I want to make sure you know that this post is full of bizarre falsehoods. New York and Seattle definitely have ventilator shortages. California had a shortage and that federal reserve of ventilators netted us a small number of broken devices that had to be repaired. Lucky us, the State had a corporate partner that could do it.
I especially want to take issue with this falsehood:
> All three are in plentiful supply. Even in localised hotspots like New York problems are limited to a handful of hospitals.
ICU beds are definitely in short supply. It doesn't matter if a bed exists in another state, folks who need ICU beds aren't usually fit to travel. That's part of why their care is intensive.
But also, only large hospitals have significant ICU capacity. So saying it's only limited to hospitals that have ICU capacity seems very disingenuous to me. It's like saying, "There is no shortage of ICU beds at local clinics." That's true, because no one expects substantial ICU capacity at local clinics. If they had it, it'd be welcome right now.
> I've been reading about the near deserted state of most hospitals for over a week now. I don't understand where Marc is getting his information from if he isn't aware of this.
Where are you reading this? I have relatives in healthcare in NY. They do not relate your story to me.
> Vaccines can't be created for a virus that doesn't exist yet regardless of how many vague warnings there are, so this isn't remarkable: it's inevitable. As for therapies, that's what ventilators and CPAP are.
Who would CPAP machines be for? Why bring them up?
> Given the data appearing in a flood of new papers, showing that the virus is not dangerous enough to warrant current policy, no unusual rates of manufacturing scale-up will be required.
The medical literature is in fact saying the opposite. But now I'm morbidly fascinated what the "reopen the economy" and "it's just the flu" crowd are circulating as "scientific literature."
> Tax credits, quantitative easing, loan subsidies. The government has many ways to distribute money to people.
None of which are actually effective in the face of historic unemployment.
> In fact making medical masks is hard. It requires special materials and machines, the supply of which can't be rapidly scaled up.
Making masks which reduce individual aerosol dispersal is easy. N95 masks are harder. We definitely could scale them up rapidly if we wanted to. This is the territory where things like IP law do matter and do cost lives.
New York doesn't have a ventilator shortage and never did. It had a predicted shortage based on bad simulations, but never a real one. In fact it's now sending ventilators elsewhere:
"On April 2, Cuomo predicted the state would run out of ventilators in six days “at the current burn rate.” But on April 6, Cuomo noted, “We’re ok, and we have some in reserve.” Now New York appears to have passed the apex. Deaths, a lagging indicator, crested at 799 on April 9 and hit 606 on April 16, the lowest figure since April 6. Hospitalizations are also declining, and on April 16 also hit their lowest level since April 6. Cuomo today has so many ventilators he is giving them away: On April 15, he said he was sending 100 of them to Michigan and 50 to Maryland. On April 16, he announced he was sending 100 to New Jersey."
I'm morbidly fascinated by what you're reading that has led you to this belief.
Re: ICU beds: I was talking about the world generally rather than New York specifically. For example in New Jersey on April 8th only 3 hospitals were load balancing to others:
"the field hospital constructed inside the massive Jacob K. Javits Convention Center in Hudson Yards, had 340 patients as of Tuesday afternoon ... The facility has a maximum capacity of 2,500 hospital beds. As of Tuesday afternoon, the Javits Center hospital had treated about 700 patients"
Even on April 1st, the New York Post visited an ICU and found it was only handling double the normal case load, well within capacity (13 patients normally, 26 then):
Certainly there are cases where single hospitals ran out of space and started load balancing onto nearby hospitals. But, that happens during normal times too.
Where are you reading this? [empty hospitals]
The essay isn't only about New York, it's trying to generalise not only to America but the whole western world. And across the world hospitals are laying off staff due to underload:
Who would CPAP machines be for? Why bring them up?
CPAP - the pressure type, not the sleep machines - is now a common therapy for treating COVID-19. For example the British Prime Minister wasn't put on a ventilator but rather given only CPAP (basically, a mask connected to the hospital oxygen supply). This is because there's a growing belief in the medical world that ventilators can cause more harm than good for COVID patients.
None of which are actually effective in the face of historic unemployment.
That's not a rebuttal. Systems to distribute money exist. The idea they've never been built, as the essay argues, isn't right.
If you want to argue they aren't designed for sustaining a world under house arrest, by all means do so, but no country on earth has created schemes specifically for that.
Making masks which reduce individual aerosol dispersal is easy. N95 masks are harder
Andreessen was talking about medical-grade masks designed to protect doctors from patients, not ad-hoc home made things. And for those masks the point stands: it's hard to make them but he says it's easy.
As for medical literature, go read the links to papers and studies here:
There are many links to papers, comments and articles by doctors and other specialists who are arguing that the virus is clearly not as deadly as feared. For example, the serology survey that's in the first link under the April 18th update was discussed here on HN just recently.
That's good news, by the way! Don't you hope they're right? My experience is that some people posting on HN don't actually want to study what people bringing good news are saying.
Sorry, I already have decided in another post your "Swiss Doctor's" summary isnt't very credible and that National Review article seems to have an awful lot of hedging in it.
Thank you for the effort, but I don't believe there is much more to say on the subject.
I'm sorry, you're right. There was a narrow window where there were concerns, but that passed. New York DOEs face ICU bed shortages.
My response here was mostly dismissive because the poster above is clearly trying to downplay the crisis for reasons I can only speculate on. After taking a lot of time to read through the poster's previous links, I'm quite frustrated with how much time I wasted on disingenuous garbage links.
But yes, I lumped Seattle (which briefly did have a ventilator shortage) in with New York on ventilators. This is pretty much the only thing I was wrong about and I'll take this opportunity to own up. But I won't engage earnestly with the previous poster any further.
I especially want to take issue with this falsehood:
> All three are in plentiful supply. Even in localised hotspots like New York problems are limited to a handful of hospitals.
ICU beds are definitely in short supply. It doesn't matter if a bed exists in another state, folks who need ICU beds aren't usually fit to travel. That's part of why their care is intensive.
But also, only large hospitals have significant ICU capacity. So saying it's only limited to hospitals that have ICU capacity seems very disingenuous to me. It's like saying, "There is no shortage of ICU beds at local clinics." That's true, because no one expects substantial ICU capacity at local clinics. If they had it, it'd be welcome right now.
> I've been reading about the near deserted state of most hospitals for over a week now. I don't understand where Marc is getting his information from if he isn't aware of this.
Where are you reading this? I have relatives in healthcare in NY. They do not relate your story to me.
> Vaccines can't be created for a virus that doesn't exist yet regardless of how many vague warnings there are, so this isn't remarkable: it's inevitable. As for therapies, that's what ventilators and CPAP are.
Who would CPAP machines be for? Why bring them up?
> Given the data appearing in a flood of new papers, showing that the virus is not dangerous enough to warrant current policy, no unusual rates of manufacturing scale-up will be required.
The medical literature is in fact saying the opposite. But now I'm morbidly fascinated what the "reopen the economy" and "it's just the flu" crowd are circulating as "scientific literature."
> Tax credits, quantitative easing, loan subsidies. The government has many ways to distribute money to people.
None of which are actually effective in the face of historic unemployment.
> In fact making medical masks is hard. It requires special materials and machines, the supply of which can't be rapidly scaled up.
Making masks which reduce individual aerosol dispersal is easy. N95 masks are harder. We definitely could scale them up rapidly if we wanted to. This is the territory where things like IP law do matter and do cost lives.