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I'm Married to an ER Doc in NYC

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Re: I'm Married to an ER Doc in NYC

#101

Post by kmonsen »

Intermernet wrote: post #86
mixmastamyk wrote: post #79

Earlier quoted context omitted.

I and a lot of folks won’t submit to contact tracing. So it is infeasible in more ways than one.

Sorry if this seems rude, it's not meant to be, I'm genuinely curious. I understand (and support) opposition to contact tracing by badly designed technological solutions, but what is your argument against manual contact tracing? (actually asking people one-on-one who they've been in contact with if they test positive to Covid-19) I'm just after your reasoning. I promise I won't deride your decision in any way (and I…

A substantial part of the US population will not cooperate.

Re: I'm Married to an ER Doc in NYC

#102

Post by skybrian »

40four wrote: post #63
m4rtink wrote: post #32

Earlier quoted context omitted.

This is what I thin many forget when they speak against lockdown and for "heard immunity" - that this would not only result in a huge ammount of unnecessary deaths, but also pretty much wear out if not outright kill a signifficant part of medical personel. It's basically condemning them to working nonstop for months if not years, watching people die all day long & being in infection danger at all times while at work.…

I think it is more complicated than that. Almost all states very early on had some level of 'lock-down', stay at home order, or what have you. This has limited movement of people, and as a side effect, or maybe even direct order from governors, closed down/ limited many business. Including hospitals. Hospitals in America, believe it nor not, are for profit businesses. It is un-intuitive, but many of them are in serio…

It seems like the root financial problem isn't for-profit versus non-profit, it's pay-per-procedure? This is like paying the fire department based on how many fires they put out. Medicare seems no better.

(I would guess that Kaiser might be doing somewhat better since they're paid monthly but their finances aren't easy to find.)

Re: I'm Married to an ER Doc in NYC

#103

Post by kmonsen »

hcknwscommenter wrote: post #91
redis_mlc wrote: post #56

Earlier quoted context omitted.

> "Cannot"? Why wouldn't it just require a much bigger effort? Corona is basically endemic in the US. You can test nursing homes and airport arrivals, and do followup testing on a small population. You cannot test 320 million people, and do followup weekly testing on them. Perhaps you're inspired by the success in NZ or Taiwan. The US has a totally different situation. You seem to think that "doing something" is bett…

"You cannot test 320 million people, and do followup weekly testing on them." I mean, that is factually wrong. We could actually do that. It wouldn't even be that expensive. Of course, such a thing isn't really necessary. If everyone who wanted a test could get one without delay and get results back in hours, that would be sufficient to implement test and trace effectively.

Of course testing scales with the size of the country.

Re: I'm Married to an ER Doc in NYC

#105

Post by fraserharris »

stickfigure wrote: post #75
rsanek wrote: post #71

Earlier quoted context omitted.

Actually, over half of US hospitals are not-for-profit and another quarter are public. Only a small minority are for-profit. See https://en.m.wikipedia.org/wiki/Non-profit_hospital

This fact is missing something essential; Kaiser Permanente is a nonprofit but it sure isn't what you think of when you use that term. Also, it's something of a minor nit - nonprofit corporations need revenue too. My wife is a nurse for Dignity Health (another "nonprofit" hospital here in California) and has been effectively laid off for the last couple months. It's great that the ER is empty, but in the mean time nu…

Kaiser Permanente is a conglomerate that is a consortium of for-profit and not-for-profit entities. The health plans (insurance) and hospitals are not-for-profit. The physicians are organized into for-profit partnerships.

Source: https://en.wikipedia.org/wiki/Kaiser_Permanente#Operations

Re: I'm Married to an ER Doc in NYC

#106

Post by lostlogin »

toyg wrote: post #80
nradov wrote: post #69

Earlier quoted context omitted.

Yes it seems that New Zealand will attempt to wait for a vaccine and in the mean time impose a quarantine on anyone who arrives from another country. Balaji Srinivasan thinks we will see the world divided into "red" zones where the virus is still widespread and ”green" zones where the virus has been contained. Travelers will be able to move fairly freely between green zones countries. So if you're in Taiwan you might…

Considering for most countries the published numbers are very debatable (even in Europe there are plenty of arguments), imho that’s a foolish strategy. Quarantine should probably be implemented worldwide. I say that against my best interests, I am long overdue a holiday, but I don’t want to feel my lungs full of water.

> imho that’s a foolish strategy.

