I'm Married to an ER Doc in NYC • Hacker News Board

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

#61

Post by spaetzleesser » Thu, Jun 11, 2020, 4:57 AM UTC

nradov wrote: post #55

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.…

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…

"But it's important to understand the reality we're in rather than indulging in fantasies."

This seems an important point to remember in most US public discussions. If people can't even agree on basic facts, how can you make decisions?

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

#62

Post by majormajor » Thu, Jun 11, 2020, 4:57 AM UTC

redis_mlc wrote: post #56

majormajor wrote: post #47

Earlier quoted context omitted.

> The US cannot do testing and tracing because they waited too late. "Cannot"? Why wouldn't it just require a much bigger effort? I've been flabbergasted by the lack of wartime thinking this whole time in the US. We know how to mobilize things and build logistical supply chains, why can't we apply that to a in-country medical battle? Not only did the US governments (at all levels) demonstrate incompetence early, we'v…

> "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…

This isn't "hope" that I'm expressing. This is me saying that *if we never try, we'll never succeed, at ANYTHING, not just at this.

You're convinced hard equals impossible. Which is definitely part of why the US is so incompetent when it comes to this (or healthcare in general). People don't care that we suck.

I just find that sad and horrifying.

Let's say you take NYC, where the cases have been tailing off, and you implement a massive contract tracing effort there. MASSIVE. Maybe it doesn't save the whole country. Maybe it doesn't even prevent inbound infections from spreading very well.

But it's also a hell of a lot of practice for the next time we need to accomplish something big.

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

#63

Post by 40four » Thu, Jun 11, 2020, 4:59 AM UTC

m4rtink wrote: post #32

dr_ wrote: post #3

Not an ER doc, but a doc in long term care facilities which have been hit particularly hard. Fortunately things have slowed down considerably now, but at its peak it was absolutely nerve racking. There’s an element to this pandemic which many people working in healthcare have felt. We see patients fall sick often, and we see them die often, although this was at an near overwhelming scale. But what we don’t see often…

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 serious financial trouble, despite the influx of Covid-19 patients. At a cursory level, I think most people would assume the hospital business is booming, but this assumption couldn't be more wrong.

At this point, nobody wants to go in for routine examinations or non-emergency procedures. For-profit hospitals (almost all of them are) as a business, depend on providing these non-emergency services/ surgeries/ procedures. Hospitals across the country are laying off health-care workers en-masse.

So it is not correct to imagine all hospitals are running at full capacity, and burning out their workers. In fact, many health care professionals are drawing unemployment at this point.

I know this is doesn't make sense at the surface level, but it is something we all need to consider when continuing to advocate for lock-down or stay at home strategies. Our economy depends on movement of people/ goods/ services. That includes hospitals. I wish there was more serious discussion about this, and how we keep things moving as much as possible, while also protecting one another from spreading the virus.

Lock-down alone is not an solution. If your areas hospitals are at risk of reaching capacity, for sure close it down. But almost nowhere in America outside of NY/NJ is there a risk of that right now. We've tried it for a while, but now we have more understanding. Now I want us to re-imagine how we can continue a life of movement, and also reduce risk of infection.

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

#64

Post by laichzeit0 » Thu, Jun 11, 2020, 5:02 AM UTC

nradov wrote: post #55

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.…

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 pain isn’t just worth it. It’s cold and calloused but it’s either vaccine or a long drawn out constant state of fear and social distancing. The other option is short burst of mass deaths followed by a return to complete normalcy.

So my question is more like, how are countries that, in say six months, that’s population only have 10% exposed to COVID-19 going to coexist in a global world with countries that are past herd immunity and operating freely again.

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

#65

Post by thescriptkiddie » Thu, Jun 11, 2020, 5:07 AM UTC

syntheticnature wrote: post #21

el_nahual wrote: post #9

> When Alex finally gets home, he takes his scrubs off outside our front door and stuffs them into a plastic bag that he ties off tightly. He takes his hospital clogs off and leaves them outside, along with his backpack and coat. Why do doctors and nurses walk around outside in their hospital scrubs? It was unsanitary even before COVID and I just don't get it. How hard can it be to change into street clothes before l…

Leaving aside the question of changing facilities... Where do the scrubs get washed, then? Do they need to bring a special bag to transport the scrubs so they can wash them at home? Does the bag need to be washed, too? If they leave the scrubs in the lockers if they "aren't too bad" (ha), how are the lockers cleaned to ensure that they are sanitary when they put their street clothes in? How do you ensure they are san…

This is anecdotal, but a friend of mine who works in healthcare once complained that hospitals used to (years ago) provide a cleaning service for scrubs and lab coats, but now the staff are expected to wash theirs at home.

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

#66

Post by mkagenius » Thu, Jun 11, 2020, 5:09 AM UTC

9nGQluzmnq3M wrote: post #60

briandear wrote: post #52

Earlier quoted context omitted.

We diligently put on our masks out of a sense of theater and emotion rather than actual effectiveness. https://www.medicalnewstoday.com/articles/new-study-question... And the WHO continues to maintain that healthy people do not need to wear masks. And asymptomatic spread of the virus is “very rare” according to the WHO: https://www.cnbc.com/2020/06/08/asymptomatic-coronavirus-pat... Masks in the general public is jus…

The WHO recently changed its guidance to recommend masks for all, albeit only in "specific situations" where distancing is not possible. WHO has updated its guidance to advise that to prevent COVID-19 transmission effectively in areas of community transmission, governments should encourage the general public to wear masks in specific situations and settings as part of a comprehensive approach to suppress SARS-CoV-2 t…

Lets just say every one is just as clueless about this virus as WHO or CDC or Fauci or whoever. Its just a failure of our not so advanced research in this field that we are in this situation. I can't believe everyone is just so clueless.

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

#67

Post by gvjddbnvdrbv » Thu, Jun 11, 2020, 5:21 AM UTC

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…

Everything you wrote is weird and simply shows that you need a proper health care system over there.

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

#68

Post by gvjddbnvdrbv » Thu, Jun 11, 2020, 5:22 AM UTC

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…

https://en.m.wikipedia.org/wiki/Post-polio_syndrome

Covid is a new disease. Will it have long term effects?

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

#69

Post by nradov » Thu, Jun 11, 2020, 5:23 AM UTC

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…

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 be able to visit Australia or New Zealand without a quarantine.

https://podcasts.google.com/?feed=aHR0cHM6Ly9yc3MuYXJ0MTkuY2...

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

#70

Post by reubens » Thu, Jun 11, 2020, 5:29 AM UTC

el_nahual wrote: post #9

> When Alex finally gets home, he takes his scrubs off outside our front door and stuffs them into a plastic bag that he ties off tightly. He takes his hospital clogs off and leaves them outside, along with his backpack and coat. Why do doctors and nurses walk around outside in their hospital scrubs? It was unsanitary even before COVID and I just don't get it. How hard can it be to change into street clothes before l…

I can only speak for the docs, but this has something to do with compassion fatigue. The job is hard, and extending your frame of thought to public health concerns like this can be beyond the mental energy we're capable of in a day.

Bad analogy, but its like using a car to get to work instead of riding your bike. Most do it, knowing its worse for the environment.