I just don't get it...

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A Martin said:
I am in Manitoba (Just north of North Dakota) .... and yes , they didn't want me in the hospital .... I am in the vulnerable age group ... which is a polite way to say I am an old fart ... haaaa
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Could this have also have anything to do with differences between the Canadian and US health care systems?
 
jsstevens said:
There are two problems with just letting people decide for themselves:
1) Those in power have to trust people to do things right for others
(assuming those in power want to do well for us and are not just interested in power-an unproven hypothesis)
2) Those who are being trusted have to do what's right for others (this is a group problem, not simply an individual problem). Others may be employees and patrons of course.
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The problems with what we are doing are:

1) We the people have to trust those in power to make the correct dictates. That kind of top-down governmental control rarely makes the best decisions.

2) The dictates have created a significant group of people who are not following health recommendations in protest of what they see as government overreach.

 
Bob Noel said:
Just about the worst thing you can do to an elderly person is isolation.
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Right. But... these are scary times. They tell people you can have the virus and few or no symptoms. I don't want to go see Grandma, then find out a week later I gave her COVID and she died. She may say it's okay, but I would have to live with that for the rest of my life. Not sure what the solution is.
 
wrbix said:
Citation needed.
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wrbix said:
......and as a retired board certified intensivist I understand how ICU occupancy works - keep close to or at full occupancy.....
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Asking for a citation, then announcing you're actually an expert and you agree with me. Interesting flex.

I'm not an expert, but the hospitals are saying they're quite capable of operating at 80-90-100%, and surging if need be. What's the normal occupancy at her hospital? What is the surge capacity?
 
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wrbix said:
......and as a retired board certified intensivist I understand how ICU occupancy works - keep close to or at full occupancy with expectation to transfer “to floor” the least sick when bed needed. But having 100% occupancy with dozens of patients in the ER needing admission is medical infrastructure at its breaking point.
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Or it’s a sign that an efficient medical facility overlooks capacity needed for hundred year events. Fine for private facilities, but “excess” capacity has to exist as a public good. Failure to plan and deliver for that excess capacity isn’t the public’s fault.

The pros and joes in the medical field should have known this type of scenario would occur at some point in there career so they have a responsibility to plan and prevent systemic breaking downs, especially at the policy level that’s driving at least some of the challenges, especially nine months into this **** show of public policy experiment.
 
Lowflynjack said:
Right. But... these are scary times. They tell people you can have the virus and few or no symptoms. I don't want to go see Grandma, then find out a week later I gave her COVID and she died. She may say it's okay, but I would have to live with that for the rest of my life. Not sure what the solution is.
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Difficult choice. But consider how workers at long term care facilities protect the residents... they are tested, they use PPE, etc etc etc. And in order for you to have any chance of transmitting any virus to your grandmother is to first get it from someone else. Break that part of chain, don't go if you fill any symptoms, get tested, use PPE, etc and what do you think the odds are?

What would life be like for an elderly person if they never get to see any family again?
 
Lowflynjack said:
Right. But... these are scary times. They tell people you can have the virus and few or no symptoms. I don't want to go see Grandma, then find out a week later I gave her COVID and she died. She may say it's okay, but I would have to live with that for the rest of my life. Not sure what the solution is.
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My mom is 86 and has been battling cancer for 2 years (this round). She does live with us rather than at a nursing facility-though she as of the last few months should probably have been in one but here we are. She IS fully mentally capable. We were discussing the CDC vaccine priorities (medical personnel and nursing home residents first) at breakfast this morning. I (jokingly) asked if she wanted me to find her a nursing home so she could get vaccinated. She chuckled but then said (very seriously) "I've told [your wife] that I'd rather live a month seeing family than 5-6 times that where I can't." @Lowflynjack I understand why you wouldn't want to be responsible for that, but it seems to me (and I offer this in all compassion) aren't you being selfish to take your guilt over her wishes?

John
 
TCABM said:
Or it’s a sign that an efficient medical facility overlooks capacity needed for hundred year events. Fine for private facilities, but “excess” capacity has to exist as a public good. Failure to plan and deliver for that excess capacity isn’t the public’s fault.

The pros and joes in the medical field should have known this type of scenario would occur at some point in there career so they have a responsibility to plan and prevent systemic breaking downs, especially at the policy level that’s driving at least some of the challenges, especially nine months into this **** show of public policy experiment.
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How much do you spend to prepare for rare events? And are you also spending to prepare for other rare events? Where does it stop? 500 year events? 1000 year events?

We actually have excess portable capacity that can be used. They set up a field hospital in Washington state in March (or April) that was never used. They moored a hospital ship in New York harbor that was minimally used and Samaritan's Purse set up a portable hospital in Central Park (that was also never used).
 
Lindberg said:
Asking for a citation, then announcing you're actually an expert and you agree with me. Interesting flex.

