As for adding staff, now is also the time to be thinking about how to ramp that up.
Where are you getting this "hundreds of thousands more people infected than you have ventilators" idea? We've already had a couple months of the virus spreading at this point, maybe it's time to start making more realistic estimates?
The US already is at over 5k, every state has infected people, and there is no proper lockdown to speak of in any state, only "strong recommendations". Assuming the same growth rate, the US will be at 440k infected in 24 days, but sadly without the reduced infection rate after April 12.
West Virginia does not have any confirmed cases.
> 2.2 million people in the United States could die.
> The latest study available estimates there are about 62,000 ventilators in hospitals nationwide.
China had about the same number of infections 3 weeks ago as it does today, for example. And their most extreme lockdown measures are waning.
We'll see what happens in a few months, but it looks like a lack of information causing people to assume the worst.
Stop profiteering off a misery, if you've been hawking over priced toilet paper you're exploiting people in their time of need.
> We'll see what happens in a few months, but it looks like a lack of information causing people to assume the worst.
Assume and prepare for the worst - the US government has had a critical shortage of test kits and it's nigh on impossible that the case numbers we've seen are accurate. Trump has previously specifically and openly acted to keep the numbers artificially low along with generally showing a large amount of concern over the appearance of things to the detriment of dealing with the actual crisis.
The actual numbers are worse than they look right now - everyone outside of the US trusts the US's numbers as much as we trusted China's numbers, the government (though this time almost certainly through incompetence rather than maliciousness) is not a trusted reporter of real data.
Also, stop profiting off of misery.
1. Specifically "[...] would like to have the people come off. I’d rather have the people stay, but I’d go with them. I told them to make the final decision. I would rather—because I like the numbers being where they are. I don’t need to have the numbers double because of one ship that wasn’t our fault." https://www.motherjones.com/kevin-drum/2020/03/trump-keep-em...
What are you talking about, "profiting off misery"? I'm profiting off of predictable herd behavior, and putting my money where my mouth is.
Are you? Better start selling stocks if you really believe what you're saying, right?
Nature doesn't do exponential curves; they're inherently unsustainable. It does logarithmic ones, which look exponential when you extrapolate from the right point on the graph.
Two weeks ago I was constantly being told to just wait a couple of weeks, and I would see overflowing ICUs in the United States.
But here we are, and the only places that are overflowing in the States (and most other nations) are the newsrooms.
If we do the same in the U.S. then it'll be valid to expect similar results.
It's certainly true that the virus will peak and decline naturally, but it does that because most of the population has been infected so it can't find fresh hosts. With 0.7% mortality that translates to over a million dead in the U.S.
We're far behind on mitigation, and we should expect a much larger spike in cases.
Where are you getting the idea that we should trust any data coming out of China?
South Korea, Italy? Sure.
Decades of easy living in the US has made the average native dangerously naive.
China is most likely going through a second wave of the infection either now or soon, as people return to work out of necessity to prevent supply shortages and food insecurity. Notice how they've totally locked everything down online - the internet was awash with leaked videos and tweets from people inside of china - but the government has clamped down on these dissenters hard enough to discourage the rest, apparently.
The CCP lies to save face. Its existence is predicated upon the fear and/or respect of the people it controls. It is not a free society.
Much of Silicon Valley (and the coastal elite, in general) is in the pocket of the CCP. Is normal.
People will literally refer to Trump as a tyrant or "Hitler", but refuse to speak ill of Chinese leadership. It's crazy.
I can't find the % value but the stake that tencent owns in Reddit is a little concerning. That's a lot of propaganda potential.
And I like the idea to be ready for the next crisis, which will eventually come. In California, we have earthquake proof buildings, it would be sensible to have pandemic proof medical equipment.
I mean, don’t get me wrong, everything you can do is going to be another life saved – it’s just that that is because everything we can do is still not going to be enough to save everyone.
Forget about start ups and tiny companies now. The government needs to call on the big players here - those mentioned in the quote above look like a good start. Not just for ventilators but for everything else like masks and gowns that will be needed. And field hospitals capable of handling massive numbers of people. Something will need to be done about training and deploying large numbers of medical staff quickly too.
In WW2 Roosevelt commandeered the car factories to build planes and tanks. It didn't hurt the car factories as far as I know - the government paid them in full. We sorely need a leader of that caliber at this time with the vision and capacity to make bold moves like that.
