Hacker News Reader

Comment by enchiridion | Hacker News Reader

How about scale up the hospitals, or at least covid capacity in a meaningful way. How long does they public have to bear burden of insufficient health infra.

EDIT: Sorry that might have come off a bit blunt. But the entire pandemic response has been frustratingly insufficient in my opinion. A variant like Omicron was long predicted and expected. How are we not prepared with a plan to end lockdowns?

And blaming unvaccinated or anti-maskers is not a good answer. Modeling of acceptance should’ve been done. It’s not like these contrarian sentiments were surprising either.

All together it feels like this response to omicron is a public health failure.

View on HN

The US is a public health failure. We didn’t want “socialized” medicine.

So we got what we wanted, the best nurses are making $300/hr in COVID hotspots and leaving new grads and understaffed facilities in their wake.

Feel free to name the country that isn't experiencing the exact same issues regarding COVID hotspots and understaffed facilities, "socialized medicine" or not.

Japan, Israel, South Korea, New Zealand come to mind. Honestly, it’s not very hard… the US went from the respected world leader to a public health carnival sideshow overnight.

CDC is taking cues from places like South Africa and Israel now. It’s pathetic.

This is not a productive viewpoint, it’s defeatist.

How would socialized medicine help in this specific case? More power to the government? The government already has plenty of power to influence outcomes through spending. However, that power has been applied poorly.

We need mass repeal of old government regulations and the appointing of technocrats (as in people concerned with low level details of regulations). Additionally we need new highly adversarial independent regulatory bodies to prevent capitalistic interests from causing market collapse.

The current agencies are too in bed with industry, and it’s not beneficial to the public.

Giving more power to the current government systems which rolled out this poor response seems like the wrong answer.

And who will staff them?

https://www.personneltoday.com/hr/uk-lacks-nursing-staff-to-...

The ones you didn't force out because they didn't want to get vaccinated?

There are approximately 0 actual nurses capable of running critical care beds who are antivaxxers. It’s such a fringe position that’s given far more press coverage than it deserves. Blaming the hospital shortage on the hypothetical vaccine mandates chasing away capable staff is completely without evidence.

Every story of a health care provider firing unvaccinated staff has only had losses of less than 1%. That's not enough to make a significant difference.

Here are a few options:

* Spend tens of billions training new medical staff so you can save hundreds of billions / trillions on not having to lock people down

* Stop admitting COVID patients at government subsidized hospitals when there is a shortage of hospital beds, with the exception of essential and frontline workers, so that hundreds of millions of people don't need to be locked down

* Make those who are not vaccinated, or do not have recent booster shots, ineligible for care for COVID at government subsidized hospitals, when there is a shortage of hospital beds, so that hundreds of millions of people don't need to be locked down

But the go-to solution seems to be: massively violate the civil and economic liberties of the entire population, to prevent COVID surges from causing a shortage of hospital beds.

> How are we not prepared with a plan to end lockdowns?

We barely ever had anything approximating lockdowns and they ended long ago. We don't generally make plans to do things after they are already done.

> How are we not prepared with a plan to end lockdowns?

We don't have lockdowns, and haven't had lockdowns in America

> And blaming unvaccinated or anti-maskers is not a good answer

Blaming the unvaccinated, who comprise the overwhelming majority of those that get hospitalized, spread it and die, is a good answer. I think a lot of this is solved by deprioritizing them at triage time or letting them recuperate at home.

I encourage everyone eligible to get vaccinated but blaming people for making unhealthy choices isn't an effective public health measure. It didn't work in the HIV/AIDS pandemic and it won't work now. Better to focus on education and harm minimization.

Due to EMTALA, hospitals in the US are required to treat unstable patients regardless of vaccination status. Changing that would require an Act of Congress. Also note that there is no 100% reliable way for hospitals to determine a particular patient's vaccination status; the registries have some data quality and record linkage problems.

I share your frustration, but the anti-vax people were expected. It’s like sitting into the wind at this point. The game plan should’ve been built around there non-compliance.

Poor leadership only plans for things going how they want.

As far as lockdowns are concerned, we have had the mass shutdown of in person school and work, as well as the forced closure of many restaurants and entertainment venues.

I was using the shorthand.

> The game plan should’ve been built around there non-compliance.

That is correct, and that's why they proposed the OSHA rule for mandating vaccinations after months of incentives. I think some % of non-compliance is understandable, but the remaining unvaccinated seem to be doing it for political reasons over anything else.

> As far as lockdowns are concerned, we have had the mass shutdown of in person school and work, as well as the forced closure of many restaurants and entertainment venues.

Right, we had those last year. Not since, in America at least.

I am in the US and schools are still doing "distance" learning and restaurants are not allowed at full capacity.

That’s not a lockdown by any reasonable definition of the term.

I don't know any school districts that have permanently been doing distance learning (though some, stupidly, are doing another round of it because of the omicron surge) and I have not heard of any restaurant capacity restrictions in my very blue, COVID conscious city.

Well, where I am things are still quite restrictive

The AMA doesn't want an oversupply of competition.

False. The current physician shortage is primarily caused by insufficient federal funding for medical residencies. Every year there are doctors who graduate from medical school but are never allowed to practice medicine because they can't get matched to a residency program. The AMA has been lobbying Congress to increase the supply for years.

https://www.ama-assn.org/press-center/press-releases/ama-fun...

There's other sources of money. Hospitals have like a trillion dollars of revenue at this point, I bet diverting some of that to training doctors would work out fine.

>Every year there are doctors who graduate from medical school but are never allowed to practice medicine because they can't get matched to a residency program.

Aren't 99% of unmatched, graduates of sketchy overseas medical schools?

Typically about 5% of medical school graduates don't get matched, although some of those do get in later.

https://www.ama-assn.org/residents-students/match/if-you-re-...

As for overseas medical schools, the National Committee on Foreign Medical Education and Accreditation is supposed to ensure they meet the same standards as domestic schools. I haven't seen any real evidence that they're sketchy.

https://sites.ed.gov/ncfmea/

Knowing a number of foreign medical grads, I'd have to agree that they are not, as a rule, skethcy.

Reply on news.ycombinator.com