I'm not an expert, but the hospitals are saying they're quite capable of operating at 80-90-100%, and surging if need be. What's the normal occupancy at her hospital? What is the surge capacity?
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No, all I’m trying to convey is that “100% capacity” can mean many things, and be used many ways to advance an agenda.....but 100% capacity with dozens in the ER is, indeed, a sign that something is amiss. As much as pandemic deniers would like to think otherwise, this is not typical or sustainable.
 
jsstevens said:
My mom is 86 and has been battling cancer for 2 years (this round). She does live with us rather than at a nursing facility-though she as of the last few months should probably have been in one but here we are. She IS fully mentally capable. We were discussing the CDC vaccine priorities (medical personnel and nursing home residents first) at breakfast this morning. I (jokingly) asked if she wanted me to find her a nursing home so she could get vaccinated. She chuckled but then said (very seriously) "I've told [your wife] that I'd rather live a month seeing family than 5-6 times that where I can't." @Lowflynjack I understand why you wouldn't want to be responsible for that, but it seems to me (and I offer this in all compassion) aren't you being selfish to take your guilt over her wishes?

John
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This is something I always think about:

We have been making a lot of policy decisions about how to deal with long-term-care residents “for their own good”. What we have missed is asking those residents what they prefer.
 
Matthew said:
This is something I always think about:

We have been making a lot of policy decisions about how to deal with long-term-care residents “for their own good”. What we have missed is asking those residents what they prefer.
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And in many cases, you can't, but for those that you can, we should. And "Quality of life" is a very subjective thing.

I have a friend who is primary caregiver for his older sister. She has circulatory dementia. Some times she's fully aware and other times (more and more as time goes by) she's not. Just because her circulatory system is so compromised that her brain is oxygen deprived. She can't make these decisions for herself mostly (or remember what she decided when she's not on it). Tough call all around.
 
AKBill said:
So I just made a 2 day trip to Seattle. The only reason I flew down (commercial airline) was for the doctor to check out my right eye. An accident caused me to loose sight in the eye.

I was amazed at the number of parents traveling with children. Guessing they were returning home from visiting grandma for Thanksgiving. Kids of all ages.

With the current dilemma of C19 why would you subject your toddler/child to the chance of getting the virus? I just think it's irresponsible. What is going thru these parents heads?

Personally I would have told grandma lets give it another 6 months. Maybe we can safely travel then.
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I think perhaps its shocking to you because our community has taken it very seriously, whereas most other places haven't. There's a reason that we have a case rate less than half that of the average for the rest of the state, which sits around 1 person in 22 (The US average is 1/23). More *ahem* vocal areas such as Wasilla and Palmer have case rates of 1/4 and 1/7 respectively whereas ours is 1/48. There are plenty of interesting correlations to be made with the data from this state, and an anecdotal piece of that puzzle is there's not a mask in sight if you visit either of those towns.
 
DavidWhite said:
I think perhaps its shocking to you because our community has taken it very seriously, whereas most other places haven't. There's a reason that we have a case rate less than half that of the average for the rest of the state, which sits around 1 person in 22 (The US average is 1/23). More *ahem* vocal areas such as Wasilla and Palmer have case rates of 1/4 and 1/7 respectively whereas ours is 1/48. There are plenty of interesting correlations to be made with the data from this state, and an anecdotal piece of that puzzle is there's not a mask in sight if you visit either of those towns.
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Your governor is an idiot.
Eric Johnson KOMO - Seattle is DyingFacebookMar 17, 2019
he doesn't care a hoot about the other half of the state, or the city.
 
Anecdotal:

The 4th of July weekend here looked pretty much like any other, Walmart, Lowes, Home Depot, Harbor Freight parking lots were packed. People from Texas were at a house party up here.

Cases were FLAT. Bryan health max load was ~20 patients admitted on any given report from April thru September. Seriously, they reported 5 total covid related hospitalized on July 23, then IN-PERSON school started...

Dec 1 they (Bryan health) have 112 positives, 31 no longer infectious and 12 are pending test results patients admitted.

If in-person school didn't contribute in a massive way then it sure is coincidence.
 
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jsstevens said:
@Lowflynjack I understand why you wouldn't want to be responsible for that, but it seems to me (and I offer this in all compassion) aren't you being selfish to take your guilt over her wishes?
John
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I'm not saying I'm right, I don't think there is a 'right answer' but it is something I think about.

I think you do have to consider the fact that if you give her COVID, you will have to live with it. Is it being selfish saying I don't want to watch someone die knowing I exposed them to a deadly disease, even if they were willing to take the risk? Yes. Selfishness is part of self preservation though.
 
All good reading, thanks for all the posts.

I'm headed back to Seattle Sunday for surgery on my right eye Tuesday. I've had more C19 tests in the past 6 weeks than I care to take. The most important one will be Monday, if positive my surgery gets postponed. I sure don't want that to happen.
 
TCABM said:
Or it’s a sign that an efficient medical facility overlooks capacity needed for hundred year events. Fine for private facilities, but “excess” capacity has to exist as a public good. Failure to plan and deliver for that excess capacity isn’t the public’s fault.

