor, just someone who can perform invasive medical procedures without killing a large number of people - isn't 30 days of work. Ignoring that reality will recklessly endanger people's lives. If we're talking veterinarians, dentists, nurses, res…

Maybe I'm the first to bring up this comparison, but don't people deliver babies incidentally all the time (couldn't make it in time to the hospital, etc.) An event where I'm sure some would say only a doctor is qualified to handle it. And yet we still do what we have to.

Yes and when we do it like that the risk to mother and child goes up tremendously.

Re: The U.S. tried to build a new fleet of ventilators

#260

Post by omar_a1 »

mistermann wrote: post #248
omar_a1 wrote: post #146

Earlier quoted context omitted.

Obviously because being an ICU doctor isn't something hard like writing code. Fewer buttons on a ventilator! /s But seriously, the amount of people on here trivializing modern medicine isn't helping matters. Granted, neither is business-as-usual, but a 30-day "ventilator boot camp" for untrained professionals is going to kill far more people than it helps. And a poor allocation of resources during a time of scarcity.

The number of people on here perceiving or claiming that people are trivializing modern medicine, when their actual words say nothing of the kind, may also be unhelpful.

Claiming that untrained staff could administer a ventilator from a 30 day bootcamp fits under that definition.
Post reply on HN