Comment by Yetanfou | Hacker News Reader

Comment by Yetanfou | Hacker News Reader

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You do have to keep in mind that hospitals in Stockholm - which is currently the epicentre of infections in Sweden - have adopted a policy to not admit people with a 'biological age' of 80 or over to intensive care, nor will they admit people with a 'biological age' of 70 with at least three serious conditions or 60 or over with at least two serious condition [1, 2, 3, 4]. These guidelines have been in use for a few weeks now even though there still is enough capacity to admit at least some of these people. The guidelines also state that intensive care treatment of patients who fall into one of the two categories should be discontinued. According to these guidelines people who will be denied intensive care will be offered palliative care instead. The concept of 'biological age' is not well-defined here which makes it hard to actually apply these guidelines. It is used because it is not allowed by Swedish law to deny care based on physical age whereas the law does not say anything about triage based on 'biological age'.

[1] https://www.aftonbladet.se/nyheter/samhalle/a/lAyePy/dokumen...

[2] https://www.expressen.se/nyheter/coronaviruset/ingen-intensi...

[3] https://www.dn.se/sthlm/dokument-visar-vilka-som-inte-far-in...

[4] https://cached-images.bonnier.news/cms30/UploadedImages/2020... (the actual guidelines for Karolinska university hospital)

That policy is precautionary to give doctors guidance on how to prioritize patients if/when the hospitals run out of space/resources.

To my knowledge, these decisions have not had to be made yet. As mentioned in [3] Stockholm has space over and is accepting patients from the Sörmland region.

> To my knowledge, these decisions have not had to be made yet.

According to people working in health care in Stockholm they have used these policies for a few weeks now [1], the article (from the 2nd of April, 2½ weeks ago) contains two references to cases where patients were denied intensive care (and, as a consequence, died) who would have received care before these policies were enacted. The (anonymous) nurse states that Sjukvården är inte öppet ärlig med att vi redan har en katastrofsjukvård där man inte prioriterar de som man bedömer är sjukast, utan de som man bedömer har störst chans att rädda which (loosely) translates to care givers are not open about the fact that we already optimise for throughput instead of prioritising those who need the most care

[1] https://www.aftonbladet.se/nyheter/a/9v4z2q/sjukskoterska-vi...

The article is almost three weeks old. The anonymous nurse predicts the imminent total collapse of the health care system where even the field hospitals will overflow and it's too late to do anything about it. This has clearly not happened.

The nurse goes on to blame deregulations and financial aid to banks and corporations. This seems more like the personal feeling of a rather leftist nurse published by a left of center tabloid.

I am sure there have been misinterpretations of the directives and there have probably been times where prioritizations have been done based on local and short term conditions. But it is not an active and commonly used policy.

With the disclaimer that I'm only using Google Translate, it appears this document is from one hospital and is not a requirement, merely a guideline / informational document.

And this wouldn't be surprising - most hospitals do have written policies for how they'll triage should it become necessary.

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