Hacker News Reader

Comment by PragmaticPulp | Hacker News Reader

> preemptively turning away non-vaccinated covid patients to maintain that minimum availability.

Hospitals aren't going to turn away patients while they have open beds, period. Triage isn't about making moral judgments to favor future patients who may or may not be more deserving than someone in the ICU right now.

Regardless, it wouldn't work. The moment hospitals made being vaccinated a requirement for receiving care (which is horrific and would never happen), every single unvaccinated COVID patient would simply lie and say they were vaccinated. Hospitals aren't going to send critical patients home to come back with their vaccination cards before receiving care. The more you incentivize patients to lie in order to receive treatment, the worse things get.

View on HN

every single unvaccinated COVID patient would simply lie and say they were vaccinated

You realize medical records are digitized and shared across medical institutions, right? I got vaccinated at a county clinic, but my health insurance provider still knew without me having to tell them.

COVID vaccination records are currently spotty and not always available. Are you suggesting we turn people away unless we can conclusively prove their vaccination status? Anyone who got vaccinated in a state (or country) without readily accessible records gets turned away? The whole concept is infeasible.

People who have non-COVID life-threatening emergencies are already being turned away because the beds are already full.

Ultimately this is part and parcel of our privatized medical system where there were way more hospital beds per capita in the 70s/80s than today while costs have gone through the roof.

Not turn them away immediately. They should be given a grace period to get their docs in order. Say a few days. Then if they still do not have verifiable evidence, yes they would be prioritized lower.

My vax card existed in paper form only until I showed it to my GP at my next physical who then entered it into Epic.

Could CVS have reported it to someone? Maybe. Did they? All evidence points to “no”.

I am curious -- if you contact CVS and say 'I lost my card', would they give you a new one? Or some other info?

Not sure how it goes in US, but in Europe you can quite easily get pseudo-vaccinated. Costs couple hundreds € depending on place but it's rather widespread, especially right now, when you can pick place where you want to be "vaccinated".

It's simple. You show, your dose gets straight to trash, all the papers are OK. Show up in couple months for the next "dose".

This is really upsetting. People literally tossing vaccine into the trash to claim they are vaccinated and can travel.

It's upsetting on multiple levels. I'd like to know more to see if it's anything more than an anecdote.

> it's rather widespread

Source?

In practice clinical systems interoperability is still very limited. Many provider organizations remain unable to share data with each other, especially across state lines. State immunization registries exist, but data updates lag and some patients will have been vaccinated in other states or countries.

>The moment hospitals made being vaccinated a requirement for receiving care (which is horrific and would never happen), every single unvaccinated COVID patient would simply lie and say they were vaccinated.

How would this work if by getting vaccinated you get a record of the vaccination? The card everybody receives isn't the only record of vaccination. There's some database (or multiple). Hence why in California specifically you can look up your name and cross-reference it with where you received the vaccination and it'll show you your digital record along with a QR code that links to it.

If someone arrives at the emergency room in critical situation we're not going to have them wait while someone in the records department tries to confirm their vaccination status.

What if someone claims they were vaccinated in another country without readily accessible records? Do you just turn them away? Doesn't work.

How do you know if someone is unvaccinated? Don't worry, they'll tell you.

But seriously have you ever been to a hospital? Everything happens very slowly. When a patient is waiting around in the emergency room, there are many hours to make the decision where they're going next.

Also, are hospitals not still doing separate wards for Covid/not-Covid? A good first pass would be simply increasing the allocation for non-Covid.

It works like this: if you end up in the hospital because of COVID, the odds are really, really overwhelmingly indicating you’re not vaccinated.

No need to check ID, reality will do the heavy lifting for you.

I encourage everyone to get vaccinated if they can, but breakthrough infections with severe symptoms are still common among older patients.

https://www.beckershospitalreview.com/public-health/nearly-6...

Yes, it would be unfortunate to be on the wrong side of that.

But triage isn’t about being perfect, it’s about doing what you can quickly without second guessing it.

15:1 odds are good enough for a quick decision about who to prioritize.

triage is also not about making morality judgements.

It should be. Like it or not, one cannot avoid the moral implications of a decision to treat or not to treat. If more of the hospital resources are being used by people who knowingly placed themselves in harm's way, then there are less resources available for those who bear less responsibility for their predicament. There are already examples of this kind of moral judgement in medicine - eligibility for scarce transplant organs.

The biggest number I have seen was something like 15x more likely to be unvaccinated. That's not "really really overwhelmingly", nor is it enough for ER admitting people to assume anything.

15:1 odds are definitely high enough to address the issue in triage.

Perfect is the enemy here, we just need to do the best we can, given the moments and information we have.

Why is it horrific to not treat people who aren't vaccinated, given you have to triage? I agree that if you don't need to triage then we absolutely treat everyone. But once you're exceeding capacity and know you have to turn people away, then I think triaging based on vaccination status is reasonable.

Parent comment was suggesting they turn away unvaccinated patients in order to leave a certain number of ICU beds open.

Reply on news.ycombinator.com