I am vaccinated, but as a human being, is this a useful approach?
I am vaccinated, but as a human being, is this a useful approach?
There is a lot a play in The Philippines. First off this goes back to the beginning of his term, and an inquiry into Denguevax which they used to berate the previous President. This forced a lot of people to fear vaccines. Many people are not vaccinated against even the most common illnesses such as Measles, TB etc. Some because they refused to be (religion playing a part) and some because there just aren't the resources.
Then there was issues with supply of vaccines, which made the leadership look incompetent. They had this same line when they could not even acquire vaccines, that they would punish people who did not get vaccinated.
This is his final term with elections this year, and he is facing investigation by the ICC. He is a hardliner who took power, and 1000s if not 10s of 1000s of people died in a drug war which he is clearly a provocateur of. If the opposition gets in, he will likely end up in the Hague, so he needs political support and the country loves hardliners.
The list goes on from there, to corruption in the government health care department, potential corruption in the supply of PPE and other equipment, coming last in many lists of response performance in dealing with covid etc etc.
If it was non-vaccinated people it would be the Church, drug addicts, foreigners or whatever. This isn't demonization of the unvaccinated, it is an Authoritarian response to being a bad situation.
In fact have any governments imposed mandatory injections yet?
But I agree, it's lose-lose situation. Just hard to imagine it could be worse than what we have going on now.
Some of them undoubtedly will double down, but those people are probably unreachable by sanity anyway.
Initially there were hopes that vaccines would suppress the spread of the virus enough to end the pandemic, and if that turned out to be true then the unvaccinated would in fact be prolonging the pandemic, but now we know that that is not true. Anyone can get Covid, and anyone can give it to someone else. Vaccines are about personal protection at this point, not community protection.
https://www.smh.com.au/national/hospitals-are-being-crippled...
We have also had the ambulance system issue statements that they are having delays in reaching people (code reds).
The unvaccinated make up the bulk of people that need hospital treatment here. Their choice to remain unvaccinated is having a direct impact on the community as a whole.
https://www.cdc.gov/mmwr/volumes/70/wr/mm7046a5.htm (Impact of Hospital Strain on Excess Deaths During the COVID-19 Pandemic — United States, July 2020–July 2021)
https://medicalpartnership.usg.edu/covid-19-staggering-stati... (Staggering COVID-19 Statistic: 98% to 99% of Americans Dying are Unvaccinated)
https://www.media.pa.gov/pages/health-details.aspx?newsid=15... (Vaccines Work: 97% Of COVID Deaths, 95% Of Hospitalizations And 94% Of Cases Are Among Unvaccinated Pennsylvanians)
https://www.npr.org/2021/09/10/1036023973/covid-19-unvaccina... (Unvaccinated People Are 11 Times More Likely To Die Of COVID-19, New Research Finds | September 10th, 2021)
https://www.statnews.com/2021/08/18/health-workers-overwhelm... (‘It’s soul-draining’: Health workers deployed to Covid hot zones are overwhelmed by deaths among the unvaccinated)
https://ourworldindata.org/covid-deaths-by-vaccination (Our World In Data: How do death rates from COVID-19 differ between people who are vaccinated and those who are not?)
https://www.cbsnews.com/news/covid-us-hospital-icu-bed-short... (Veteran dies of treatable illness as COVID fills hospital beds, leaving doctors "playing musical chairs")
https://www.vox.com/coronavirus-covid19/2021/9/14/22650733/u... (Americans are dying because no hospital will take them)
Why would the healthcare system of the alleged preeminent nation on planet Earth not have capacity for its citizens past a certain threshold?
Many cities have older hospitals that have yet to match the population increase. If so, why is that? And should someone do something about it?
Edited, to add one more question: if they shouldn’t, why not?
If your question is, “Is the US healthcare system capacity not elastic?”, the answer is, unequivocally, no, no it is not. So get your vaccine(s) and don’t be an unnecessary burden on your fellow human, whether that’s someone who needs healthcare or someone who provides it.
My question has nothing to do with the elasticity of the healthcare system which obviously has its own hosts of issues and which we won’t get into here.
But if you’d rather pivot to that then the spirit of my response still has play: why hasn’t the healthcare industry optimized the incentives for healthcare workers to take on this Sisyphean task? Can you please point to some instances of hospital boards increasing pay, benefits, etc. that could offset the risk for these workers?