The pros and joes in the medical field should have known this type of scenario would occur at some point in there career so they have a responsibility to plan and prevent systemic breaking downs, especially at the policy level that’s driving at least some of the challenges, especially nine months into this **** show of public policy experiment.
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At the beginning of this when NY was killing everyone, it came out that when they'd wargamed out a pandemic, they knew they'd need to either have more ventilators and beds just sitting around or have a plan for who they were going to let die. They chose the latter. Then when all the stories came out about rationing care, of course no one wanted to be the one to stand up and say, "Yeah, actually, this was our plan all along. In order to avoid paying for too much excess capacity, we planned to let a bunch of you die. That was our decision and we're sticking to it." Instead they just threw blame around and expected to be bailed out.
 
Lowflynjack said:
I'm not saying I'm right, I don't think there is a 'right answer' but it is something I think about.

I think you do have to consider the fact that if you give her COVID, you will have to live with it. Is it being selfish saying I don't want to watch someone die knowing I exposed them to a deadly disease, even if they were willing to take the risk? Yes. Selfishness is part of self preservation though.
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At the beginning, I tried to keep my mom and in-laws away for exactly this reason. If they were going to get COVID and die, I didn't want it to happen here. But all of them made clear that they just didn't want to live alone in their homes away from their families and especially their grandkids. They're adults and ultimately they made a rational decision that they can live with. I couldn't deny them that. Might have been different if we'd actually stuck with "2 weeks to flatten the curve."
 
Lindberg said:
At the beginning of this when NY was killing everyone, it came out that when they'd wargamed out a pandemic, they knew they'd need to either have more ventilators and beds just sitting around or have a plan for who they were going to let die. They chose the latter. Then when all the stories came out about rationing care, of course no one wanted to be the one to stand up and say, "Yeah, actually, this was our plan all along. In order to avoid paying for too much excess capacity, we planned to let a bunch of you die. That was our decision and we're sticking to it." Instead they just threw blame around and expected to be bailed out.
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Does this count a death panel?

IBTL
 
wrbix said:
No, all I’m trying to convey is that “100% capacity” can mean many things, and be used many ways to advance an agenda.....but 100% capacity with dozens in the ER is, indeed, a sign that something is amiss. As much as pandemic deniers would like to think otherwise, this is not typical or sustainable.
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I’ve been pretty lucky. I’ve never run across a pandemic denier. I can imagine it would be frustrating to talk to someone like that for any length of time.
 
wsuffa said:
Does this count a death panel?
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That's exactly what it is, and it is economic, not political. If demand exceeds supply of a scarce good, there must be a mechanism for distributing the available supply. Eliminating price as that mechanism doesn't solve the scarcity problem, it just means you need another way to decide.
 
Here in IL our whole state went on lockdown in the beginning due to bad outbreaks in Chicago. The problem is much of the rest of the state including where I live wasn't seeing one. Our county had I believe under 10 total cases or close to that by the end of summer. At the time people in this part of the state were pointing this out and begging or gov to do what we and many other states do now- break up the state into regions. At the time our gov was very dismissive of the idea and actually laughed at one point when someone brought it up in a press conference. This same governor also had his family traveling to FL while we were all supposed to be staying home.

In response our county board, state's attorney, and city/county police all stated they wouldn't enforce any of the governor's mandates. Yard signs expressing negative opinions of our governor went up everywhere and there were petitions for a recall circulating... people down here didn't like him before but his handling of the situation bumped that up to outright hatred. Our county wasn't the only one to do this, it was common across much of the non-chicago parts of IL.

So fast forward to now, we did finally see COVID outbreaks starting in Oct. That case count is now close to 1000 and we've seen deaths, mostly in nursing homes. Our region, along with most IL regions are seeing restrictions again. Among other things restaurants are supposed to be closed for indoor dining- except many of them are not. Some owners are saying it's either defy the order or go out of business. Maybe if they hadn't been shut down when there was no outbreak that wouldn't have mattered. Local officials, knowing the situation these businesses are in, won't do more than talk to the owners and give a token($10/week last I heard) fine.

We have a mask mandate, I think less than 50% comply. Maybe more or less depending on which store you're going into. It was closer to 10% until wal-mart and other stores started requiring them. IMO the mask defiance is as much symbolic as anything. All the restriction we've had are about mitigation. So with that being the case, some thing were allowed while others weren't. A lot of those choices were based on value judgements on what was worth a risk and what wasn't and a lot of that made no sense from a public health perspective. Protesting is OK but a walk in the park isn't? The mostly outdoor independent garden center can't be open but you can go to wal-mart or home depot and buy anything you want?

The arrogant and authoritarian attitudes of some elected officials early on destroyed a lot of public trust and with it any chance of widespread cooperation. I can't help but notice when I traveled to FL after they dropped statewide restrictions I saw nearly everyone wearing a mask. Makes me think there's something to just telling the public the truth, making recommendations, and letting everyone figure out what makes sense for them. Yeah some will make poor choices and we'll disagree on what is and isn't reasonable, but it beats the situation of mistrust and defiance that the alternative has created.
 
Locked. Pending MC review.

Edit: The thread will remain closed per MC vote.
 
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