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Comment by rwcarlsen | Hacker News Reader

I don't agree that it would necessarily tax health care systems "beyond what they're capable of handling" (for my definitions of those words). I also disagree that economies would be devastated if we had avoided all lockdown and economy-affecting mitigations. But I understand that reasonable people could disagree with me on both those issues and that is fine.

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Durinng their peak earlier this year, Italian doctors were choosing who lives and who dies in the normal course of triage. That's the definition that matters to public health policy.

To me, beyond what it is capable of handling - means that the system gets damaged - not the people that it is treating. What you described is what I would call "beyond it's peaking capacity for treating patients". Not a general "beyond capacity to handle". Imagine driving a car. Not being able to fit all your friends in the car is different than the car frame being crushed because too many people climbed onto it. I'm saying that the former is what we have/will experience - not the latter.

Tbh that sounds like a ridiculous standard. Our hospitals are fine as long as they haven't been hit in a nuclear first strike and are still standing?

This feels a bit tortured. COVID has, is, or is threatening to overload our healthcare system as evidenced by:

1) Severely reduced in-take of new patients of patients due to lack of beds available (and longer COVID recovery time)

2) Reduced ability to effectively care for other patients due to limited beds and transmissibility of the disease, and workforce reductions as healthcare workers get sick (this is not a hypothetical, this is happening in the hospital my wife and brother work at).

3) Forcing healthcare works to perform their jobs without subsequent PPE for their own protection, increasing their own health risks and creating serious issues for mental well-being when working in this environment day-in and day-out.

The healthcare system is designed to treat patients. Believing the system is not exceeding what it can handle because somehow "the system itself" is not damaged (which I'm not even sure what you mean by that) but dismissing patient care and outcomes is like evaluating a vehicle's crash rating, but not evaluating the damage to the vehicle occupants.

That is not true on two fronts. First, doctors were not choosing who lives and who dies. They were deciding who would have the higher chance of survival if they were treated. There is no certainty that a) the selected treatment group would survive or b) the unselected would have survived but for the triage.

Secondly, that is exactly what triage is! People die, doctors are trained to decide of a group of people which are dying, who has the better chance of not dying.

I think this is missing the mark. Italian doctors were choosing who would get an ICU bed and who would not. There were more patients needing ICU beds than the beds available. Not giving an ICU bed to someone in need meant basically a death sentence. That is not the normal state of affairs, as far I can understand.

Well again, not _really_. We were also ventilating people who didn't need it. You don't need an ICU bed if you aren't vented. Furthermore, the mortality rate of being on an ventilator is non-negligible.

I would be interested in seeing if there is data to say whether being put in the ICU actually _increased_ risk of death. Of course this would be hard to prove as only the most sick went to the ICU etc.

This fake story should die already.

(from another post) >To me, beyond what it is capable of handling - means that the system gets damaged - not the people that it is treating

I think your definition of "what they are capable of handling" (for some reason I can't reply to your other clarification of this definition) isn't one that many people would think is a good one. It may be technically correct in some domain, but this isn't it. Healthcare systems are there to provide healthcare for people, and if they can't do that (as in this situation) then they are incapable of handling it. In addition (in the UK at least, can't speak for anywhere else), this has led to not only ICU capacity being exceeded, but also routine healthcare being diminished - either because of people being unable to visit a hospital, or unwilling to do so.

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