
Man diagnosed with coronavirus near Seattle is being treated largely by a robot - denzil_correa
https://edition.cnn.com/2020/01/23/health/us-wuhan-coronavirus-doctor-interview/index.html
======
nimbius
Whenever I see these outbreak stories (sars, mers, etc..) and it affects a US
citizen, I always wonder who actually pays for this level of intensive care.

Ambulance trips in the states are routinely $3,000. my trip to the ER after a
wreck was $3800. If you dont have insurance, how do you pay for an "isopod"
and a quarantine with a medical robot? What reasonable insurance company would
ever cover these expenses? (mine hardly covers birth control.)

Healthcare is private here. When i go to the hospital they ask if "i am a
member." Do these treatments take place at in-network facilities? is there
such a thing as an in-network facility for being quarantined with an incurable
new disease? Can I be compelled to pay for health services in this case if i
DO NOT want them?

Its at least reassuring to see CNN is dancing around the HIPAA implicationf of
misidentifying or identifying the patient...although I wonder if its only
because they recently emerged from a slander/libel lawsuit for painting a
highschool kid from kentucky as a racist during a rally.

~~~
mdorazio
> who actually pays for this level of intensive care

If you have decent insurance, you pay your maximum out of pocket and insurance
pays the rest (at negotiated rates).

If you don't have decent insurance, you declare bankruptcy and the hospital
ends up paying for all except the few dollars they are able to get out of you.
This is pretty much the same situation as when homeless people show up at an
ER, which is legally obligated to help them regardless of ability to pay.

~~~
duxup
I think it is VERY hard to tell what is "decent insurance" anymore.

It might say that your hospital stay is covered on paper ... but then at the
hospital the robot (or another doctor) might not be billed through the
hospital and some outside group that is suddenly out of network.... there's no
way to know.

~~~
colechristensen
The ACA mandates the maximum [maximum out-of-pocket] that an insurance plan
can require. There's no such thing as good or bad insurance when it comes to
extreme medical events. "Good" or "bad" depends on how much of your premium
your employer covers and how expensive it is when you only use a little bit of
medical services.

The worst-case max out of pocket for any insurance plan in 2020 is:

$8,150 for self-only coverage

$16,300 for family coverage

In America, it is important to have liquid savings to handle life events like
losing a job or a serious health issue. We get taxed less, have fewer safety
nets, so we need to build our own safety net. You can argue that one way is
better than another way as a big picture, but many people misconstrue the
individualist vs. collectivist societies as a serious moral issue instead of a
choice. Some of the _details_ of each can be serious moral issues, but the big
picture is simply a difference in priorities.

Bottom line: If you can come up with $16k/year to cover medical expenses for a
serious issue, you won't go bankrupt.

~~~
kayodelycaon
> If you can come up with $16k/year to cover medical expenses for a serious
> issue, you won't go bankrupt.

The US median income is $63k... $16k would be 25% of that.

~~~
lwhalen
Indeed, and do you know what kills you faster and more reliably than lack of
free/subsidized medical care?

Lack of food (9 days), and lack of potable water (72 hours). Since we seem to
be leaning towards the opinion that the gov't needs to provide everything for
us and we should have minimal/no responsiblity for our own sustenance, repair,
or longevity, where's the Free Sh*t Army slogans for no-cost food and water?

