Whether we catch it is not the issue, the vast majority of us will. It's whether when you do and have complications, you can go to the hospital or die waiting for an ambulance that never comes because the system is overwhelmed.
You do your 4 year undergrad and at your first job, no one trusts you. Your supervisor/senior engineer checks Everything you do. You are reserved for paperwork and unskilled manual labor which is also checked. After a few years (4) you get some Freedom, but still checked by your seniors. Anything important, even when you are a senior engineer goes through your Managers and directors.
I don't see why this system wouldn't work in medical. We build airbags and bridges. Both safety critical.
I would even say having 1 physician is more dangerous than having a team of Engineers with less Schooling.
When choosing a primary physician at one of the San Francisco Kaiser Permanente campuses, I noticed that a substantial number of doctors had overseas medical training. Which was fine by me--I'm an enthusiastic Kaiser member and support their cost management strategies--but I found it interesting.
> So they're now using a mixed strategy of both out-sourcing and in-sourcing medical training to address high costs.
Not as much as they could though - there are still federal caps on the number of fellowship seats available as well as pretty strong restrictions for physicians coming from overseas (although if I recall correctly, California has less stringent restrictions than most)
We discuss insurance as a big part of the cost problem, but regulatory capture on the supply end is another huge (and unnecessary) factor.
You don't need full MDs for respiratory therapy, or for many medical treatments. PAs and RNs can do a lot, and it's far easier and less expensive to attain those certifications than full MD.
Doctors wouldn't let either of those things happen because it would lower their salary. The AMA is a powerful lobbying association, no way any law that lowers doctor salary would pass.
Lobbying power can be confronted by other considerable lobbying interests. Large healthcare conglomerates would seem to have considerable interest in reducing labor costs.
A crisis like this would be the perfect opportunity to fix some of these supply side issues. Lobbying is less effective when voters are paying attention and the government is in crisis-response mode.
There are two extra years of classes for med students, at which point they begin doing rotations through all the different specialties. During rotations, they are essentially “reserved for paperwork and unskilled labor which is also checked.”
This process continues in intern year and residency, during which time they gradually build competency and trust.
Much of medicine in the US is delivered by nurses, who have a training regime even more similar to what you suggest.
Categorically false for modern medical school. My daughter started rotations almost immediately, alternating with classes every couple of months throughout. She rarely did 'paperwork' (computers), had close patient contact immediately and was doing procedures almost from the start, under close supervision. Her final rotations had her in the operating room, handling her own patients from triage to discharge, doing night shifts etc along with a resident.
Things have changed rapidly in medical education. At least some places.
It is not my experience that keyboards are part of their garden wall. I have used bluetooth keyboards with my iPads going back to the first generation of iPad Mini.
What their keyboards do offer is tighter integration. That’s not a wall, it’s more like growing enticing apples in the orchard within the garden.
Not much different than the situation with upgrades for my Volvo. The Volvo stuff is tightly integrated. OEM stuff sometimes involves compromises, like plugging things into the port and fiddling with bluetooth.
I'm not sure what you're getting at here, bluetooth & USB keyboards all work fine. I've used aftermarket keyboards exclusively for the past... 6 or so years on the iPad.
To follow up, yes, it does. But because iPadOS doesn’t support all the swipe gestures on my first generation Magic Trackpad that my Mac does—notably scrolling—I’m disconnecting it. If I’m going to have to touch the screen to scroll, why have the cursor?
It's a useless industry, it's a disposable luxury. I feel for the workers, but as a whole, less disposable luxuries sounds good for fiscal responsibility and productivity.
That's unnecessarily harsh, but I do agree we might want to consider developing an economy less based on such types of consumer spending. If a particularly bad flu can take us out like these, we are very fragile indeed.
My job was ending due to bad sales, my next job is on hold until people return to work.
Our daycare said they are charging us money but we can't come (they said this week only... But this is after we complained).
The only business but really affected? My wife's company who treats people 1 on 1. But who knows even that might be slowed down from paranoid customers.
