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

nytimes.com

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

#61

Post by rajandatta »

onetimemanytime wrote: post #55
cycrutchfield wrote: post #48

Earlier quoted context omitted.

About 4 years of medical school, and around 4 more years of residency training.

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...

I would think you could augment with other personnel - interns, students, volunteers - who are trained and who's only job is to watch the ventilator and monitor a patient. They do not try and treat a patient but call for help if the patient's condition takes a downturn or equipment shows a problem they have not been trained to address.

This is not general purpose training - but very bounded / specific notes.

That's got to be better than exhausting more vital personnel.

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

#62

Post by ALittleLight »

cycrutchfield wrote: post #48
romanows wrote: post #41

Earlier quoted context omitted.

I wonder how long it would take to teach someone to be more help than harm? After 30 intensive days of training, what would candidates lack?

About 4 years of medical school, and around 4 more years of residency training.

Really? They spend 8 years learning how to operate a ventilator?

Medical professionals learn how to do their entire job in a similar time frame. Ventilator operation is surely a small part of that. I'd be astonished if it would take someone more than a week or two to learn the basic mechanics of how to use a ventilator. None of the theory or nuances, but a course that says "hook it up like this, do X, Y and Z and come get me if this or that happens".

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

#63

Post by tmpz22 »

noelsusman wrote: post #60
oefrha wrote: post #30

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…

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.

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

#64

Post by zozbot234 »

worik wrote: post #26
pdonis wrote: post #4

Earlier quoted context omitted.

> Governments are so utterly broken and inefficient that they can’t do it. Exactly. Which means we should not be depending on governments to do it. This is exactly the sort of thing that private startup companies should be doing, without trying to involve the government's bloated and inefficient bureaucracy. > even if they produced a design now we have supply chain problems globally For this particular crisis, yes. B…

I completely disagree. If the government had done it in house they could have succeeded. The problem here was the profit motive. Cheep ventilators endanger profits. It is a side effect of free markets (I like free markets) that big firms get bigger, get more market power, kill off competition then price gouge. Health is a bad bad place to have free markets as the incentives are almost all wrong (exceptions: E.g. runn…

There's no "free market" in healthcare; it's one of the most heavily regulated sectors in the economy. It's a known side-effect of regulation that big and politically-connected firms are advantaged over smaller and leaner ones, market power tends to increase in lockstep with the regulatory burden, and a lot of price gouging becomes feasible that wouldn't occur in a more contestable environment.

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

#65

Post by cycrutchfield »

ALittleLight wrote: post #62
cycrutchfield wrote: post #48

Earlier quoted context omitted.

About 4 years of medical school, and around 4 more years of residency training.

Really? They spend 8 years learning how to operate a ventilator? Medical professionals learn how to do their entire job in a similar time frame. Ventilator operation is surely a small part of that. I'd be astonished if it would take someone more than a week or two to learn the basic mechanics of how to use a ventilator. None of the theory or nuances, but a course that says "hook it up like this, do X, Y and Z and com…

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?

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

#66

Post by noelsusman »

burfog wrote: post #51
dang wrote: post #13

We changed the URL from https://dnyuz.com/2020/03/29/the-u-s-tried-to-build-a-new-fl... to that of the article that it fully ripped off (and banned that site).

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…

The news portion of NYT does not have a severe political bias, and they obviously don't license their content to dynuz.com.

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

#67

Post by AnthonyMouse »

neffy wrote: post #27
pdonis wrote: post #21

Earlier quoted context omitted.

The government tried, but then canceled the contract at the request of the big company that had bought out the small company they originally had the contract with.

Exactly. The issue in some sense isn't government, it's the corruption of government by corporations that have been allowed to become to big and to powerful, to the extent that the US Government itself has been deliberately defunded. (Sure, I know Government spending grows every year, but so does the money supply and corporate profits. Control for monetary expansion, and the US Government's portion of the economy has…

> Control for monetary expansion, and the US Government's portion of the economy has been steadily shrinking.

What? No it hasn't. It has kept pace with GDP since the end of WWII (prior to WWII it was much smaller), and the rate of GDP growth is higher than the rate of inflation. The size of government in the US has been growing continuously in real terms since before Eisenhower.

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

#68

Post by AnthonyMouse »

worik wrote: post #52
pdonis wrote: post #47

Earlier quoted context omitted.

> Government is not congress, or a president. It is civil servants beavering away. The civil servants work on what Congress and the President set as priorities. They cannot execute plans that span multiple Congresses and Presidential administrations unless every single Congress and Administration over that time period agrees to support the plan.

They flew to the moon. They built a horrifying arsenal. I really do not see why they cannot build a health system. They have done so here.

Healthcare is a much larger proportion of the economy than NASA ever was. And if you're trying to put up the US military as an exemplar of US government efficiency and competence, no thank you.

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

#69

Post by choeger »

cycrutchfield wrote: post #65
ALittleLight wrote: post #62

Earlier quoted context omitted.

Really? They spend 8 years learning how to operate a ventilator? Medical professionals learn how to do their entire job in a similar time frame. Ventilator operation is surely a small part of that. I'd be astonished if it would take someone more than a week or two to learn the basic mechanics of how to use a ventilator. None of the theory or nuances, but a course that says "hook it up like this, do X, Y and Z and com…

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?

Look how radiologists work nowadays. They don't see their patients face to face. Everything except the decision making has been handed to someone else so they can be most efficient. That's the model a huge COVID19 ICU could work like.

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

#70

Post by faitswulff »

oefrha wrote: post #30

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…

I think about this whenever I think about how many expert frontline healthcare workers we’re going to lose in the coming months, especially considering the state of PPE in the USA. It may not show up immediately in economic metrics, but we will be losing untold man years of training and expertise.
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