~~~
lexs
That's a rather polemic way of talking about this topic. No one but a strawman
actually talks about "free shit" or "no-cost", it is about social distribution
of burdens for these extreme cases. Paying a reasonable price for drinkable
water through i.e municipal water companies seems to fit your "responsibility"
requirement. Paying 25% or more of your _yearly_ income for a medical bill
because you had bad luck...not so reasonable in my opinion and has nothing
much to do with "responsibility". And let's not pretend it is about no costs
or free things, everyone is paying for it through taxes according to their
means. Are you seriously suggesting to let someone on disabilities or social
security starve to death cause those are essentially your "no-cost food and
water" slogans. This notion of "having the government provide" shows the
twisted view on government, it's not a separate entity the money comes from
society, society is providing, is that such a bad thing for a society?

~~~
lwhalen
Food-stamp recipients and folks on social security are completely different
classes of citizen. Firstly, we expect the food-stamp recipient to eventually
get off of them and start providing for themselves. The social security
recipient has paid into the system their entire life, and they are now
entitled - by virtue of having lived long enough and paid enough in - to start
withdrawing the money they've been coerced into depositing.

Interestingly enough, most economic studies of social security show that
putting the same money into a low-risk index fund would've netted more gains,
plus that money would've been available to the person with far fewer 'strings
attached' (vis a vis able to be withdrawn earlier if desired,
descendants/spouses able to withdraw in case of untimely demise, etc). Coerced
gov't meddling, again, has proven to be the more-painful economic road to go
down, as opposed to letting individuals choose what to do with what they've
earned.

~~~
jacobwilliamroy
>food stamp receipients

>folks on social security

I notice that you call some people "folks" while others are simply
"receipients". Do you think poor people are human?

~~~
lwhalen
Certainly. But humans are supposed to be responsible for their own outcome,
more often than not. America is the land of opportunity. Many people who are
otherwise more than able to work, choose to Trustifarian it up and be a pimple
on the backside of society when they COULD choose to be productive members. I
am perfectly happy to pay taxes and lend a hand up. It's when I'm obligated to
give a hand-out that I get cranky.

~~~
jacobwilliamroy
So you don't actually know of anyone who is abusing the system in the way that
you claim? You're... just making stuff up?

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llamataboot
Can someone explain why /this/ level of isolation is necessary?

I understand that comparison of mortality rates is difficult, so this does
seem "more deadly" than the flu, but likely we have no idea of the actual
number of people with it, both for reporting reasons and because many people
may just have minor symptoms.

But, if we use SARS as a comparison which also had this level of pandemic
fear+isolation (and was way way worse handled in China at the beginning) I
think final stats were like 1000 deaths worldwide. Compare that to what, over
2k deaths in just the US every year from the flu?

I'm not saying we shouldn't be concerned (it is new and unknown, and seems to
have a higher mortality rate than other viruses) but it seems this level of
treatment (and entire city-wide lockdowns in China right now) is like Ebola
level precautions for what seems like a difficult but fairly standard level
respiratory virus?

Honestly curious here from medical professionals/epidemiologists..

~~~
Voloskaya
You said it:

> It is new and unknown

Better be safe than sorry. Can you imagine what we sould say if the virus
ended up spreading and killing a fair amount of people just because we
couldn't be bothered taking a few precautions?

The reasoning is simply that there is no good reason not to do it.

~~~
llamataboot
Sure, but we know the flu is deadly and relatively communicable and we
certainly don't take this level of precaution.

I'm suggesting that there is a spectrum between "taking some cold meds and
still going to work" and "locking down entire cities and treating people with
robots" and that many considerations go into where we decide collectively (and
individually) to be on that spectrum.

I'm not arguing this isn't dangerous, that there isn't unpredictability or
anxiey about something new, or even that the precautions aren't necessary, I'm
just curious as to why this particular coronavirus has landed on the far right
side of the serverity-of-precautions scale.

\--

(I mean there's also "no good reason" not to make sure the entire world has
access to clean drinking water and antibiotics and those things kills a fair
amount of people...)

~~~
Voloskaya
> Sure, but we know the flu is deadly and relatively communicable and we
> certainly don't take this level of precaution.

We know exactly how deadly the flu is (i.e. not very), how to prevent and
treat it and we can accurately predict how it will spread.

The coronavirus is a zoonotic disease, a virus that jumped from animal to
human this doesn't happen every other day. Most of these diseases are very
deadly, much more than your regular flu. We also don't know much about it or
how to prevent/treat it.

So again the reason why we take a lot of precautions is that a lot is unknown
about this virus and its effects.

------
ssully
Slightly related and not worth it's own post, but someone in Chicago has been
diagnosed with the coronavirus, making them the second person in the US with
it.

[https://www.chicagotribune.com/news/breaking/ct-
coronavirus-...](https://www.chicagotribune.com/news/breaking/ct-coronavirus-
china-epidemic-illinois-case-20200124-yx2xd3yeovar3o25ei6bfvvbze-story.html)

~~~
Cynddl
Sadly not available in Europe. Three years after GDPR and these big news
outlets still haven't figure how to provide content without invasive privacy
breaches.

