2. Thus far, it's worked to keep hospitals functioning. We're doing worse than most other countries (https://91-divoc.com/pages/covid-visualization/).
Very few regions have had anything close to overwhelmed hospitals. More regions have had to lay off hospital staff than have been overwhelmed. Some like UW medicine now face a $500 million budget shortfall due to the ban on elective procedures.
Social distancing measures may have an effect on r_t as low as 0.1 per analysis by Nate Silver. Others show a negative or no correlation between government lockdowns and reduction of r_t.
It is fair to question if these lockdowns - as instituted - have done anything.
I feel like that's a symptom of a much larger problem...
That's a bit of a red herring. Hospitals aren't laying off ER and ICU staff. They're furloughing in areas like dermatology, plastic surgery, and the like - parts of the hospital that see largely elective procedures.
Stop. This is incredibly misleading.
Elective just means that you can choose the time to do the surgery. It doesn't mean they are optional for health.
Elective surgeries include inguinal hernia surgery, cataract surgery, mastectomy for breast cancer, kidney transplant, and hip surgery.
Most surgeries are elective.
Don't minimize this as a bunch of delayed facelifts.
There's a range of severity in "elective" procedures, certainly. There are a lot of procedures folks will willingly postpone right now, and it's not surprising that hospitals are furloughing staff that service them.
It is disingenuous to suggest that furloughs in these elective areas demonstrate an excess of capacity in the ER/ICU.
Which will mean that department's staff - docs, nurses, receptionists, billers, cleaners, etc. - will be more likely to be on the furlough lists than the ER or ICU.
https://www.hcup-us.ahrq.gov/reports/statbriefs/sb186-Operat...
Knee replacements, hip replacements, even Coronary artery bypass graft can be considered "elective" if there is not an urgent need.
My kids get eye exams at the hospital. My son's allergist is there. These visits can wait, and they make up a lot of a hospital's business; the staff in those areas have little to do at the moment.
[1] “We are grateful to the Administration for clarifying that transplantations are an essential surgery which can be performed safely if a hospital feels they have the staff and resources available during the COVID-19 crisis,” said Joseph Vassalotti, MD, Chief Medical Officer, National Kidney Foundation. https://www.kidney.org/news/national-kidney-foundation-urges...
My wife has had to "visit" an OB/GYN over Zoom.
I don't know how effective or not midwives and such are (I really should get on that...) but women are having to go without them or choose to go without having fathers by their sides. Some places have stopped any visitors from being present.
There are potentially long term health impacts from the above changes, I'd imagine.
Not all of what a hospital deals with is immediately life threatening, though putting it off can certainly make it so.
Hospitals are rightly trying to figure out what rules make sense. It's not surprising there's some uncertainty, and adjustments will be made as we learn more.
Yes, that's right -- sorry for the mix up.
> If so, New York indicated doulas wouldn't be counted as visitors, but essential healthcare staff
Thanks for sharing, but that's seemingly not the policy in the actual hospitals that I can see.
From NYU Langone's visitor policy (https://nyulangone.org/patient-family-support/visiting-hours):
> Labor and delivery patients are permitted one visitor throughout the labor, delivery, and postpartum period, which can include a partner, family member, doula, or other support person. The visitor cannot be rotated.
It seems like there is no option to have both a doula and the father present.
I honestly have no idea if we would even use a doula--I've done approximately zero research into them at this point--but it's a pretty hard choice to make at the moment.
I could buy this line of reasoning if there was any indication that hospitals outside of NYC were at any point “whelmed”, nevermind “overwhelmed.” All across the country you’ve got doctors and nurses getting their hours cut, furloughed, and laid off. And the ones who actually are in the hospitals have enough time to coordinate elaborate dance videos on TikTok.
You know, it IS possible for both “lockdowns work” and “the models and experts were a bit off base” to be correct.
I hope we don't overcorrect, open up too soon and too much, and get to see what the other side of getting it wrong looks like.
Also, I don't think you can accurately determine the workload of a nurse based on a 30 second tiktok video. You know, I saw some truckers sleeping for a few hours at a truck stop on the highway. Why aren't they driving to deliver their packages? Clearly they have plenty of time.
An overloaded _system_ does not necessarily result in overloaded _workers_. In fact, it should minimize the number of overloaded workers as much as possible to avoid preventable mistakes. Taking some time to film a fun video with your coworkers should be viewed as workers taking necessary time to unwind, not as workers taking unnecessary time to goof off.
When you disallow elective procedures and everyone else stays away from hospitals for fear of catching the disease, they kinda do.
But another limiting factor is the facilities with which they work. When I say "not every doctor" I don't just refer to the warm body that went to medical school, I'm talking about the doctor and the facilities they use to perform their duties. A podiatrist's office can't just turn into a COVID ICU overnight, however willing or able that podiatrist may be to lend a helping hand.
For example, Russia looks like its #2 on the page but Russia has less than half the population of the US. If you look at per capita Russia would be above the US according to your graph.
(There's also one further down, "normalized by country population", in which we still don't look great.)
I think that the number of cases which is the default isn't all that important. In fact the higher number who are infected could make herd immunity happen sooner. The number of deaths is far more important. When you look at that on your chart the US is behind many Western European countries and it definitely doesn't look as bad. Its not great but it could be worse.
Do you have a chart that is looking at population density? I think that would also be a useful comparison when comparing different areas. Its not fair to compare NYC with Nebraska for example. I am not really sure how the European countries compare and am interested in a comparison if you know of one.
Until this question is answered clearly and officials show that whatever goal they set is achievable in a reasonable timeframe, I think it’s unreasonable to expect people to continue to comply.
The actions you take for #2 and #3 are similar, and which one you wind up implementing depends largely on how long the vaccine takes to develop.
Edited: meant to say states are doing 2 (comment initially said they are doing 3)
As more people become immune, the spread naturally gets slower, reducing the likelihood of hospitals being overwhelmed in the first place and thus reducing the desire to maintain stricter control. The individual risk of any given social interaction is reduced.
Conversely, the more infected, the more dead, meaning the number of life-years that would be saved via a stricter lockdown until a vaccine or effective treatment gets developed gets smaller and smaller.
I believe the shortest time it has taken to develop a new vaccine is the 5 years it took to develop one for Ebola, so I don't think one will be available in any meaningful way for this pandemic, though I'd love to be wrong.
Other companies like Sinovac have also been doing challenge testing already (I believe Oxford too, but AFAICS they haven't published anything yet) in animals, so far with good results. EDIT: Sinovac findings were a preprint, but now it's been published in Science, so I guess it has more weight.
Also to speed up trials, Oxford is doing a hybrid Phase II / Phase III trial, hoping to get emergency use authorization in September if vaccine responses are positive.
Lastly, most companies and consortia are ramping up manufacturing at-risk (because there's no guarantee vaccines will work) to make sure the demand is met earlier.
So it is likely that if a vaccine works, it will be around earlier than before. Whether everyone will be able to have it, is a different matter entirely.