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Comment by throwntoday | Hacker News Reader

Yes because no effort was made to increase ICU capacity which was continues to be the biggest issue

No, that isn't the biggest issue. The ICU is the last resort, it's the point where we throw incredible amounts of effort and hardware at the problem to gain a chance of still saving them. And even then 50% still die, and others likely will have permanent damage from the severe course of the disease.

The biggest issue is that not enough people got vaccinated.

ICU itself causes massive damage too. Side effect like died of hands and feet are not uncommon.

Vaccinated are still being hospitalized. How much longer will you buy into the narrative that they are not when so many countries are showing evidence to the contrary.

Would you please stop posting flamewar comments to HN? You've unfortunately been doing it repeatedly, and we ban that sort of account.

If you'd please review https://news.ycombinator.com/newsguidelines.html and stick to the rules when posting here, we'd appreciate it.

Vaccines reduce severe courses of the disease by about 90%. The number vary depending on what you look at exactly, and for elderly people boosters are really mandatory to keep the vaccine effective.

Reducing the number of severe cases by a factor of 10 is very from from not working.

>Vaccinated are still being hospitalized. How much longer will you buy into the narrative that they are not when so many countries are showing evidence to the contrary.

What "narrative"? What are you even talking about?

No-one, including the person you responded to, has claimed that vaccinated people can't get sick. The claim (backed by statistics) is that the unvaccinated are being hospitalized at a much higher rate and for a much longer duration.

You're arguing a point that no-one is disagreeing with.

Please do not take HN threads further into flamewar, regardless of how wrong someone is or you feel they are. It just makes everything worse.

https://news.ycombinator.com/newsguidelines.html

True, unvaccinated people are being hospitalized at a higher rate and for a longer duration.

However, we are not talking about "the unvaccinated", rather about "a tiny unfortunate fraction of unvaccinated people". There are 4,690 covid patients in ICU beds and 25M unvaccinated people. Assuming all covid ICU patients are unvaccinated, the covid ICU incidence rate within the unvaccinated population is 0.02%.

For an analogy, we could reason that because the prison population skews 90/10 male/female, all males should either undergo a vasectomy, or pay a recurring 10k euro fine. I hope this is obviously unethical.

Your prison thing is widely weird and not sure at all how you relate those two.things.

Yes the point is to make sure that those ICU capacity which is very small and normally enough would and is struggling due to covid and vaccination helps.

What is so hard to understand?

Vaccine mandates enforced by heavy fines and/or prison are criminalizing being unvaccinated with the number of "boosters" the authorities deem necessary. Justified by group "crime" statistic differentials. We may argue that it is done in service of a good cause, but it is still criminalizing. Our weird reality.

We are allowed to enforce a lot of things as a society.

We banned toxic paint, we enforce certain vaccines (polio, measles)

It's only logical to enforce a vaccine on people.

Same as you will get reanimated when you have an accident.

We formed and created rules around our society for a long time and those limitations are here for the good of all of us.

A society can't be forced to have a medical oath and in parallel has to watch when people don't play along.

You expect us to do the best to help you in an emergency and in parallel expect total freedom?

Not how our society works. Srsly get over it.

Could you please not post flamewar comments to HN? I'm afraid you've already broken the site guidelines more than once with this account.

If you wouldn't mind reviewing https://news.ycombinator.com/newsguidelines.html and taking the intended spirit of the site more to heart, we'd be grateful.

Sure, but how many vaccinated people are ending up in the ICU, compared to unvaccinated? How many are dying?

Also consider that a population of 100, and 90 of those people are vaccinated. Uf 15 vaccinated people end up in the hospital, and 5 unvaccinated people also end up in the hospital, vaccination is still clearly better for you. But people will still say "75% of the people in the hospital were vaccinated; clearly the vaccines aren't working!" Yeah, well, out of vaccinated people, only 16% ended up hospitalized, while 50% of unvaccinated people ended up hospitalized. Those are the real numbers that matter. Percent of cohort hospitalized, not percent of total hospitalized.