It’s the anti-lockdown people that are anti-math. Any reasonable person can see that the lethality of the virus is much worse when the healthcare system is saturated. If you accept this, then the only solution is to reduce the transmission rate to reduce saturation of the healthcare system, i.e. “flatten the curve”.
I think the point of the UK strategy is doing such a thing early doesn't help much: if you bring in such measures while the number of cases is small, you'll delay the peak but it won't reduce it much unless you can sustain it all the way through, and by increasing the time you're trying to sustain it you run the risk it won't be sustainable.
That's dubious, and why many people have been calling on the UK to expose their analysis to peer review.
Since early contagion is an exponential process the rate of growth (and all higher derivatives) also grows exponentially along with the number of infected. As a result, "as early as possible" also ends up being the correct time to maximally spread out the peak with the least intrusive countermeasures.
In order to conclude that delaying mitigations will do a better job of reducing the peak they must be making some highly novel assumptions. ... or just not actually reasoning about it formally at all and instead depending on intuition which is often not particularly accurate for exponential processes.
> If you accept this, then the only solution is to reduce the transmission rate to reduce saturation of the healthcare system, i.e. “flatten the curve”.
But for how long can you keep people holed up in their homes? This is a tradeoff that the government (whatever it is, in whatever country), must be prepared to face (even if it just means extending lockdowns).
Also, once the curve is flattened, will you allow people to leave their homes, and if so, what if another outbreak occurs? Will you lock people periodically every year until treatments are available?
(meant with no rhetoric: a question that I keep asking myself) Will this be sustainable in the long run?
This graph explains what it is they're going for. Basically, they're trying to keep the health system below saturation, but busy, in the hope of chugging through the "inevitable" number of cases at a sustainable rate.
Of course, that requires them to be able to "apply the brake" appropriately to keep things from becoming saturated. Which is why I thing the best word to describe the attitude of the UK government is "ballsy".
EDIT: Link to the original Lancet article the figure is from
If we didn't pay taxes we wouldn't have schools, roads, or the internet, and maybe even your mortgage (along with countless other things). So imagine where you life would be without it.
That strategy only works because other people are paying taxes and mortgages.
I'm actually a big fan of a Stateless, decentralized society. But you can't reach that place just by Galting your way there. You need at least a modern city to go with you.
You know, it's easy to dunk on these folks. Especially since the American Libertarian party has allowed itself to be infested with a lot of silly and even racist people. But globally this crisis does show that the "decentralize and democratize" sides of the political compass have a point.
In the US, central authority substantially impeded pandemic response. Both out of apathy (substantially defunding and deprioritizing support in 2018) and selfishly, with key CDC officials acting on behalf of the executive to suppress key information and decline assistant from other countries (and the WHO) who have better testing infrastructure.
We only discovered the Seattle COVID-19 outbreak because a (heroic, imo) doctor decided to destroy red tape that was blocking her from doing important work [0]. The US has been refusing to evaluate South Korea's current treatment method [1] which is clearly saving lives.
More in my camp, the notion of enforcing borders is hurting us more than protecting us in a lot of cases. E.g., border control chokepoints in airports are creating infection hotzones that are going to do much more harm than good. Great job loading everyone with a nascent infection and then sending them out into society with no possibility of tracing where they got it, customs! Way to do exactly the opposite of whatyou wanted to do! [2]
Even more ridiculous is how currently US IP law, a longtime foil, is being used to hold up giving Chinese citizens access to potentially very effective antiviral drugs because Gliead is afraid China will undercut them. [3] Sure the world is on the brink of a global economic collapse and in the worst case a few percentage points of the global population could die and the majority of people living could see their lifespans shortened due to complicatons, but yeah let's worry about that quarterly stock price and IP law.
Libertarianism in America is rife with contradictions and racist buffoons, but right now I think there is a lot of positive things to be said about decentrialized and anti-authoritarian societies. It's certainly hard to imagine them doing worse than our current government.
Was it the constant commercials that sold you? The fruit logo?