Coronavirus in Massachusetts (Boston, Cambridge: studio, frequency, maternity)

[id77]

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?

In your new scenario above, I think the priority would still be towards the younger people, for the reasons mentioned in my just-posted response to another question. There may be some medical reasons to exclude certain individuals, but I would think the overarching goal, regardless of type of virus, would remain preservation of individuals who are most likely to produce long-term benefits to society.

[2sleepy]

Originally Posted by id77

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.

Absolute nonsense, no one is in a position to look at someone in a hospital bed and make a subjective decision as to whether a person is 'worthy' which to you seems to mean that they will "produce other individuals in the future" or "be a working member of society for decades" If a very elderly person with cancer or serious chronic disease isn't improving while on a ventilator at some point it might be appropriate to take them off the vent and keep them comfortable, but that's as far as that should ever go.

[timberline742]

Originally Posted by 2sleepy

Absolute nonsense, no one is in a position to look at someone in a hospital bed and make a subjective decision as to whether a person is 'worthy' which to you seems to mean that they will "produce other individuals in the future" or "be a working member of society for decades" If a very elderly person with cancer or serious chronic disease isn't improving while on a ventilator at some point it might be appropriate to take them off the vent and keep them comfortable, but that's as far as that should ever go.

In an ideal world the decision should never have to be made. But it would be dereliction of duty for the medical community not to formulate a plan of action if it is ever needed. We can do both as a society. Work to make the resources available to there is a reduced chance of ever putting medical professions in such a horrible situation AND still having a plan if they are ever in such a situation.

[BostonMike7]

Originally Posted by porterhouse

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.

Agreed.

I haven't heard much about hospitals in MA being overwhelmed. My father-in-law was recently rescheduled for an elective surgery in the next week or two at one of the bigger hospitals in the region. I can't speak to any authority as to if this is actually the case over a wider region. It certainly doesn't appear to be as doom-and-gloom as I thought it would be though.

I'm not going to say everything was overblown. Just the opposite. I think the fact that things are not "as bad" is due in part of the restrictions we are currently under. Time will tell, and i'm sure when this is all over people will beat it up for years to come on whether or not the response was warranted.

The one thing I am looking at closely in the model is the April 20th peak. If that is the peak (and if it doesn't get pushed out more), then it suggests a return to normalcy may not occur to late May or possibly June. If MA's non-essential advisory started around Mar 24th, and it took a month to hit peak, than it may take an equivalent amount of time for cases to fall to a level to begin considering reopening services. School might be done for the year, and we might be looking at a soft-opening in the June timeframe. All my speculation of course.

I'm likely unplugging for the weekend. Tomorrow is a company holiday so I figure i'll use the 3 day weekend to push back from the internet/news and just focus on family life for the weekend. Have a good weekend everyone

[lrfox]

Originally Posted by BostonMike7

I'm likely unplugging for the weekend. Tomorrow is a company holiday so I figure i'll use the 3 day weekend to push back from the internet/news and just focus on family life for the weekend. Have a good weekend everyone

Sounds like a good plan, enjoy!

[id77]

Originally Posted by 2sleepy

Absolute nonsense, no one is in a position to look at someone in a hospital bed and make a subjective decision as to whether a person is 'worthy' which to you seems to mean that they will "produce other individuals in the future" or "be a working member of society for decades" If a very elderly person with cancer or serious chronic disease isn't improving while on a ventilator at some point it might be appropriate to take them off the vent and keep them comfortable, but that's as far as that should ever go.

In addition to what timberline said, I still think you're making the question too individual and personal. Even if there was a way to assess every single person individually for whether or not they're worth saving (there isn't), in the crisis at hand there simply isn't enough time for a doctor to sit down and run someone through a database to find out if that individual is "worthy" of keeping on a ventilator.

As such, the best we can do in such a situation is to make generalized decisions based on previously assigned criteria that has the statistically best chance of a net positive outcome, which is what was proposed. It's nothing personal against old people or fat people or any other people who didn't get picked.

I don't understand why this seems like such nonsense to you. As sawyer pointed out, this is nothing new.

[charolastra00]

Originally Posted by 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.

Does the model take into account surge capacity built out in the hospitals? I honestly don't know. I wonder if it also takes into account that less people are taking up beds for things like car accidents or workplace injuries.



Hospital space is also fairly uneven. BMC's ICU was at capacity one night last week before dropping back down again. Not horrible, but again, we're 2 weeks away from peak.

[Shrewsburried]

Originally Posted by BostonMike7

I'm not sure it's coming down to a literal background check between two people where the doctors sit around and say "60-year old surgeon with a heart defect who is a leading specialist in infant brain surgery, vs 24 year old struggling college student who's been in and out of rehab...who do we want to live?" I think it's strictly along the lines of likelihood of survival and full recovery. Some of the statements I am reading on this (in other threads, not here) are borderline hysterical and unrealistic in terms of the implications of this policy.


But then again....i'm not on the front lines making these calls so I am certainly not in a position to assume what is going on

I have some insight, though non-direct, into triage and it is what you outline.

Priority goes to patients with best outcome. In many cases that means younger patients as they generally have fewer predispositions, but that also might mean a healthy 62 year old gets priority over a severely obese and diabetic 38 year old. In critical situations, hospital staff gets priority as their survival ensures the survival of future patients.

[porterhouse]

Originally Posted by BostonMike7

School might be done for the year

Seems like they are gearing up to head in that direction. Most districts are actively beefing up their distance learning plans; some school districts have already pushed back to late May; the field house at Cambridge Rindge & Latin is being used as a temporary homeless shelter, including an isolation area for COVID-19 positive guests. Reading those tea leaves, it seems like in person schooling for the 2019-2020 year is likely done.

Exactly why that decision needs to be made is at THIS point, I'm not sure. It certainly may become necessary, but throwing away the rest of the year should not be taken lightly. If for nothing other than psychological reasons, it would be a huge boost for students and their communities to go back in June if it is safe to do so. I feel horribly for graduating seniors who may not have a proper graduation.

To think that Gen Xers and Boomers like(d) to tell the war stories from when they were snowed in for nearly a week by the Blizzard of 78. It will be fascinating to see how this generation of children is shaped by this pandemic. I am hopeful this is going to be the most resilient group since the Greatest Generation. Even my 95 year old neighbor told me from her window that nothing she has lived through compares to this, and she was a Rosie the Riveter during WW2 and Manhattan resident on 9/11.

Originally Posted by charolastra00

Does the model take into account surge capacity built out in the hospitals?

I highly doubt it.

[Amontillado]

Massachusetts coronavirus numbers: 503 deaths and 18,941 cases.