That's like saying, people are still hospitalized after car crashes so seatbelts and airbags are useless.

The safety of modern cars has been shown to lead to more aggressive driving, so this metaphor may track on more levels than you realize.

When all houses have sprinklers only sprinkler equipped houses will burn down. Still in absolute numbers there should be much less fires.

Right, but the point is you still need more ICU capacity.

The analogy is “every house has sprinklers so no need for a fire department any more”.

Do you, though? I see lots of numbers around hospitalizations, but how many (vaccinated) people hospitalized end up in the ICU?

Singapore does a great job of testing and the vaccination rate is >95% for the eligible population. Despite that, they have introduced restrictions due to ICU overload.

https://www.moh.gov.sg/covid-19/statistics

Look at "Proportion (%) of cases ever critically ill in ICU or died, by age and vaccination status"

Looking at the high risk group of 80+ year old (43% of all ICU cases and/or deaths), the numbers are: unvaccinated (24%), partially vaccinated (16%) and fully vaccinated (3.2%).

They don't define partially vaccinated (typically 14 days after 2nd dose). So clearly the vaccine reduces the risk of ICU/death, but the "truly" unvaccinated make up only 50% of ICU cases in that age group.

From all the local reporting the overwhelming majority of people in Czech ICU are not vaccinated. A few examples - listing from a hard-case ICU in Ostrava for a week in November:

https://mobile.twitter.com/VojtechGibis/status/1463608271378...

NEOČKOVÁN - not vaccinated OČKOVÁN - vaccinated

The last 5 patients are those that have been released from the unit in that week. The first two were move to less severe case ICU. The last three died...

One more: https://mobile.twitter.com/VojtechGibis/status/1465783542982...

Czech ICU occupancy - blue unvaccinated, orange vaccinated. And yes, we had several cases <30 years old and unfortunately even children on ICU.

People wearing seatbelts still die in car crashes. When will you stop buying into the narrative that seatbelts saves lives?

Training an ICU nurse takes about 5 years. The only realistic option during the pandemic would be to encourage immigration of ICU nurses from poorer countries, but that just moves the problem elsewhere.

How long does it take the army to train a field medic? (Serious question, I don't know if there's some extended training involved, I just assume it's far less than, say, a nursing degree.)

I think that training people to handle 90% of the issues you see in Covid-related illnesses could be done relatively quickly, if we wanted to do that. The ICU bed shortage really refers to a ICU-staff shortage, and anything we could do to relieve that burden would be a good thing.

The US Army takes 16 weeks to train a field medic. However most of that training isn't applicable to treating COVID-19 patients.

So does developing a vaccine usually. We should be taking extraordinary measure not saying "oh that will take too long don't even start"

Assigning ten teachers to a student won't make the student learn ten times as fast.

Modifying the procedures and allowing people to work before they're through arbitrary redtape does. The EUA the vaccine received is the same concept. The reason the vaccine was developed faster wasn't just the number of scientists working on it, but the amount of funding directed towards it. Increasing money to education programs would increase the amount of people they can train, allow for further optimizations to be developed etc.

Thousands of ICU nurses quit on the past few years. They are still trained and would just have to be convinced to return.

I have a suspicion that ICU training for a COVID specific nurse could be much shorter - if there were any will or basic common fucking sense among policy makers, and if there were fewer people making excuses for those who ghoulishly and cynically privatized healthcare for profit across the Western world.

A "COVID specific nurse" still needs the entire slate of training that goes with respiratory disease, inflammatory disease, etc, and all the secondary complications that come from those.

Then train 3 nurses in respiratory disease, inflammatory disease, and secondary complications separately. Put them under an experienced nurse, and incentivize them to add to their skills when they're not working.

Look at the sheer difference in numbers of healthcare professionals between America and Cuba. If they can do it even after decades of cruel and unusual sanctions, we sure as fuck can too.

Well, mistakes by ICU personnel can easily kill - and that's on top of a significant, often >50% death chance for covid ICU patients. Better make sure the people don't get as far as getting intensive care in the first place.

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