Coronavirus in Massachusetts (Boston, Cambridge, Reading: reservation, students, surgery)

[massnative71]

Originally Posted by Arya Stark

It is likely way more people have coronavirus than know it and masks and social distancing is simply not effective.

By what data or research, have you drawn that conclusion?

[GeoffD]

I haven't seen any better data on ventilators. The Brits are saying that 2/3 of the people who end up on a ventilator die. In Italy, it's worse than that. A ventilator isn't a magic bullet that cures people.

[tamajane]

Originally Posted by id77

Are all young people drug users or something? What if it's 20 year old medical student Millie?

At some point, hard decisions are going to need to be made about who gets what in what order, and those decisions need to completely remove the family/emotion element as those are too subjective. What would be your justification for keeping your 60 year old family member alive other than that specific person means more to you than some stranger?

Someone being YOUR loved one is just not good enough reason in times like this, especially given there's going to be tens of thousands of other people just like you who think their 60 year old family member is more important than your 60 year old family member.

You misunderstand. I am speaking for anyone's sixty year old family member.

Why not even bring it down to fifty?

A lot of younger people today are obese and at risk for many health problems. Maybe that counts or does it.

My question for those who approve of this type of rationing is if this virus killed mostly young people, even children, would we be keeping them off of vents and giving them to older people who would be more likely to survive? And explaining it away as, just a tough choice?

[timberline742]

Originally Posted by GeoffD

I haven't seen any better data on ventilators. The Brits are saying that 2/3 of the people who end up on a ventilator die. In Italy, it's worse than that. A ventilator isn't a magic bullet that cures people.

No one said it did. The question isn't what percentage of people put on ventilators survive.


The question is, what percentage of people that doctors want to ventilate, but can't, survive without the ventilators.


It is highly likely that the odds of survival are better with the ventilators, though it will be some time before we know that.

[timberline742]

Originally Posted by tamajane

You misunderstand. I am speaking for anyone's sixty year old family member.

Why not even bring it down to fifty?

A lot of younger people today are obese and at risk for many health problems. Maybe that counts or does it.

My question for those who approve of this type of rationing is if this virus killed mostly young people, even children, would we be keeping them off of vents and giving them to older people who would be more likely to survive? And explaining it away as, just a tough choice?

Yes, and that is why there is the field of medical ethics. And very old field, as these questions have been with us for ages. Who gets treated first of the wounded that come in from the battlefield? Those with the best chance of surviving? Those worst injured? A balance... and where is that balance? It's a fascinating field, and I don't envy the professionals that have to make those choices... but they need to be made, and they need to be made before the crisis hits.

[jayrandom]

Originally Posted by tamajane

Yeah, no.

They pull my 60 year old family member off a vent to give it to 20 year old meth head Millie, there's going to be a real problem.

Yeah, there's going to be a problem. There's going to be a host of problems if we have to start rationing ventilators. I doubt your 60 year old family member is going to get pulled for an actual meth head, though. More likely it'll be a 30 year old mother of two young toddlers. Or a 35 year old firefighter who is the father of 3. Or a 40 year old nurse. Or a 25 year old grocery clerk.

Look, none of us want those close to us to die. Most of don't want anyone to die. If I had the choice, I'd probably prefer my parents live while some stranger in their 30s doesn't. That's probably why a) I don't get to choose and b) why they make guidelines.

In the abstract, a generic 60 year old should be further back in line than a generic 20 year old. If there are medical reasons to switch the order, fine. Doctors should try to do their best with the resources they have. (I could see medical reasons as one of the things that might keep an actual meth head at the back of the line).

Once you start trying to evaluate non-medical reasons why someone should live and someone should die, you enter a debate that will likely never see an end. I'm sure that 20 year old meth head has been through some tough stuff in their life. I'm sure that a 60 year old has done some stuff they aren't proud of. There isn't time to sift through everyone's life and determine their overall worth and there will never be agreed upon criteria.

[BostonMike7]

Model for Massachusetts has once again been revised lower.

https://covid19.healthdata.org/unite.../massachusetts

April 20th is the forecasted peak.

[sawyer2]

I don't understand the confusion here. Prioritizing/triaging/allocating medical care in a disaster situation where you have limited medical resources is nothing new.

Your likelihood to survive, co-morbidities, long-term survival prognosis, known medical professional are typical scoring factors but these are all terrible inexact decisions.

This is why we are all doing our part to self-isolate to try and avoid this situation. Lets hope it doesn't come to this.

[porterhouse]

Median trend line of model projects all beds to exceed capacity tomorrow (4/10) (not remotely close to happening), ICU beds to have exceeded capacity a week ago and exceed even best case lower limit area of "certainty" by today (again thankfully not the case).

Hopefully it is correct about MA deaths trending lower, but it's hard to take the models seriously for anything other some directional information at this point.

[id77]

Originally Posted by 2sleepy

And who do you think should decide who is a 'bad hombre' and who isn't?

The "bad hombres" will be what one person perceives as someone wholly undeserving of a ventilator or other scarce resource that will get one because there won't be checks done that satisfy that person's concerns.

And really, there is no level of screening that ever will satisfy everyone. There'll always be someone who felt they or someone they knew got unfairly shafted.

My guess, based on the proposed prioritizations, is that the focus is on people who, should they survive, pose the highest chance of continued contribution to general society, including biological opportunity cost. Very few 60+ year olds will be procreating anymore, and many won't be working much longer. Saving the life of a 25 or 35 year old person isn't just a matter of survivability of that individual, but also of that individual to produce other individuals in the future and/or be a working member of society for decades to come.