> Unfortunately, our website is currently unavailable in most European
> countries. We are engaged on the issue and committed to looking at options
> that support our full range of digital offerings to the EU market. We
> continue to identify technical compliance solutions that will provide all
> readers with our award-winning journalism.

~~~
koheripbal
Our company website is the same. We just decided it wasn't worth it to cater
to EU users, so we geo-blocked the whole continent.

~~~
Cenk
Instead of turning off the whole site for EU users, why not just turn off the
tracking for them?

~~~
toast0
Turning off a site for EU is pretty easy: setup a geo IP lookup and return a
sad page; minimal testing and you're unlikely to break it.

Turning off trackers is harder, you do the same geo IP, but then you have to
find all the places you put trackers, and disable them, and test the site
without them, and somehow make sure when the next tracker is inserted, it
doesn't go to EU. If your code is well managed, it might be easy, but if
you're a newspaper, who knows. They may have several different generations of
template systems, with older articles staying on what they were published
with, or older articles may be static html with embedded trackers.

------
yellow_lead
I would like to take this moment to say that the virus is very serious and any
people thinking of traveling to China in the next few months should strongly
reconsider. Death counts and infected counts coming out of China seem to not
be very accurate, as they don't match other organization's models.

------
ceejayoz
They've had these telepresence robots for a while. Good for this scenario -
reducing contact with an infectious patient - and super useful for rural
clinics that might not be able to staff an in-person full-time doc.

~~~
Merrill
It doesn't look like a robot in the sense that it cannot move or manipulate
anything. It looks more like a conventional nursing terminal station fitted
with a video camera for remotely viewing the patient. There doesn't even seem
to be an input device for the patient to use other than voice?

~~~
ceejayoz
Nursing terminals tend to have keyboards, and I'm not sure what input device
you'd expect a patient to use other than voice and camera - you don't touch an
in-person doctor, do you? If the back two wheels are motorized, it could
readily move itself around (and non-mobile robots are still robots; ask any
factory worker).

It looks fairly similar to this telepresence robot from Cisco:
[https://www.cisco.com/c/en/us/products/collateral/collaborat...](https://www.cisco.com/c/en/us/products/collateral/collaboration-
endpoints/telepresence-clinical-presence-system/data_sheet_c78-648400.html)

------
xattt
Finally, a work-from-home solution for Nursing!

------
squiggleblaz
The weird thing is that nursing staff move the robot around in the room. I
guess they get dressed up in suitable isolation suits?

~~~
soylentcola
I read it as nurses remotely moving the robot around from outside the room so
they didn't risk contact.

~~~
ghostpepper
That makes more sense. I was also confused by the wording in the article.

~~~
cfqycwz
I think it actually _is_ nurses physically moving the device around the
room—the photo looks like it's just on casters, not motorized wheels.

------
java-man
Who is going to clean the robot??

~~~
ceejayoz
One of these UV disinfectant robots: [http://www.uvd-
robots.com/](http://www.uvd-robots.com/)

~~~
giarc
The robot (self driving) part of it is just unnecessary. Why complicate things
when there are staff in the hospital (porters) whose sole job is to move
patients and equipment around the hospital. I say this as an infection control
professional who works in a hospital and has experience with this type of
technology.

~~~
ceejayoz
There are a lot of nooks and crannies in a hospital room. Requiring humans to
move it around would mean they have to put it in a spot, leave the room, flash
the lights, and then reposition and do it all over again, repeatedly.