Possibly for most, but for New Zealand and Australia it looks ok.

Re: I'm Married to an ER Doc in NYC

#107

Post by rscho »

jariel wrote: post #94
40four wrote: post #63

Earlier quoted context omitted.

I think it is more complicated than that. Almost all states very early on had some level of 'lock-down', stay at home order, or what have you. This has limited movement of people, and as a side effect, or maybe even direct order from governors, closed down/ limited many business. Including hospitals. Hospitals in America, believe it nor not, are for profit businesses. It is un-intuitive, but many of them are in serio…

"I know this is doesn't make sense at the surface level," No it makes perfect sense, and it doesn't matter if it's 'nonprofit or for-profit' - the inefficient use of resources is just the same. Hospitals are the most expensive places in the world to run, with very highly trained personnel, gear, etc.. In a socialized system, if they are not used, it's a massive inefficiency. Now imagine a system where 10's of million…

When a system is socialized, funding is also shifted so that the poorer taxpayers contribute less than the richer ones. So no, it's not just shifting around deck chairs. There's a balance to strike.

Re: I'm Married to an ER Doc in NYC

#108

Post by lostlogin »

el_nahual wrote: post #30
wahern wrote: post #23

Earlier quoted context omitted.

The fact they're worn around so freely should be a hint that they merely look like surgical scrubs, not intended to be used like surgical scrubs. Realistically, I would think scrubs are common because 1) they've become emblematic of healthcare occupations[1] and 2) they're easier to clean and relatively cheap--they protect the wearer from spills and contamination, not the other way around, and in contrast to traditio…

Yes, I know surgeons actually change into sterile scrubs before going into surgery, but even "normal" parts of hospitals are biologically filthy. Even the possibility of bringing MRSA into the outside world should merit a change of clothes.

> Yes, I know surgeons actually change into sterile scrubs before going into surgery

No, they put clean ones on, then put something sterile over the top. The racks of scrubs are used by everyone. You just grab a pair. You check the crotch doesn't have a hole in it, and that the elastic is still stretchy.

Re: I'm Married to an ER Doc in NYC

#109

Post by beachy »

laichzeit0 wrote: post #64
nradov wrote: post #55

Earlier quoted context omitted.

Through US government incompetence we missed our chance to contain and suppress the virus back in February. Now the pandemic is so widespread that it's impractical to do enough contract tracing and isolation to eradicate the virus. In many areas the authorities aren't even bothering to try. So we're on a path to herd immunity whether we like it or not. Obviously this is a bad state of affairs. But it's important to u…

Say the US gets to herd immunity and the rest of the world has done a really good job at containing the virus, e.g. New Zealand. What are they realistically going to do long term? Shut up their country until a vaccine arrives? Quarantine everyone coming in or going out for two weeks? Who is realistically going to want to travel into or out of there with those kind of restrictions. I seriously wonder if the short term…

You're seriously saying that a "short burst of mass deaths" is a better option than getting your shit together and doing proper social distancing followed by proper contact tracing?

It's great that we've got rid of the virus for now in NZ, but yes, there are many questions, including whether there will still be an incentive to even try for a vaccine once major countries reach herd immunity (if and when that happens).

But it truly astonishes and depresses me that the US - the country that went to the moon, that invented the internet, that built a military capability that literally saved the world in ww2 - seems to have given up.

How hard would it really be to do proper contact tracing in a population of 300 million? Yes it's a big job, a very hard job, but the big jobs, the tough jobs, that's what Americans do!

Re: I'm Married to an ER Doc in NYC

#110

Post by afiori »

beachy wrote: post #109
laichzeit0 wrote: post #64

Earlier quoted context omitted.

Say the US gets to herd immunity and the rest of the world has done a really good job at containing the virus, e.g. New Zealand. What are they realistically going to do long term? Shut up their country until a vaccine arrives? Quarantine everyone coming in or going out for two weeks? Who is realistically going to want to travel into or out of there with those kind of restrictions. I seriously wonder if the short term…

You're seriously saying that a "short burst of mass deaths" is a better option than getting your shit together and doing proper social distancing followed by proper contact tracing? It's great that we've got rid of the virus for now in NZ, but yes, there are many questions, including whether there will still be an incentive to even try for a vaccine once major countries reach herd immunity (if and when that happens).…

> the US - the country that went to the moon, that invented the internet, that built a military capability that literally saved the world in ww2

two of those are in part result of propaganda

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