It'd be interesting to see how much of the actual production of Medtronic, GE Healthcare, Allied Healthcare, etc. takes place within the United States.
Roosevelt also commandeered Americans with Japanese ancestry to live in concentration camps.
These sorts of powers are dangerous, an I doubt and edict that extreme would be very effective, it's just this feeling of we have to do something. What the government needed to do two months ago was place very large orders with all the manufacturers and pay enough so they're being made 24/7. The ramp-up time for much more is probably too long, and the peak need will be April-June, hopefully less after that. I doubt you could retool and train a random factory fast enough for that.
Scaling production != building new lines/factories, just reprioritizing, for significant uptick in units shipped.
But you have to hope that those production lines aren't also providing mission critical goods.
Call on them to do what, stand behind the President in a press conference and give short speeches? They manufacture ventilators for hospitals, and it's the hospitals who pay for them.
If the problem is lack of ventilator production capacity, the "Tool up like WW2" proposal would be to take Vortran's designs and expertise making things like the go2vent , and get them made in Lego's factories.
And if to make that happen the government has to hand out a few solid gold cadillacs, medals or eminent domain orders then so be it.
(Obviously, Vortran and Lego are just examples; the point is in WW2, what the war effort wants the war effort gets)
> The WPB directed conversion of industries from peacetime work to war needs, allocated scarce materials, established priorities in the distribution of materials and services, and prohibited nonessential production. It rationed such commodities as gasoline, heating oil, metals, rubber, paper and plastics. It was dissolved shortly after the defeat of Japan in 1945, and was replaced by the Civilian Production Administration in late 1945.
> In 1942-45, WPB supervised the production of $183 billion worth of weapons and supplies, about 40% of the world output of munitions. Britain, the USSR and other allies produced an additional 30%, while the Axis produced only 30%. One fourth of the US output was warplanes; one fourth was warships. Meanwhile, the civilian standard of living was about level.
It was the WPB that coördinated all contracting and procurement through 12 regional offices and 120 field offices... At a time when the very basic tenets of information theory, and subsequent digital communications, had just begun to gestate in the heads of Claude Shannon.
Joseph Stalin said in 1943 at the Tehran Conference:
> Without American production the Allies could never have won the war.
Basically, it's been done before. You don't need to look far for inspiration: the historical record basically hands us a blueprint.
Of course they are going to stand behind your president and give short speeches... if literally everybody is just accepting that as a given without actually pushing back on the whole thing, holding people accountable now and demanding proper statesmanship.
I personally don’t see how filling up small companies orderbooks with a giant federal order makes sense when other countries like Italy and Germany have a real and active shortage today, while the US still has capacity. Ramping up production as we face a second wave is going to be happening regardless. There’s more than enough demand globally and from the various hospitals already. Adding more orders on top of it doesn’t exactly make things run more smoothly, there should be plenty of capital readily available for them to expand.
Supporting the hospitals/industry in their purchasing and production efforts and clearing red tape is something that could help now. Which I believe is what the giant stimulus and relief packages include already?
I guess people won’t be happy unless they buy it all up themselves first then donate it to the most needy, or hoard it more efficiently than others?
But, the federal government doesn't order ventilators. That's not how the US system works, we don't have an NHS like the UK.
But otherwise I’m agreeing with you that there are better ways than flooding orderbooks for federal stockpiles. Like subsidies, capitalization, and removing red tape for both hospitals and manufacturers.
The President also has emergency powers under the Stafford Act to (1) put government orders at the "head of the line" for any manufacturer, and (2) to pre-fund production of materials or products necessary to protect the public or national interest in an emergency.
They also built things like machine guns.
The problem now, is the car factories have so much automation. The lines are specifically built to build one thing, the robots are designed to do one thing. You can't run a tank down a Ford Focus paint line.
* Since the federal government has be slow to respond, I am beginning to wonder how much of our emergency supply chain is NOT located within the US. In a pandemic situation, every country is going to be looking after their population first. We may have lost the capacity.
* The expected death count is 1-2 million. Our country is full of people with preexisting conditions.
* Heart Disease: 22,000,000. Death rate due to Coronavirus: 10%
* Diabetes: 34,200,200. Death rate due to Coronavirus: 7.3%
* Chronic Respiratory Disorder: 16,000,000. Death rate due to Coronavirus: 6.3%
* High Blood Pressure: 108,000,000. Death rate due to Coronavirus: 6.0%
* Cancer: 1,735,000. Death rate due to Coronavirus: 5.6%
Granted, there is a lot of overlap, but even if we just use High Blood Prease, that's 6,000,000 deaths alone (multiplied by expected spread of virus e.g. 70%). This excludes death rates for all healthy people over 60.