I guess my major point here is that your highly rational civic minded approach to the crux of the issue here is disjointed: on one hand you lament the ineffectiveness of the healthcare system and in the same breath take a defeatist approach to it as if nothing can be done internally to alleviate the toll the virus is taking on it.
And the sad reality is: it’s the same old shit, everyone wants to praise the heroes (Tiktok nurses) and yet, here we are, two years later, with the same dysfunctional system that got us here. At what point will we collectively try to address the root cause instead of the end user?
Again, here’s reality, with a little less imagination:
Similar to the tech industry, people who architect these systems are, lo and behold, nowhere to be found when these systems go haywire.
And because of this the media apparatus and their apologists uses the oldest trick in the book which is: “Let’s frame this as a them vs. them thing and let people strangle each other over hospital beds”.
When in reality, all that needs to be done is break out the same checkbook that pays for all our wars.
I’m sorry man, but the increased load on facilities, and furthermore, the “lack” of qualified professionals is an apologist pundit opinion full-stop, and quite frankly, borderline offensive.
The carrot can be a check for $1000 (or whatever gets the job done), and the stick can be restrictions on indoor dining and gyms or similar. That should hopefully get us close, and might even save money compared to letting this go on forever.
It takes 10 years to train a doctor and 6 years to train a nurse.
Exactly what exactly is your plan to get more doctors / more nurses?
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In my state, we've declared an emergency. The national guard has been deployed to hospitals to run non-medical jobs. Student nurses are now allowed to work in hospitals / clinics, and we've even signed cross-state agreements to share our excess nurses in a pool with other states (so that as we get hit with COVID19 emergenies, we can help pass nurses around and better distribute the load as needed).
If you got any better ideas, we're all ears. Immigrant visa applications are __heavily__ slanted towards doctors / nurses as well. Its an open secret that if you want USA-citizenship, just train to be a nurse then move here. Our systems are firing 100% on hiring more nurses and we still don't have enough of them.
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Port-cities (we have a few of them) can make requests to the US Navy for hospital ships. This doesn't work for land-locked states but its an option for us.
Sure, they’ll be overworked, but hey, when the going gets tough, the tough get going, don’t they?
How about an increased emphasis on putting together the right incentives that ameliorate their personal risk tolerance just enough so that they’re OK with double shifts?
Everyone has a price.
So how about we just get to the part where we get those (who can and want to help) what they need so that we can move on.
We've cut out 20% of non-essential surgeries in our state to make room for COVID19 patients. "Non-essential" surgeries include biopsies and other potential-cancer events.
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We have plenty of hospitals actually, and equipment. USA is very very rich, we can afford anything. Its the nurses / doctors we can't afford right now, cause they're non-existent.
We can poach doctors/nurses out of school, maybe grab a few more doctor/nurse immigrants, and finally pool doctors/nurses together to make them more efficiently distributed across state-lines. But that's about it. You can't squeeze blood from a stone. You can't just "magic" doctors into reality by asking them to work twice as many hours.
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This is no longer a "find student doctors/nurses" situation. We're well into "cancel other surgeries", and triage of care. Yes, here in the USA we've run out of health-care resources.
The reality is that there aren't that many interventions that need to take place to help those with a serious case of COVID. It's not open heart surgery nor is it a more garden variety surgical procedure such as cyst removal or non-invasive plastic surgery. Apart from intubation and steroids in some cases, where's the rocket science here? An EMT or an army medic, with the right equipment, will more likely than not guarantee the same quality of healthcare that an MD or nurse will give.
Although I hardly think you'll meet me halfway on that, so here's this question: Do you think the situation is/was helped by firing all unvaccinated healthcare professionals at hospitals around the country? If so, why? If not, why?
Yes.
1. A family friend died from getting a nurse pass COVID19 to him. He was age 35. He further passed COVID19 to his father, who also passed away.
2. People come to hospitals to be protected from diseases. At a minimum, doctors/nurses themselves should be protected to minimize the chance of them spreading it to others.
3. The majority of "off" nurses / doctors in my area are due to COVID19 illness, not from firings. Vaccinations would reduce the chance of the workforce getting sick or spreading the sickness around.
