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Comment by standardUser | Hacker News Reader

The primary concern form day one has been the capacity of our healthcare systems. "Peak pandemic mortality" includes scores of people dying from unrelated illness due to lack of care. Does anyone truly think its acceptable to let people die in ambulances outside of hospitals because a highly contagious disease filled all the hospital beds and medical staff is too fatigued to work? Maybe people with a political axe to grind pretend to think that.

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I think the real problem is that in most countries the healthcare system was "optimized" to such extent that even seasonal flu was almost clogging it every year. And now SURPRISE, any disease, even a tad bit more deadly and contagious than the seasonal flu would make it collapse. TOTALLY UNEXPECTED.

As always, the standard gimmick of neoliberalism is to pin the blame for the collateral damage of its policies on the relatively powerless people who refuse its self-serving "solutions."

We've banned this account for using HN primarily for ideological battle. It also appears to be a single-purpose account, which goes against the intended spirit the site (curiosity), and therefore is not allowed here.

Would you please not create accounts to break HN's rules with? If you don't want to be banned on HN, you can email us at hn@ycombinator.com and give us reason to believe that you'll use the site as intended in the future.

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Which non-“neoliberal” (whatever that means) country had plenty excess hospital capacity to handle peak Covid case counts?

Cuba?

No, lots of people do actually think that, but we believe that three main methods can be employed to mitigate this:

1. aggressive triage based on chances and QALY remaining

2. increased healthcare funding

3. voluntary isolation of individuals who see lockdown as being preferable to their personal coronavirus risk

Will it result in more deaths than February 2020? Sure. But we don't have that choice because sars2 exists now.

We think it's better to ration healthcare and therefore doom an unlucky minority, versus rationing life itself for everyone (via lockdowns and restrictions) and slow killing everyone.

As far as I can tell, most of the lockdown debate centres around an erroneous idea that we can just do X, Y, Z, and then immunosuppressed Harriet can rejoin the world and avoid contracting coronavirus.

But she just can't. Even the original strain would have eventually infected her with high probability unless we continued to cycle lockdowns or she voluntarily isolated.

From examining Swedish death spike data, you can see that viruses like COVID occur about once a decade, the last being Swine Flu in 2009:

https://swprs.org/wp-content/uploads/2020/10/sweden-monthly-...

Its just that, using Swedish data again, Western societies are significantly more aged: eg. there 120,000 80-84 year old men (prime COVID death territory) in 2020, vs only 101,000 in 2009. Its similar in many other Western countries: about 20% more elderly people, in absolute numbers.

As such, the 'same' types of respiratory viruses will simply kill more people.

The decisions is thus a social and political one: do we lockdown and force 6-monthly vaccinations on everyone, based on elderly deaths that will occur anyway simply due to the baby boomer cohort entering their twilight years?

I think we need to just get more efficient at end-of-life care, focusing on simpler treatments and comfort, as well as euthanasia-on-demand for anyone over age 75.

I think taking a shot every six month is totally worth it if that will let your grandma live two years longer.

IMO casual masking (stores, airplanes, etc) and a shot every 6 months isn't the annoying part about covid, it's the economic damage of lockdowns, school closures, social gatherings missed, extreme isolation of the vulnerable, travel not happening and the supply chain logjams it has been creating everywhere as a result. You can't go to an office consistently and have face to face lunches coworkers with as a result.

"Our vaccines are working exceptionally well. They continue to work well for Delta with regard to severe illness and death - they prevent it, but what they can't do anymore is prevent transmission."

CDC Director Rochelle Walensky

It would seem fairly important to actually ask the grandmas what they think about this, rather than decide on their behalf.

The four elderly members of our immediate family are all fairly adamant that the young have suffered enough, and "hell, yes" they want to see their grandkids, and no, they aren't asking about vaccinations and negative tests.

I'm minded to respect their opinions.

Yes, and we don't ask them either if they'd feel better if we took them, we just do it for them, it's understood.

I agree. However, the currently existing vaccines don’t seem to do anything at all to stop the spread, so your biannual vaccination does not help grandma much.

How are you estimating what the spread would have been in the absence of vaccination to draw that conclusion?

> Does anyone truly think its acceptable to let people die in ambulances outside of hospitals because a highly contagious disease filled all the hospital beds and medical staff is too fatigued to work? Maybe people with a political axe to grind pretend to think that.

Given widespread availability of vaccines, I think it is acceptable to turn away any non vaccinated people without medical exemptions to preserve hospital capacity.

In the US, hospitals aren't legally allowed to turn away non vaccinated people due to EMTALA. Also note that there is no 100% reliable way for hospitals to determine a particular patient's vaccination status.

https://www.cms.gov/Regulations-and-Guidance/Legislation/EMT...

Regardless of the legality of turning people away the commenter you’re responding to sounds pretty heartless.

Yep. We really need to stop this "us versus them" mentality. This looks like a war between the vaccinated and the unvaccinated, while the "people above" are doing their own greedy thing and laughing at us fighting each other.

I wish I could tell people that:

The vaccine does not prevent transmission as much as you think it does.

You do not spread as easily as you think you do, and you can personally attempt to reduce it even further.

You are vaccinated, and if it is indeed effective and you believe in it, you should not be worried much.

The unvaccinated are people too who probably do not have any malicious intent, and most likely pose little, or no risk to you.

Merry Christmas!

Will it be you turning these people away?

Always puzzles me to see people suggesting all these “just let them die” silver bullet algorithms.

It wouldn't be explicit turning away, but if your in a triage situation, most doctors and medical systems will focus on the most time serious and the people they are most able to save if they have limited capacity. And if your not vaccinated, the ability to save you will be less than the vaccinated and the people with other acute medical issues that are not COVID. That is what will happen in practice in such a regime.

> And if your not vaccinated, the ability to save you will be less than the vaccinated

Is there any evidence that this is true at the point of presenting with equal acute symptoms? Sure, your symptoms are likely to be less acute if you are vaccinated, but that's not the issue, the issue is response to treatment given similar symptoms.

Would you also be of the opinion that, due to the widespread availability of healthy food options and Richard Simmons exercise videos it's acceptable to turn away the overweight to preserve hospital capacity?

That's not how healthcare works, besides that it puts the rest of the population at risk. This isn't the best comment in this thread by a long shot.

> Given widespread availability of vaccines, I think it is acceptable to turn away any non vaccinated people without medical exemptions to preserve hospital capacity.

Person A is "fully vaccinated", last dose five months ago, hasn't taken a Covid test since.

Person B is unvaccinated, but had a PCR test yesterday and is negative for Covid19.

Let's say you're clinically vulnerable, which of A or B would you rather sit next to during a meal?

When you say "unvaccinated" here are you using the currently-accepted official definition which includes people that have received a COVID-19 EUA vaccination/booster within the last 14 days? Do you think that this would be likely to make people that were were concerned about side-effects from the vaccines more or less likely to get vaccinated?

> The primary concern from day one has been the capacity of our healthcare systems.

This is clearly not the case for the vast swaths of our public health institutions who have supported and eagerly carried out mass terminations of healthcare workers who refuse the Covid vaccines.

Capacity of healthcare systems shouldn’t be the primary concern, preventative immune defense and avoiding hospitalization in the first place should be.

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