All sources are from coronavirus related wikipedia articles and .gov sites dedicated to American health statistics.
> The ventilator industry is getting a burst of desperate orders from China and Italy.
Why don't the feds see the urgency here? Is it not predictable that the US will be in the same situation shortly?
If the feds won't take action, can state governments work around them and order directly?
I'm kind of in shock at how exposed we all are.
EDIT: via Pittsburgh Post-Gazette https://www.post-gazette.com/news/health/2020/03/14/covid-19...
At 20 patients a day (aiming for 100 by the end of the week) this isn't an industrial scale testing scheme, but given how slow we've been that's still a significant chunk of testing capacity and it would've been great for Pittsburgh to have access to it sooner.
“Respirators, ventilators, all of the equipment — try getting it yourselves,”
> “Respirators, ventilators, all of the equipment — try getting it yourselves,” Mr. Trump told the governors during the conference call, a recording of which was shared with The New York Times. “We will be backing you, but try getting it yourselves. Point of sales, much better, much more direct if you can get it yourself.”
Distributing these is the sort of thing the federal government can do far more effectively than an "every man for himself" approach.
Not making an opinion on its efficacy... although I guess every discussion of US needs giant political asterisks these days so it doesn’t get derailed.
You wind up with some people having two years worth, and others using the empty cardboard tube in desperation.
Government is our best chance for a good outcome in a real crisis.
No one wants to be the governor who gave supplies to another state when the next election comes up.
Because the United States is a collection of fifty sovereign states, not a centralized government. Why is the EU not taking EU-wide action here, and leaving responses up to constituent governments?
That's the 10th amendment. Pretty sure it says the exact opposite of what you just stated.
The _only_ powers the Federal Gov. has are those granted by the constitution. They cannot go claiming powers not specified therein.
That is in direct contradiction with this statement:
> powers the federal government has not claimed belong to the states
The Fed Gov. can't just claim supreme power. That's exactly what the 10th amendment is intended to address.
> However, federal statutes and treaties are supreme only if they do not contravene the Constitution.
That's the exact point I was trying to make
If the hospitals and other facilities need funding to help with that, that's something governments might be able to help with. But it's still the facilities themselves that should be forecasting an obvious future need and taking steps to meet it.
> If there is a risk of a surge in need, and if it takes three months to boost part deliveries, somebody ought to be placing orders right now. But a hospital might well hesitate, given the perhaps equal risk that the extra machines will never be used. Who would eat the cost? That explains why the German order came from the government.
This development (https://www.isinnova.it/easy-covid19-eng/) looks very promising for 'sub-intensive' cases -- adapting decathlon masks to provide positive air pressure (to help reinflate lungs) without intubation or leaking contaminated exhaust.
I don't know how many of these rapidly improvised ventilators can provide constant pressure, but if the closed mask method could be used successfully to prevent serious cases from progressing to ICU (or more importantly, keep people in their homes a little longer), it could have a huge impact.
This is not a given. Ventilators damage alveoli, which (I am not a doctor, so not 100% sure) I think is not recoverable. Thus increasing air flow with a basic ventilator might do more harm than good, so whether it is worthwhile depends on the patient.
That said, building good ventilators should be very easy as well with the modern industrial base.
I'm afraid you're sadly ignoring the power of willful ignorance.
Note: I think it's fair to say, SK is/was ready or has responded well, patient 31 notwithstanding.
I think the USA needs to work on the basics, but other nations will have so interesting advanced strategic decisions. i.e. Does ventilator design changes frequently? Does it make sense to have an on-demand factory or just build up a stockpile of ventilators that can be distributed as needed?
Be careful what you wish for: https://en.wikipedia.org/wiki/Hygiene_hypothesis
I encorange you to think what,would happen in a scenario where airborne ebola is burning through the world at the same time as most of our antibiotics start to fail due to resistance.
It's so horrendous to think about. I can't belive you think it's not worth preparing for. You reckon the USA should scrap its military until an invading force turns up on the west coast?
This looks completely different if, in 10 years, we can produce vaccines in months, not years.
Hopefully they've been able to rapidly shift production to meet the upcoming demand for respirators and other products this pandemic will need.
And I mean in terms of practical outcomes of home use.