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Since hospitals are going to become the hottest of COVID19 hotspots (not only because of COVID19 patients visiting, but also as other immuno-comrpomised / weaker individuals visiting. Pregnancies, cancer, even "the flu" can be a complicating ailment that weakens your immune system to make COVID19 hurt more), its absolutely essential to minimize the COVID19 spread at hospitals / health care centers.
Even if we lose some doctors/nurses over it, minimizing COVID19 spread (and preventing it from getting worse) takes priority. A huge priority.
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> An EMT or an army medic, with the right equipment, will more likely than not guarantee the same quality of healthcare that an MD or nurse will give.
Army Medics are by-and-large doctors.
EMT is basic training. Its enough to maybe diagnose / run tests, but we're not talking about serious COVID19 treatment decisions (ex: whether or not a patient has reached the point to need a ventilator).
> The reality is that there aren't that many interventions that need to take place to help those with a serious case of COVID.
Dexamethasone, monoclonal antibodies, ventillators. These tools save lives but require proper training to deploy.
If you stick someone into a ventilator unnecessarily (ie: shove a tube down their throat so that it can breath for them), you're unnecessarily inflicting trauma upon them. Furthermore, that's a procedure that you want a trained nurse to do, to minimize the discomfort.
Dexamethasone cuts death rates by 50% under ventilators IIRC. But as a steroid, it weakens the patient's immune system (!!!), potentially making COVID19 worse. Its a cost/benefit analysis that has no solid rubric for proper use. Instead, you rely upon a doctor (someone who has studied the human body's mechanics to a significant degree) to make that call on a case-by-case basis.
Monoclonal antibodies cost $2000. Omicron may or may not be stopped by them, that's once again, the decision that a doctor should make that a lesser-trained EMT / Nurse / Physician assistant is likely incapable of. Given the high cost of the treatment, the number of supplies in the hospital, and the expected results... do you give monoclonal antibodies to a particular patient?
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Even a simple blood-IV goes horribly wrong if an untrained person attempts it. You can literally kill a patient if done incorrectly. You want a trained nurse who is good at it.
Each "missed" attempt causes blood vessels to tense up, making your next attempt harder. Even a good nurse can have a bad day and cause a patient to be pricked 4, 5, 6 times. I know cause its happened to me.
Having well trained nursing staff do IVs is just common sense (and its a skill that doctors don't really have, physically feeling for the vein and popping the needle in there). You need that sort of thing if you want monoclonal antibodies btw, to get shoved into the system. Doctors are more knowledgeable of more issues / human mechanics.
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In any case, you want __nurses__ for this current situation. That's our bottleneck right now.
And a lot of the elevated salaries and AMA power actually started during WWII with income caps (where better healthcare was a company perk to attract workers), and got exacerbated with the introduction of Medicare in the 1970s, where Medicare used to cover any procedures, so doctors could get obscenely rich via over-billing. The pullback on that actually caused doctors wages to be stagnant, albeit on an artificially elevated level.
(See Canadian vs US doctor's salaries for ex - which tracked until 1990s but recently diverged quite a bit in favor of US doctors)
Also, foreign trained medical specialists can't practice in the US without re-doing the board exams and residency - another protectionist move to limit doctor supply. There is an argument there that it maintains quality (since you can practically buy medical degrees in certain countries), but I think an easier pathway for foreign medical professionals to practice in the US could still help.
I know all of this since my mother is actually a foreign-trained doctor who re-did residency in the US and has been practicing for 20+ years.
https://www.ama-assn.org/press-center/press-releases/ama-fun...
This is true for obesity as well though, and HIV, STDs, etc. which are overloading the health system.
The data is clear about the following:
- The vaccine is better than nothing for most people.
- If you're over 50 and unvaccinated you have a high risk of severe outcome.
- The vast majority of people have low / negligible risk of severe outcome.
- Stopping variants was never possible.
- Stopping the spread was never possible.
- Slowing the spread is only meaningful among people who will get hospitalized -- e.g no reason to lock kids out of school for 2 years.
As for demonizing, I think there's little evidence this is encouraging the unvaccinated to switch sides. It begs the question why leaders haven't imposed mandatory injections at this point? Surely it would be less painful than this.
Maybe governments want the division as an excuse to push some agenda? who knows.
Maybe they didn't want the kids spreading it to people who would have been hospitalized?
https://www.nytimes.com/2022/01/04/briefing/american-childre...